Ganglion

What is a ganglion?

A ganglion is a hard gelatinous nodule formed around joints and tendons, filled with a thick, sticky, colorless, transparent, gelatinous substance. These cysts are not cancerous and in most cases are harmless. They occur in many locations, but most often develop in the wrist area, although they can also appear in other joints. Ganglions result from the production of excessive joint fluid inside the joint or in the sheath surrounding the tendons.

From the physiological side, the presence of fluid content in the joint cavity is desirable, as it prevents the bony and cartilaginous surfaces from rubbing against each other. However, its excess causes an increase in pressure, stretching of the capsule and, consequently, the formation of a cyst, and thus a nodule visible under the skin in the joint area. Such a gelatinous cyst cannot be drained, because the connective tissue lining the cavity can form a valve that allows only unilateral fluid flow.

A ganglion can appear and disappear quickly, and can change its size. Many cysts of this type do not require treatment. However, if a wrist ganglion hurts, affects function and significantly limits joint mobility, or if it looks bad from an aesthetic perspective, several treatment options are available. However, it is worth remembering proper prevention, as a condition already treated can recur.

What is a ganglion and how to get rid of it?

A gelatinous nodule (ganglion cyst) can form in the wrist, but also in other joints. Daily computer use and other activities that constantly engage the joint in work put strain on the wrist and can lead to the formation of a ganglion - an often painful and non-anesthetic nodule filled with smear.

Ways to treat a ganglion:

• hand massage
• relieving pressure on the limb
• puncture with aspiration of the contents and application of medication
• surgical removal

Invasive methods give immediate and most lasting results.

Where does a ganglion most commonly occur?

Ganglions can theoretically arise anywhere, especially in the area of a joint exposed to repeated trauma or overload (the area of the joint capsules). Most often they localize on the dorsal surface of the wrist, for example, as a result of intensive computer work (wrist ganglion). Nowadays, this joint is one of the most exposed to daily strains.

In physically active people, ganglions are also found around the knee joint and on the feet (foot ganglion), where they form after exposure to injury. They can cause pain, as well as mimic other ailments - carpal tunnel syndrome or Baker's cyst. The latter affliction can be suspected when the lesions are located in the popliteal region and cause pain in the knee joint.

The most common is:

• wrist ganglion (ganglion on the wrist),
• ganglion on the fingers of the hand,
• ganglion of the knee,
• ganglion on the elbow,
• ganglion on the foot.

Ganglion - causes of formation

Although the exact cause of ganglions is not fully understood, there are several theories and factors that may contribute to their development.

• Minor injuries or joint strain can lead to cyst formation. The injury can cause joint fluid to leak out, which accumulates and forms a ganglion.
• Some studies suggest that cysts can form as a result of abnormalities in the joint structure that allow joint fluid to leak out and accumulate in cysts.
• In older people, ganglions may be associated with osteoarthritis.
• Inflammation of the tendons around the joint can also be a factor in ganglion formation.
• There is a belief that genetic predisposition may play a role in the development of ganglions, although this requires further research.

It is worth mentioning that ganglions often appear for no obvious reason, and some people may be more prone to developing them than others. They are most common in young people between the ages of 20 and 40, and women are more prone to the condition than men.

Ganglion - symptoms

A ganglion is filled with gelatinous contents, hence its other name - gelatinous cyst. It can be both painless and cause discomfort and pain, which can be chronic and worsen during joint movement. Some degree of pain is possible, especially after acute or repeated trauma. A ganglion sometimes varies in size - sometimes it is so small that it can only be felt by palpation, and sometimes it is a sizable lesion clearly protruding above the surface of the skin. Despite its often sizable size, it is partially movable to the substrate. Although the contents of the cyst are formed from joint fluid, it is denser than it, because during the formation of the ganglion, the water is partially resorbed. The growth is quite hard and strongly convex, which often poses an aesthetic problem, especially for women. However, it is a benign lesion and should not be feared.

How is a ganglion diagnosed?

The appearance of a ganglion, even if it is relatively small and does not cause pain, should prompt us to go to a surgical clinic. Ganglion cysts or nodules containing solid contents can be cancerous lesions, so it is important to consult any nodule with a doctor. An orthopedist diagnoses a ganglion based on history and clinical examination, sometimes ordering diagnostic imaging. The most common tests are: Ultrasound and X-ray, sometimes, but not very often, also MRI. They allow identification of the contents of the cyst, which, along with the typical location, confirms the diagnosis. If all examinations confirm the presence of a ganglion, the doctor decides to implement appropriate treatment.

What is the treatment of a ganglion?

Ganglion treatment in the initial stage of the disease is conservative and is mainly based on limiting movement in the affected joint through offloading, such as using a sling, splint or orthosis. Pharmacotherapy is also often implemented to reduce inflammation. Massage therapy, known as "breaking up" the ganglion, may be another component of non-operative treatment. However, it is worth giving this to an experienced physiotherapist. If such treatment does not work, it is worth considering slightly more invasive methods and physical therapy. In some cases, a puncture (puncture) of the ganglion is performed with aspiration of its contents (aspiration of the gelatinous substance from inside) and administration of a steroid drug, preferably under ultrasound guidance.

Ganglion - surgical treatment

If the above treatment options fail, surgery should be considered. Surgical treatment involves excision of the cyst using arthroscopic or open techniques. The excision is usually an outpatient procedure and the patient goes home the same day. Removal of the lesion does not always produce permanent results, so it is advisable to opt for a combination of surgical treatment with the support of a physiotherapist to achieve optimal results and enjoy good form for as long as possible. After the procedure, minor discomforts such as swelling and tenderness may occur. Usually a return to normal activities occurs 3-6 weeks after the procedure.

How to prevent the formation of ganglions

Is it possible to prevent the formation of a ganglion? No, you can, however, reduce the likelihood of its formation. It is necessary to take regular breaks while working with a computer, perform stretching exercises and take care of active rest in leisure time. Before practicing sports, especially those that put stress on the joints of the hand, knee and foot, it is necessary to perform a comprehensive warm-up, and the training itself should not be too strenuous, if done after a long break from sports. Also, do not forget to strengthen all parts of the muscles of the body - this improves posture, and thus reduces the tension of areas prone to ganglion formation. If you suspect that your joint is subject to too much stress, you should reduce the number of exercises, change the nature of work or reduce the time spent in front of the computer.

Natural medicine and ganglion, or home remedies for getting rid of nodules

For today's medicine, diagnosis and treatment of ganglions is no problem at all. When we observe a nodule in the area of a joint in ourselves, it is worth reporting it to a specialist, who will diagnose the problem, confirm the diagnosis and exclude cancer. Home and so-called natural ways of treating gall cysts we suggest skipping, and with the problem go to a doctor, who will solve the problem.

Related articles:

Learn about other possible hand and wrist injuries.

Bibliography:

• Ganglions of the Hand and Wrist - Thornburg, Lacy E. MD - Journal of the American Academy of Orthopaedic Surgeons: July 1999 - Volume 7 - Issue 4 - p 231-238
• Ortho Bullets - Ganglion Cysts - Michael Day MD
• National Library of Medicine - "Ganglion Cysts of the Proximal Tibiofibular Joint: Low Risk of Recurrence After Total Cyst Excision" - Ioannis D. Papanastassiou, MD, PhD
• OrthoInfo - "Ganglion Cyst of the Wrist and Hand" - Tyler Steven Pidgeon, MD, FAAOS; Charles D. Jennings, MD