A ganglion cyst or a Bible cyst is a benign swelling or bulge that often appears around or on joints and tendons in the hand or foot.
A ganglion manifests as a subcutaneous lump or nodule.
The size can change in time and it can also disappear completely.
A ganglion in the musculoskeletal system is a spherical accumulation of fluid produce from an adjacent joint capsule or tendon sheath.
They're typically round or oval and are filled with a jelly-like fluid.
A ganglion cyst is most frequently located around the dorsum of the wrist and the fingers. Along, the musculus extensor carpi radialis brevis is a common site of occurrence because it passes over the dorsum of the wrist joint.
A ganglion cyst usually appears spontaneously without any particular cause.
What is the reason behind its appearance?
Ganglion cysts are the most common benign soft tissue tumors of the hand and wrist.
Ganglion is a mucin-filled hernia of synovial tissues from joint capsules or tendon sheaths due to one-way valve phenomenon.
The cyst expands in size and the fluid cannot flow freely back into the synovial cavity.
The cause of the ganglion cyst is unclear, although prior trauma, synovial herniation, internal derangement, and a degenerative process associated with mucin production are possible
Symptoms
It is present adjacent to joints or tendons.
Ganglions are usually minimally symptomatic
Patients may present with a myriad of symptoms such as:
Dull aching pain, change in size, spontaneous drainage, and sensory nerve dysfunction
Medical management
Aspiration
Surgical excision and splinting to avoid movement that can refill the cyst.
Physical Therapy Management
Non-surgical
To restore the normal use of the hand.
If managed surgically
The main goal of physical therapy is to restore the normal use of the hand by regaining full mobility of all the joints of the hand. This includes:
Exercise, splint therapy, edema relief and scar tissue reduction.
Exercises to achieve full mobility includes the following:
Disclaimer :- We recommend you not to try these exercises on your own initially. Your physical therapist’s guidance is much required for you to learn them appropriately. Remember that exercises learnt in a wrong way can harm you than help you. Once your therapist is convinced of you mastering them, he or she will give you the green signal to go ahead.
PROM (passive ROM) exercises: there are 3 finger joints (MCP, PIP and DIP-joints) and 2 wrist joints (radiocarpal en mediocarpal joint). It’s important that all the possible movements are trained.
PNF (proprioceptive neuromuscular facilitation) exercises: the finger is kept in flexion by the therapist. The patient needs to keep this position for a while (active), afterwards the patient relaxes the finger. Repeat for al fingers.
Tendon gliding exercises: from wrist flexion with finger extension to wrist extension with finger flexion.
Blocking exercises: lay your hand palm side up on a table. With your opposite hand grasp and hold the affected finger at the middle section just below the end joint. Bend and straighten the finger at the end joint only while holding the rest of the finger straight. Repeat for all joints and fingers.
Scar tissue management
Stretching
Skin mobilization
Flexibility exercises
Strengthening exercises
With specialized therapy there is a lower recurrence rate and a faster recovery. Patients with a ganglion cyst are able to use their hand back, 2 weeks after the surgical excision,
At Valley Healing Hands, Brownsville, Texas, WE provide the best physical therapy treatment for Ganglion cysts. Our patients are satisfied with our services. You may learn about their opinions here and get connected with us. Our patients love us, you too will!