Do you have a lump around a joint or tendon? It could be a ganglion cyst. This is a non-neoplastic (cell growth that may appear tumour like) soft tissue lump caused by leakage of fluid from the joint into the surrounding tissue. It is commonly known as Gideon’s Disease or Bible Bump.
Cysts are most commonly found around the back of the wrist, top of the fingers and foot. They are caused by distention (pressure within) a weakened area of a joint capsule or tendon sheath, which causes synovial fluid within the joints to be released into the surrounding area. This can happen due to synovial cysts, post-traumatic degeneration of connective tissue and inflammation. However, other mechanisms such as repeated stress, facet arthosis (a degenerative spinal condition like arthritis) and degeneration of connective tissues can also cause a ganglion cyst.
Your consultant and physiotherapist can diagnose your ganglion cyst by observation and touch, but further investigations such as X-ray, and ultrasonography should be obtained to exclude any other pathology and increase diagnostic confidence.
With regards to treatment of the cyst this is normally performed by your consultant via arthroscopic (key hole) surgery or by mini-opening wide-awake excision of the ganglion cyst. Other alternative treatments are draining the fluid from the cyst using a hypodermic needle with a corticosteroid injection afterwards into the area. However there is always a 50% chance of recurrence of the ganglion cyst after treatment.
Historically, the lump was struck with a large heavy book, such as a Bible. This would rupture the cyst and the fluid would drain into the surrounding tissues, hence Bible bump.
How Can Your Physiotherapist Assist with Ganglion Cyst?
If you suffer with any stiffness around the area of the ganglion cyst or have post-operative scar formation causing restrictions in movement of that joint, your physiotherapist can perform mobilisation techniques or breaking down of scar tissue techniques alongside stretching and mobilisation exercise programme provided to you.
Post by Zoe Birch, Head of Orthopaedic Physiotherapy at Physiocomestoyou.