A ganglion cyst is a fluid-filled swelling of the lining of a tendon or joint. Although ganglions can form on any part of the foot, they most often appear on the top of the foot and the front of the ankle joint. Ganglions tend to change in size and usually grow slowly.
There are many reasons a ganglion can form. Repeated irritation to the lining of tendons or joints can lead to ganglion cyst formation. Other possible causes include:
- Shoe gear that puts stress on joints or tendons such as high topped sneakers or boots
- Bone spurs (bony outgrowths) on the top of the foot
- Bone spurs that put pressure on tendons or joints when combined with certain shoe gear
Ganglions often form with no symptoms. Ganglions sometimes swell and their size can change with different activities or a change in weather. However, as the ganglion enlarges it can cause pressure on the overlying skin leading to pain with shoe wear. Additionally, if the ganglion puts pressure on surrounding nerves, this can cause tingling, numbness and pain.
How Are They Diagnosed?
Your Weil Foot & Ankle Institute Surgeon will start by discussing your symptoms and follow that with a thorough physical exam. Because ganglions are sometimes mistaken for tumors, it's important to have a complete examination. Many times, ganglion cysts can be diagnosed on the basis of their appearance when examining your foot. Sometimes, additional testing may be performed, particularly if there is any question about the diagnosis of the mass, its extent and if surgical excision is planned for the future.
Imaging and Additional Testing
X-rays are usually ordered to evaluate the bones around the ganglion cyst for possible extension into the bone. This will also help determine if there is a bone spur in the area that is causing the ganglion cyst.
Magnetic resonance imaging (MRI) may be done both to aid in diagnosis and aid in surgical planning. MRI can show your Weil Foot & Ankle Surgeon both the location and the extent of the ganglionic cyst. The Weil Foot & Ankle Institute has three extremity MRI's on site at our Des Plaines, Highland Park, and Lincoln Park locations. These extremity MRI's only take about 30 minutes for the study and only requires the patient put their foot into a painless machine avoiding the uncomfortable claustrophobia that some MRI devices create.
Needle aspiration of the cyst can be performed under local anesthetic and in the office. Removing the fluid in the cyst can help decrease pain and swelling and increase foot comfort. This will decrease the size of the ganglionic cyst. In addition, while the area is numb, the cyst can be injected with a medication that may help decrease the amount of fluid that accumulates in the area.
Ganglions are often difficult to treat without surgery; however, some non-surgical treatments exist to increase your foot comfort.
- Pads placed around the ganglion can ease pressure and friction.
- Applying Vaseline to the ganglion can also help with easing pressure, pain and friction.
- Fluid removal (with or without an injection) may also relieve symptoms, however, ganglions often re-occur when treated by this method.
- Limiting movements or activities that increase pain may bring relief.
- Icing the ganglion for 10-15 minutes may temporarily relieve inflammation and pain.
- If your inflammation is severe, your doctor may treat your symptoms with medication.
Surgical treatment is recommended when a ganglion cyst is causing ongoing or severe pain. If this is occurring, a physician from the Weil Foot & Ankle Institute may recommend surgery to remove the ganglion cyst. During the procedure, the ganglionic cyst is removed and the root of the cyst is treated so that the cyst has a lower chance of recurrence. If bone spurs or other bone problems are causing the ganglion cyst, these things will be addressed at the same time.
The post-operative course for this procedure varies based on any other procedures that are performed at the same time; however, most patients can expect a full, functional recovery.
For more information see one of the Doctors of the Weil Foot & Ankle Institute. Please call 847-390-7666 to schedule an appointment.