A ganglion cyst is one of those bumps you sometimes see on people’s wrist. Also called a Bible cyst, it is a benign (non-cancerous) subcutaneous nodule or swelling that often appears around or on joints and tendons in the hands or feet. A ganglion manifests when the tissue surrounding these joints becomes inflamed and swells up with “jellylike” joint fluid. The fluid-filled ganglion sac is formed from the lining of the joint or tendon.
Moving parts have lubrication fluid — in a car, for instance, the engine has motor oil. In the body, joints and tendon sheaths (space around tendons) make synovial fluid — a thick lubrication fluid — that is supposed to stay in the joint or the tendon sheath.
A ganglion grows out of a joint or the lining of a tendon, looking like a tiny water balloon on a stalk, when the tissue surrounding that joint or tendon bulges out of place and there is a joint-fluid “leak” into it. The fluid inside the cyst is in fact a thicker version of the synovial fluid that ‘lubricates’ your joints and tendon sheaths.
It is generally caused due to some kind of trauma to the joint but the cause may not be evident in all cases. Ganglion formation is more common in women (M:F = 1:3) and 70% of them occur in the late teens and young adulthood.
Some joint diseases such as osteo or rheumatoid arthritis have also been associated with ganglion cysts.
Occupational factors play an important role in their development. In occupations that require overuse of certain joints such as the wrist and fingers causing their wear-and-tear, for instance, in writers, people engaged in typewriting, piano players, tennis and badminton players, etc. risk for developing ganglion cysts becomes multifold.
The main symptom is one of a lumpy swelling. The size of the cyst can fluctuate, often getting larger when you use that joint for repetitive movements. Larger ganglions can sometimes be unsightly. The ganglion lump can be characterized by:
- Location: Ganglion cysts most commonly develop along the tendons or joints of your wrists or hands (usually the backside). The next most common locations are the ankles and feet. These cysts can occur near other joints such as shoulders, elbows, and knees as well.
- Shape and size: Ganglion cysts are typically smooth and round or oval. Small ganglion cysts can be pea-sized, while larger ones can be plum-sized (around an inch in diameter). Some are so small that they can’t be felt. They might change size, growing larger or smaller as more fluid leaks-in or gets absorbed. They may manifest as a single cyst or have multiple lobes.
- Consistency: Depending on the size, cysts may feel firm or spongy. Some cysts can be quite hard and get mistaken for a bony prominence.
- Pain: Ganglion cysts usually are painless. But if a cyst presses on a nearby nerve — even if the cyst is too small to form a noticeable lump — it can cause pain, tingling, numbness or muscle weakness. This pain can restrict the range of joint movement and activity of an individual.
Ganglions never spread to other areas of the body.
During the physical exam, your doctor may apply pressure to the cyst to test for tenderness or discomfort. He or she may try to shine a light through the cyst to determine if it’s a solid mass or filled with fluid.
He or she might also recommend imaging tests — such as X-rays, ultrasound or magnetic resonance imaging (MRI) — to rule out other conditions, such as arthritis or a tumor. MRIs and ultrasounds also can locate hidden (occult) ganglion cysts.
A ganglion cyst diagnosis may be confirmed by aspiration, a process in which your doctor uses a needle and syringe to draw out (aspirate) the fluid in the cyst. Fluid from a ganglion cyst will be thick and clear/translucent.
Ganglion cyst care
Ganglion cysts are often painless, requiring no treatment. Your doctor may suggest a watch-and-wait approach. If the cyst is causing pain or interfering with joint movement or is unsightly, your doctor may recommend:
- Immobilization. If the cyst presses on a nerve, it might give tingling or numbness. In such a situation, it may help to temporarily immobilize the area with a brace or splint during certain activities to reduce pain. Avoid long-term use as it can cause the nearby muscles to weaken.
- Many over-the-counter pain relievers, such as ibuprofen can be used in addition. In some cases, modifying your shoes or how you lace them can relieve the pain associated with ganglion cysts on your ankles or feet.
- Massage techniques can also help drain fluid from the cyst.
- Aspiration. In this procedure, your doctor uses a needle to drain the fluid from the cyst aseptically. As the cyst shrinks, it may release the pressure on your nerves, relieving pain. Drawback — the cyst may recur.
- Surgery. This may be an option if other approaches haven’t worked. During this procedure, the doctor removes the cyst and the stalk that attaches it to the joint or tendon, through excision. Surgery can be performed through one larger incision or arthroscopically (via several small incisions). Healing is faster in Arthroscopy. Rarely, the surgery can injure the surrounding nerves, blood vessels or tendons. The cyst can recur, even after surgery.
A common home remedy to get rid of a ganglion cyst in older times consisted of “thumping” the cyst with a heavy object such as a thick book or Bible (thus the name – Bible cyst), to try and make the cyst rupture or pop!! If it worked, it would burst the cyst under the skin. The fluid would then be absorbed into the bloodstream. It did work for some lucky ones!!
This isn’t a good solution though because the force of the blow can damage surrounding structures in your hand or foot. There is always a chance of recurrence, as the wall of the cyst doesn’t get removed this way, and the fluid may form again to refill the ganglion.
Also, don’t try to “pop” the cyst yourself by puncturing it with a needle. This is unlikely to be effective and can lead to infection.
Homoeopathic treatment of Ganglion
Largely, a ganglion is labeled as a surgical condition, however, homoeopathy treats it as medico-surgical. Homoeopathy can boast about bringing a complete and painless recovery in many a case of ganglions. Although surgical excision cannot be ruled out as a remedy in a few, I myself have had success in more than 20 cases of ganglion in the last two decades. Below are the pictures of a case that was cured recently at my chamber.
Homoeopathy comes as a beneficial option as it offers a treatment that is gentle, safe and non-surgical, yet effective. The well-selected remedies help to reduce the pain and improve mobility while dissolving the growth at the same time, to get rid of the condition. A few of the remedies I’ve found curative are:
- Ammonium Carb
- Aurum Met
Surgeries done for ganglion are associated with rare complications such as nerve damage, joint stiffness and/or a recurrence.
Visit a Homoeopath near you for an expert pre-treatment analysis and a subsequent treatment of Ganglion before going for any invasive options.