Ganglion Cysts—Mysterious Lumps and Bumps

Our bodies take a lot of lumps and bumps over a lifetime—nicks, scrapes, bruises, and bangs from accidents, injuries, or just bad luck. Sometimes, though, lumps and bumps appear for no clear reason. One of the most common of these is the ganglion cyst, a soft-tissue mass filled with a jelly-like fluid that can appear on your skin—often the top of your foot, or right in front of your ankle.

Assessing the Risk Factors

Although the precise cause is not known, we do know that ganglion cysts are relatively more common in women than in men, and in young adult to middle-aged people more often than other age groups. It’s possible that an underlying flaw in a joint capsule or tendon is the major contributing factor, possibly triggered by repetitive stress or trauma.

Looking at Symptoms

The most obvious (and in many cases only) symptom of a ganglion cyst is the mass itself. The bump is usually soft to the touch and can vary in size. One to three centimeters (roughly half an inch to an inch and a half) is normal, but it may get larger or smaller over time depending on your activity.

The bump itself is usually not painful, but depending on its size and location it can cause pain elsewhere. If it’s pressing on a nerve, you may feel aching, burning, or tingling sensations, and if it’s in a weight-bearing area it can push up uncomfortably against other tissues. Furthermore, a large cyst may make it difficult to fit into your shoes comfortably and may result in uncomfortable friction between the bump and your footwear.

If you do develop a cyst, even if it’s not causing you discomfort or limiting your mobility, it’s still wise to get it evaluated by Dr. Danciger, in order to get a confirmed diagnosis, rule out other conditions with similar symptoms, and assess current and future risk.

Tackling Treatment

If the ganglion cyst is relatively small and not causing any pain or restricting daily activities, it may be best to simply wait and observe it for a while. The cyst itself is not dangerous unless it’s pressing on a nerve or artery, and it may even disappear on its own in time. However, there are forms of cancer that can mimic ganglion cysts, so identification is important. 

For cysts providing moderate problems, conservative treatments may be selected. A foot brace or splint, combined with plenty of rest, will often help the cyst to shrink in size. When you’re out and about, select a good pair of shoes with plenty of extra space (and perhaps a little extra padding) to prevent rubbing or irritation against the growth.

For a more aggressive approach, we may carefully drain the sac with a needle and follow it up with a steroid injection. In more serious cases where there is significant pain or limitation of mobility, we may choose to excise the cyst entirely via a surgical procedure. The surgical procedure features a lower risk of reoccurrence than draining (which may require a few sessions), but also poses more risks.

Never, under any circumstances, try to drain or treat a ganglion cyst yourself. This is a serious infection risk and may end up causing more damage.

Making the Call

Cysts may not seem like a big deal—and in many cases, they aren’t—but that doesn’t mean you should wait until it hurts to go get a diagnosis. Professional evaluation is the only way to be sure whether or not the mass is dangerous, and what kind of treatment (if any) is appropriate.

Dr. Harvey Danciger
Dr. Harvey Danciger is a podiatrist and foot surgeon in Palm Desert, CA specializing in the foot and ankle