List of ointments for hygroma: alternative treatment and surgery

What it is

Hygroma (synovial cyst or ganglion) is a formation that is a capsule filled with thick liquid.
This is a benign cyst that mainly forms in the joint area. Most often these tumors appear on the hands. More than half of all neoplasms on the hands are hygromas. The size of the hygroma varies from 0.5 to 6 cm in diameter. Small tumors, as a rule, do not cause discomfort other than aesthetic ones. Large hygromas can be difficult. This is due to pressure on nearby nerve fibers. This leads to pain, which requires prompt medical intervention. Moreover, in approximately 50% of cases, hygromas go away on their own¹.

According to one epidemiological study, hygromas are formed annually in 3 people for every 10 thousand population². In the vast majority of cases, these are persons aged 20-30 years. Hygromas are extremely rare in older people and children. In women, such tumors appear 2-3 times more often than in men.

"Professional" hygromas

Most often, hygromas are formed in athletes who use sports equipment. These are tennis players, hockey players, golfers, weightlifters and others. Musicians, typesetters, painters and turners also often encounter hygroma. Any work associated with high load on a joint (or group of joints) increases the risk of synovial cysts.

When is surgery needed?

Most people with hygroma want a clear answer to this question. However, the doctor cannot answer it. A synovial cyst is not a dangerous disease; it has a chance to go away without any treatment; surgery (like any intervention) has its own possible complications and risks. Whether to operate on a hygroma or not is a patient’s informed decision. When a person understands the situation and is ready to share responsibility for the decision made with the doctor, then one can choose the time and place to perform the intervention.

How is the operation to remove hygroma performed?

I will describe the basic principles using the example of the most common dorsal hygroma on the wrist.

• The operation is outpatient. There is no need to stay in the hospital.
• Local anesthesia. Anesthesia means unnecessary risks, as well as excessive preoperative examination. I use a mixture of lidocaine and epinephrine, this avoids discomfort from the tourniquet, reduces the likelihood of a toxic reaction to the anesthetic and prolongs the effect of pain relief to 4-5 hours.
• Transverse access. Longitudinal access leaves rough, unsightly scars.
• It is imperative to excise the fragment of the joint capsule from which the hand hygroma grows. Only the skin is sutured.
• I don't use immobilization. For the first 2-3 days, a thick soft bandage is applied, which limits movement and makes the early postoperative period as comfortable as possible. Prolonged immobilization after surgery can lead to stiffness, but does not affect the likelihood of relapse.
• The skin heals in about 2 weeks.

Hygroma symptoms

In 30-40% of cases, hygromas are asymptomatic. The only manifestation that worries a person is a compacted lump near the joint. Most often this is the wrist joint or fingers. In other places, synovial cysts appear much less frequently.

Hygromas are rarely large. They grow very slowly and simply do not have time to reach large sizes.

A doctor examines a hygroma. Photo: familylifestyle / Depositphotos

In addition to the pineal formation, other symptoms are also observed with a synovial cyst:

• limited mobility of the affected joint;
• pain in the area of ​​the cyst (usually aching pain);
• decreased or increased sensitivity of the skin (possible slight numbness in the area of ​​the hygroma);
• burning sensation, tingling, crawling and other sensations (arise due to pressure on nerve fibers).

More pronounced symptoms are observed when the hygroma is located under the joint ligament. In this case, a lump above the skin may not form. In this case, the skin over the cyst becomes rough and peels off. Subglottic hygromas often lead to dull and pressing pain. Sometimes the pain spreads to other parts of the limb.

How to distinguish a hygroma from a cancerous tumor

Only a doctor can do this, so if any formations (bumps, bumps, etc.) appear, you need to go to the clinic. Unlike malignant tumors, hygromas can increase and decrease in size. Typically, a synovial cyst shrinks with rest. After exercise, it noticeably increases in volume.

A characteristic feature of hygroma is that the skin above it retains all its properties (color, structure, elasticity). The exception is hygroma growing under the ligament. In most cases, hygromas on the arm remain painless on palpation.

When to see a doctor

You should consult a doctor if a characteristic lump or lump appears.

Traditional methods

Some people recommend simply crushing the cyst. Under no circumstances should you do this! First of all, it is very painful. Secondly, it is really dangerous, as it can cause inflammation. If the membrane ruptures, fibrous fluid will either fill the tendon sheath or disperse into nearby tissues. This can provoke infection and the onset of a purulent process. If the hygroma bursts, you should immediately seek medical help! In addition, hygroma can be easily confused with more dangerous diseases. To avoid unpleasant consequences, if tumors rupture, you should immediately go to the hospital. If we talk about more gentle folk remedies, then they are all aimed at the gradual resorption of the tumor:

• warming up
  with compresses, salt and a copper coin helps normalize blood circulation in the limb and gradually reduces the size of the hygroma;
• baths
  and infusions will help reduce pain;
• lotions
  can help reduce tumor size.

It is worth remembering that not a single folk method is a complete alternative to traditional medicine.

Complications

The main danger of hygroma is that it can compress nerve fibers, blood vessels and soft tissues. This occurs when the size of the synovial cyst increases.

When nerve endings are compressed, pain occurs. In most cases it is aching or pressing pain. But there are also cases of acute unbearable pain (it all depends on the affected nerve endings).

When vessels are compressed, trophic disorders develop. In this case, the tissues do not receive enough oxygen and nutrients. In the most severe cases, this causes tissue necrosis (death).

In rare cases, a synovial cyst leads to the following serious complications:

• Thrombophlebitis is inflammation of the vein walls with the formation of blood clots. In this case, swelling forms near the hygroma, and the skin acquires a bluish tint.
• Damage to nerves with their further replacement. In this case, innervation is disrupted. The person experiences various sensations, often tingling or numbness.
• Contractures are a violation of joint mobility.
• Inflammatory joint diseases - bursitis and tendovaginitis.
• Suppuration and sepsis. Such complications arise when the hygroma bursts.

If the hygroma is damaged

This often happens with cysts located on the palmar surface. When performing household work, the hygroma can be damaged. In this case, there is no need to squeeze out the contents of the cyst. Treat the affected area with an antiseptic and apply a sterile bandage. Try to see a surgeon within a few hours.

Carrying out physiotherapeutic procedures

One of the methods of treating hygroma is physiotherapy. The following procedures are carried out:

1. Warming up with UV rays;
2. Mud wraps;
3. Application of paraffin masks;
4. Electrophoresis.

Warming up with UV rays has a moderate anti-inflammatory effect and accelerates the tissue healing process. When using ultrasound in the treatment of hygroma, blood microcirculation in the body improves, inflammation decreases, and tissues are enriched with oxygen.

The corresponding procedures are prohibited in the presence of acute inflammation. Physiotherapy can provoke rupture of the walls of the hygroma and leakage of pus into the arm cavity.

Treatment of hygroma

If the hygroma is small in size and does not cause problems, then you can do without special treatment. The only thing a person needs to do is get tested. You should make sure that it is really a hygroma and not another tumor.

As statistics show, in approximately 33% of cases, hygroma goes away on its own within several months or years (usually up to 6 years). And in 50% of cases, the period of spontaneous resorption of the cyst is 10 years³.

If the hygroma has many chambers, grows relatively quickly, or is a source of pain and inflammation, then it needs to be treated. The most effective way to treat hygroma is surgery. In 8-9 cases out of 10, after removal of the hygroma, no relapse occurs. With conservative treatment, hygromas reappear in 80-90% of cases.

Despite the obvious effectiveness of surgical treatment, doctors did not abandon conservative therapy. Let's look at these methods in more detail.

Conservative treatment

The main non-surgical method of treating hygroma is aspiration puncture. A small puncture is made in the cyst, from which the contents are sucked out using an aspirator or syringe. After this procedure, hormonal anti-inflammatory drugs and sclerosants are injected into the cyst cavity. The latter lead to gluing of the cyst walls and scarring (instead of liquid, the capsule is filled with connective tissue). If the hygroma contains pathogenic bacteria, then antibiotics are also introduced into the cavity.

Some clinics practice physiotherapeutic methods of treating hygroma. These are electrophoresis, magnetic therapy, mud therapy, paraffin baths and others. However, such methods of therapy are ineffective. If you decide to undergo such treatment, be prepared for the fact that it will be ineffective.

Surgery

As a rule, indications for surgical treatment of hygroma are:

• severe pain syndrome;
• contractures;
• rapid growth of the tumor;
• unaesthetic appearance.

If you notice rapid growth of a cyst, contact your surgeon as soon as possible. The larger the size of the hygroma, the more difficult it is to remove. This is due to compression of blood vessels and nerve fibers - it will be more difficult for the surgeon to separate the cyst.

Hygroma removal is a simple operation that is performed under local anesthesia. In case of complex localization of hygroma and/or its large size, general or conduction anesthesia (complete anesthesia of the desired area) is allowed.

Surgical removal of hygroma. Photo: familylifestyle / Depositphotos

When removing a joint hygroma, it is important to remove all cyst cells. Otherwise, there is a high probability of relapse of the disease. After removing the tumor and washing the capsule, a drainage tube is installed to drain the fluid. As a rule, after 1-2 days the tube is removed. A pressure bandage is applied to the patient's wound, and the limb is fixed with a plaster splint. Already on days 7-10, the postoperative wound heals and the patient’s stitches are removed.

ethnoscience

For hygroma, treatment with folk remedies includes compresses with sea salt, ointments based on yolk and vinegar, as well as rubbing the cyst with alcohol tinctures. This treatment is ineffective. This way you will only waste time. This is strictly forbidden, especially if the hygroma increases in size.

Puncture

Hygroma puncture is a quick and safe way to get rid of it. Also, a puncture can be considered as a diagnostic procedure: if you get a gel, it means it’s definitely a hygroma. The probability of relapse after puncture is about 80-90%. Injecting any medications into its cavity does not reduce the likelihood of relapse. It is worth remembering that the entry of steroid hormones (they are sometimes used in the hope of influencing the possible return of hygroma) into the subcutaneous fat or articular cartilage can cause very serious irreversible destruction of these structures.

Types of hygroma

Hygromas can be single or multiple. There are cases when several synovial cysts form in a limited area of ​​the body and then grow together.

Hygromas are classified according to their location on the body. Hygromas of the wrist, hand and fingers are most common. They account for about 90% of all cases. Much less often, such cysts form in the knee (Becker cyst) or ankle joints. Let's take a closer look at these varieties of hygroma.

Figure 1. Localization of hygroma. Image: kjpargeter/freepik.com

Hygroma of the wrist

This is the most common location of a synovial cyst. It is especially noticeable if the wrist joint is flexed. In most cases, such a cyst appears on the back of the joint. But sometimes a hygroma forms on the side or at the base of the palm.

This bump feels like rubber to the touch. On palpation, a springing effect is felt.

Hygroma of the hand

Most often, such tumors occur on the finger or palm. Hygroma of the hand is rarely a cause of concern. In most cases, it is small in size (up to 1 cm). Large hand hygromas can make themselves felt when performing household work.

Hygroma on the finger

In most cases, such hygromas form on the back of the finger near the nail. Such cysts are hard, so they can be mistakenly perceived as bone or cartilage growths.

Hygromas on the palmar side of the fingers are usually larger than those on the back. Because there are nerve fibers running along the sides of this side of the finger, these synovial cysts can be painful.

Hygromas of the lower extremities

Hygromas occur much less frequently on the legs. This most often occurs on the back of the fingers or feet, as well as in the ankle area. If the hygroma is large or located next to nerve fibers, then serious problems arise with wearing shoes.

Diagnosis of pathology

Diagnosis of hygroma begins with examination and palpation of the formation. Obtaining information about how the tumor appeared, as well as palpation determination of its properties, provides the specialist with basic information. An ultrasound examination of the tumor allows us to say with certainty that the existing tumor is a hygroma.

Also, when a hygroma is diagnosed, the patient is prescribed an X-ray examination of the hand and wrist joint to determine the condition of the surrounding bone structures. In controversial cases, CT or MRI of the wrist may be used.

Causes

The exact causes of hygroma are unknown. There may be a hereditary component, since cysts form more often in blood relatives. This is due to the congenital weakness of the tissues that form the joint capsule. It is also noted that the cause may be inflammatory diseases of the joints - tenosynovitis, bursitis and others.

Among the factors contributing to the development of hygroma are the following:

• High physical activity. Hygromas often appear in people who work out in the gym.
• Performing monotonous movements. As a rule, these are high loads on the joint associated with a person’s professional activities. For example, typists, assembly line workers and others are affected by the disease.
• Inflammatory diseases. In addition to inflammatory diseases of the joints, these are metabolic disorders, autoimmune and infectious pathologies that affect the joints.
• Injuries and previous surgeries. Hygromas often form after injuries or operations on the hand.

Work associated with increased stress on the joints increases the risk of hygroma. Photo: undrey/freepik.com

Medicines for therapy at home

Medicines for home use do not require expensive ingredients in the preparation recipe, but have highly effective medicinal properties. Recipes for affordable and fast-acting remedies are presented in the table:

Prognosis and prevention

No one is safe from hygroma. This tumor can appear even in the absence of the above factors. No specific methods of prevention have been developed for synovial cysts. At the same time, some recommendations can reduce the likelihood of hygroma. These include:

• avoiding injuries and hypothermia of joints;
• timely treatment of inflammatory diseases of the musculoskeletal system (in particular, arthritis, arthrosis and others);
• compliance with safety precautions when playing sports (never neglect warming up before the main workout);
• give your joints rest while working;
• follow the principles of a healthy lifestyle.

Alcohol compress

You can make homemade dressings at home yourself using traditional medicine recipes, or you can follow your doctor’s recommendations. Modern medicine produces pharmaceutical alcohol tinctures that are very easy to use. It is enough to moisten a piece of bandage in the tincture of calendula, valerian, celandine, apply it to the formation and wrap it with a warm cloth for 20 minutes. An alcohol compress is simple and affordable. The process of its preparation includes the following steps:

• take 70% medical alcohol and dilute it in a ratio of one to two;
• soak a piece of gauze in the solution and place it on the hygroma;
• cover with cling film and wrap with a woolen scarf;
• Leave the compress on for 10 hours (preferably overnight).

If you use undiluted alcohol, you may burn your skin.