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Cysts

A cyst is an enclosed cavity or sac of tissue that is lined by tissue called epithelium. These generally contain either fluid or viscous (semi fluid) liquid and can occur anywhere on the body and in many sites on the foot.

What causes a cyst?

Although trauma can predispose to cyst formation (in the foot this can be due to shoe irritation), they can occur for no specific reason.

Do they get worse?

Although they can slowly increase in size, they can also remain static causing no problem.

What are the common symptoms?

Prominence / swelling (which is often soft and mobile / fluctuant)
Discomfort
Redness
Difficulty in shoes
May vary in size

How is it recognised?

Clinical examination and a detailed history allow diagnosis. X-rays or more specialist scans are sometimes required to help evaluate the extent of the cyst.

What can I do to reduce the pain?

Wear good fitting shoes
Avoid high heels
Wear a protective pad
See a podiatrist

What will a podiatrist do?

If simple measures do not reduce your symptoms, there are other options:

Advise appropriate shoes
Consider draining the cyst
Advise on surgery

Will this cure the problem?

Draining the lesion may resolve the problem although recurrence is common.

What will happen if I leave this alone?

The cyst may remain static or it may get bigger.

How can I get rid of the cyst?

Surgical excision is usually required to resolve the problem.

I have heard it is very painful.

The nature of surgery means that there will be pain and swelling, usually worse the night after surgery. However, with modern anaesthetic techniques and pain killers, this can be well controlled. The level of pain experienced varies greatly from patient to patient with some experiencing no significant discomfort.

Will I have to have a general anaesthetic (be asleep)?

Not if you did not want one. Many of these procedures are performed perfectly safely under local anaesthetic (you are awake). Some patients worry that they may feel pain during the operation but it would not be possible to perform the operation if this were the case.

Will I have to stay in hospital?

No. As long as you were medically fit and have adequate home support, many patients are able to have this type of operation performed as day surgery and go home.

Will I have to have a plaster cast?

This generally not necessary although some protection in the early stages may be necessary for larger cysts or cysts underneath the foot.

Are there a lot of complications?

There are risks and complications with all operations and these should be discussed in detail with your specialist. The specific complications will depend on the nature and location of the cyst. A thorough examination of your foot is important so that these complications can be minimised.

When will I be able to walk again and wear shoes?

In the majority of cases, you will able to walk with the aid of crutches within 2-4 days but you will remain somewhat limited for the first 2 weeks. If you need a cast or the wound is on the sole of the foot, you may not be able to walk on the foot for up to 3 weeks.

Some patients are able to return to wider shoes within two weeks with 60% of patients in shoes at 6 weeks and 90% in 8 weeks.

Generally, patients are mobile quite quickly after cyst excision but this does depend upon the nature and site of the cyst.