Though less common than their hand and wrist counterparts, ganglion cysts also occur in the foot and ankle. Stress or injury, such as overuse or a sprain, causes a cyst to form. This non-cancerous growth appears as a knot or lump that protrudes from a joint. Ganglion cysts can affect anyone, but they develop more commonly in adults age 20 to 40 and in women more often than men.
Learn about these common issues so you know how to handle them if they arise.
A ganglion cyst may have no symptoms, other than the presence of the cyst itself. The cyst is not normally painful to touch, but some symptoms may occur that cause discomfort or reduce function in the foot or ankle.
Tendon, Joint, or Nerve Issues
Cysts located directly on a tendon or joint can cause a dull, aching pain. A case of tendonitis or arthritis in the joint can make the cyst painful due to increased inflammation of the tissues. Cysts that lay on a nerve can cause numbness, tingling, or a burning sensation in the surrounding tissues. Proximity to a nerve can also result in muscle weakness that hinders the movement of the joint and its capacity to do work.
Shoes can irritate a large cyst. A cyst on top of the foot causes the skin to rub against the shoe eyelets or laces. A cyst on the ankle can become irritated if it rubs against the collar of a shoe or the shaft of a boot.
Podiatrists use a combination of physical examination, medical history, and imaging to diagnose a ganglion cyst.
Exam and History
A ganglion cyst normally appears as a round or oval lump. Palpating the area allows the doctor to tell if the area is painful or inflamed.
Doctors use soft-tissue imaging techniques like MRI to evaluate the true size of the cyst and determine where it is originating from. Cysts do not appear on x-rays, but x-rays can reveal arthritis and other conditions which may be associated with a ganglion cyst.
Ganglion cysts sometimes go away without intervention, especially if the patient can rest the affected joint. For persistent or painful cysts, conservative treatment options can provide relief.
Changes to footwear can ease some of the discomfort caused by a cyst on your foot or ankle. Wear shoes that are roomy enough to avoid excess friction on the cyst. Adding extra padding or lacing shoes differently can also alleviate some of the irritation. At home, apply ice to the joint, especially in the evening, to reduce inflammation.
When symptoms persist even with self-care, the podiatrist may use a syringe to remove some of the fluid out of the cyst, called an aspiration. Shrinking the size of the cyst can relieve irritation and alleviate some of the pain or numbness due to pressure on the joints, tendons, or nerves. This treatment usually includes a cortisone injection into the cyst following aspiration. Unfortunately, the results are often temporary and the cyst often returns with this method.
If other methods fail to bring relief, surgery may be the best option for treating a stubborn cyst.
Recovery involves a number of factors including the size and location of the cyst as well as treatment of any other associated conditions. Generally though the patient is kept non weightbearing for 2 weeks in a splint to allow the soft tissues to heal, followed by 2 weeks in a walking boot. It may take several months for swelling, pain, and nerve irritiation to resolve.
Surgery to remove ganglion cysts is generally the most successful treatment; however even with surgery the ganglion cyst can return.