Ganglion Cyst

Definition

A ganglionic cyst is a noncancerous lump or bump that most commonly develops in the tendons or wrist or hand joint. This cyst is often oval in shape, usually containing a soft substance such as a gel. 

Complications

A cyst can promote the occurrence of carpal tunnel syndrome.
 
Treatments

If the cyst is not painful or does not affect movement, usually no treatment is offered, according to the Sonia Physiotherapy Clinic.

On the other hand, if the cyst is problematic, the doctor can use the following methods:
- Immobilization. Immobilizing the forearm can help decrease cyst growth. You can use a wrist brace.
- Needle puncture. A needle is used by the doctor to drain the liquid in the cyst. Sometimes the doctor injects an enzyme into the cyst to facilitate removal of the gel (cyst contents). In addition, after the puncture the doctor sometimes injects a steroid to limit its recurrence.
- Surgery. If the other methods do not work, the doctor may perform surgery to remove the rod that attaches the cyst to a joint or tendon. 

Good advice

- Avoid drilling a cyst with a needle yourself. In addition to being unlikely to be effective, there is a risk of infection.

- Avoid typing with a heavy object on the cyst, this alternative method has not proven and it can even aggravate the situation by destroying the structures around the cyst.


Treatment of a synovial cyst

A cyst that occurs for no particular reason should be monitored but not necessarily treated. After the push, it happens that the cyst stabilizes, evolves and then regress spontaneously after 6 months. "It is estimated that 30 to 40% of wrist cysts spontaneously fade after the first 4 months," recalls Dr. Sonia Chowdhury

If the pain and discomfort are not too important, it is better not to intervene and see how the cyst evolves over time. The doctor then simply recommends the wearing of a splint to put the wrist at rest.

A puncture is always possible but often discouraged for different reasons. There is a risk of infection and the solution is only partially satisfactory: "You empty the liquid but the pocket remains present," adds Dr. Sonia. For the same reasons, it is not recommended to crush the cyst: the pocket remains and the cysts then tend to recur, becoming larger.

In case of traumatic cyst, recurrence and particularly troublesome pains, an excision (removal of the cyst by surgical intervention) can then be considered. This is the most effective solution. Surgery is performed on an outpatient basis under local anesthesia. The surgeon removes the lesion and then has it analyzed.

The patient then keeps a bandage for a few days and keeps the joint immobilized for a fortnight. During the entire convalescence, it is advisable to avoid carrying heavy loads, gestures of strength and to protect the joint (especially for the toilet). In principle, the resumption of normal activities becomes possible after 4 to 5 weeks.

Whether regressing on their own or being treated by surgery, synovial cysts tend to recur in about 10% of cases. The recurrence is treated in the same way as the initial situation, ie local surgery in case of pain or severe discomfort. It is possible to consider a second surgery if the cyst is located in the same place.