What is the best treatment for a ganglion cyst?

Doctor's Answer

A ganglion cyst is a swelling comprising of a sac (covering) which is filled with a clear, gel-like fluid called synovial fluid. Synovial fluid is found in joints and within tendon sheaths. The synovial fluid functions to bathe and nourish the surrounding tissue as well as a lubricant.

A ganglion cyst is formed due to a small rent made in the joint capsule or tendon sheath which then allows synovial fluid to leak out. This small rent may be caused by an injury or due to degeneration (wear and tear). When this happens, the body usually attempts to heal itself by sealing the rent.

In the process of doing so, a tight sac is developed to trap the leaking synovial fluid, thus forming a ganglion cyst. Ganglion cysts may be so tightly filled that sometimes they may feel like a bony protrusion. As the ganglion cyst enlarges, it may cause pain due to compression and stretching of the adjacent structures. It may also impede movement in the nearby tendons and joints.

The best treatment to eradicate a ganglion cyst is surgery. Surgery aims to not only remove the ganglion cyst but also to clean up the damaged joint capsule or tendon sheath to facilitate the healing of the rent which caused the development of the ganglion cyst. Of course, there is always a risk of recurrence of the ganglion cyst despite surgery.

The alternative option is to leave the ganglion cyst alone and wait for spontaneous resolution, which may occur in some cases. The time taken for this varies from several months to years. This option should only be considered if the ganglion cyst is small and does not cause any discomfort or impingement of motion in the adjacent joints.

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