What is a ganglion?

A ganglion is a small cyst that contains a thick jelly-like material. It looks and feels like a smooth lump under the skin. It is not fully understood how they occur.

A ganglion is usually attached to a joint or tendon, and the fluid inside is like a thicker version of the fluid which 'lubricates' the joint and tendon sheaths (synovial fluid).

The two common sites where they are found are on the back of the wrist and on the top of the foot next to the small joints. Other sites of the body are affected less commonly.

What are the symptoms of a ganglion?

The main symptom is one of swelling. Ganglions usually are very smooth and round. Their size can vary from being very small (pea-sized) to being larger (plum-sized). Larger ganglions can sometimes be unsightly. They can sometimes be painful, particularly if they lie next to a nerve. They never spread to other areas of the body.

Although they are present all the time for most people, they can be present intermittently or, for some people, they may disappear altogether.

What is the treatment?

If a ganglion does not cause symptoms it is best just to leave it alone. However, many people prefer to be rid of them, especially if they are causing pain or discomfort.

Many people have heard of the traditional cure. That is, to smash them with a heavy book (tradition holds it to be the family bible). This bursts the cyst under the skin. The fluid is then absorbed into the bloodstream. In some people (who are brave enough) this works well, but there is a high chance of it recurring as the walls of the cyst can reform. However, it is an instant cure for some.

In some cases it is possible to aspirate (suck out) the fluid with a needle and syringe. If the jelly-like fluid is very thick this may not work. Also, if it does work, there is a chance that the cyst will recur as the wall of the cyst is not removed, and the fluid may form again to refill the ganglion. However, in some people it cures the problem. As it is quite easy for a doctor to do, this is often attempted first.

Surgical removal of the ganglion is the most successful cure. This is a relatively minor operation. This is the treatment that is most likely to be permanent. However, in around one in five cases after a ganglion is removed, one recurs again at the same site.

References

• Genova R, Walsh JJ; Ganglion Cyst, eMedicine, Aug 2009