A Ganglion cyst is a small fluid-filled sac that can develop along the tendons or your joints. They are most commonly found in the wrist and hands but they may also develop in the foot or the knee. Most cysts’ will look like a lump and may feel firm or spongy when they are touched. The majority of ganglion cysts are painless however; some may become painful, tender to the touch, cause weakness or even tingling in the area and may interfere with the joint’s range of motion.
What Causes Ganglion Cysts?
Some theories suggest repetitive microtrauma may lead to the development of a cyst but there is no general consensus on this. They can also appear spontaneously, and are 3 times more likely to affect women over men. The hand on the photo belongs to my niece, who developed this ganglion cyst handwriting essays and taking notes while preparing for exams.
Signs and Symptoms of Ganglion Cysts
- A visible lump/mass that may fluctuate in size
- It may feel firm and tender to touch
- The pain (if present) may increase with movement of a joint (i.e. bending the wrist)
How Can Physiotherapy Help with Ganglion Cysts?
Most cysts (38%-58%) resolve on their own if they are left untreated. However, if the cyst is painful and interfering with daily activities, physiotherapy can help to improve your pain and function.
- Education about modifying activities/exercises
- Role of using a more neutral grip during daily activities (wrist kept straight)
- Finding the potential aggravating factors and help with load modification
- Use of a brace/tape/compression (if applicable)
- Gentle manual therapy for forearm and hands if needed
- Laser/ultrasound/acupuncture to help reduce inflammation and pain
- Exercises aiming to normalize movement of the hand/foot
If conservative management has not been effective, surgical intervention may be required to remove the ganglion cyst, if it continues to be troublesome. Physiotherapy is usually recommended after the procedure to help normalize the use of the joint affected. For instance, if the cyst is removed from the wrist, it may become stiff afterwards. Physiotherapy can help improve the range of motion with manual therapy and creating an appropriate home exercise program. Modalities such as laser and ultrasound can be used for inflammation in the area. Scar tissue massage can also be performed to help prevent the buildup of excessive scar tissue around the incision site.
Exercises for Ganglion Cysts
Tendon glides (claw, fist, tabletop)
Wrist ROM (flexion, extension, ulnar deviations and radial deviations)
Isometric wrist flexion, extension, ulnar deviations and radial deviations
Wrist CARs fingers straight and bent
- Gregush, R. E., & Habusta, S. F. (2018). Cyst, Ganglion. In StatPearls [Internet]. StatPearls Publishing.
- Physiopedia, Ganglion Cyst. Retrieved from: https://www.physio-pedia.com/Ganglion_Cyst