Alice,

A couple of months ago I developed a hard, bony growth on my instep. I noticed that the top of my foot was hurting, and when I took my shoe off, there was a red lump the size of a quarter (it's not red all the time, just from rubbing against the shoe). A friend of mine who is a nurse said that it's probably a ganglion cyst and the best thing to do would be to, and I quote, "hit it with something really hard," like a dictionary, or a hammer. It should break up immediately, she told me. She hasn't seen it, by the way — this was over the phone.

I'm surprised that she thinks it's a cyst, because it's awfully hard — I would have just thought that it was a bone spur. What do you think? And is smacking a cyst with a dictionary really the way to go?

Thanks so much for your help.

— Another Alice

Dear Another Alice,

Stop — it’s not hammer time! In the old days, smashing fluid-filled cysts with heavy objects such as a large book or hammer may have been an acceptable treatment method. Today, however, using any object to hammer away a podiatric protuberance may lead to dangerous health problems and injuries. There are a number of clinically appropriate (and less painful) ways to treat these kinds of foot conditions. The growth you describe may be a bone spur, ganglion cyst, or something else entirely. Without a proper diagnosis from a health care provider, however, there's no sure way to know what the growth may be or how to treat it.

Bone spurs are protrusions that usually form where bones meet. They often cause no symptoms and in some cases no treatment is needed. If a bone spur is accompanied by pain, swelling, or reduced joint mobility, getting it checked out by a health care provider is recommended. A bone spur is diagnosed through a physical exam and an x-ray, MRI, or ultrasound. Treatment, when necessary, can range from over-the-counter (OTC) pain medicines and extra protective padding to surgery (when the bone spur inhibits normal movement).

On the other hand (or foot), ganglion cysts are non-cancerous bumps filled with thick, clear fluid and can occur on feet, ankles, wrists, or hands. The exact cause of ganglion cysts is unknown, and many of these cysts do not cause symptoms. These cases usually do not require treatment and often go away on their own. However, some ganglion cysts can cause pain (if pressing on a nerve) or impair movement. Like bone spurs, diagnosing a ganglion cyst consists of a combination of a physical exam and an x-ray, MRI, or ultrasound. Treatment usually includes one of the following:

  • Immobilization: Wearing a brace or splint — as instructed by a health care provider — may prevent the cyst from growing. The pain should decrease as the cyst becomes smaller.
  • Aspiration: A health care provider may drain the cyst with a needle and inject the area with steroids to prevent regrowth. This is absolutely not a home remedy as botched efforts can range from not working to causing an infection. Yikes!
  • Surgery: As a last resort option, surgery may be recommended if immobilization and aspiration aren’t successful. Unfortunately, there is no guarantee that surgery will keep cysts at bay permanently — it’s still possible for them to grow back.

In less serious cases, OTC medications or a cushion device (like a donut that fits around the cyst) may suffice.

Since a medical professional has not yet examined your foot, you may want to consider making an appointment to see a health care provider or a podiatrist. S/he will be able to examine the growth, figure out what it is, and treat it appropriately. For more resources, such as finding a podiatrist in your area and/or additional information about foot conditions, check out the American Podiatric Medical Association. In the meantime, you may find relief from the good old RICE treatment: Rest, Ice, Compress, and Elevate.

Here's hoping that this response hammered home your options,

Alice!
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