The exact etiology of the development of ganglion cysts is unknown, they are believed to arise from repetitive microtrauma resulting in degeneration of surrounding connective tissue such as ligaments, tendons, and joints.

Many ganglion cysts are asymptomatic

Others may present with pain, tenderness, weakness, and dissatisfaction with cosmetic appearance. In regards to the foot, they may causing rubbing in shoes or the inability to wear certain shoes

Conservative treatment

• Asymptomatic patients can be observed

• Shoe gear modifications

• Aspiration of ganglion cysts

Surgical Treatment: is indicated for patients with continuing symptoms who have failed conservative management.

• Surgical excision is usually performed as an outpatient procedure.

• “RICE” Rest, Ice, Compression, Elevation

• Reduction of activity levels.

• Oral medications

• Shoe gear changes/Orthotic/Supportive devices

• Immobilization

• Physical therapy

  • Stretching exercises

  • Tendon strengthening

  • Manual therapy, Graston, Dry needling

• Pain laser, extracorporeal shock wave therapy (ESWT)

• Injection Therapy biologic/amniotic, PRP,

Surgical therapy is optional for 10 to 30% of patients who fail conservative therapy.

• Open/Endoscopic Debridement

• Topaz or Tenax

• Resection of the superior calcaneus (Haglund deformity) and bursa

• Detachment and reattachment of the Achilles tendon