NERVOUS SYSTEM – Ganglion
Nowadays, we see ganglion and lipoma occurring commonly. Both make the person suffer more cosmetically than due to the real symptoms. Unlike lipoma (a connective tissue tumour which is infiltrated with fatty tissue), which can occur anywhere in the body, ganglion mostly occurs in the wrist. There is difference of opinion with the origin and treatment of ganglion. Whatever may be the cause or origin, Homeopathy can answer it very well, without any painful procedure.
Ganglion – It is the most common problem which arises in the wrist. It is a small, cyst-like lesion
which usually occurs from synovial membranes of joints or tendon ends or ligaments or nervous sheaths, i.e., in connective tissues or sheaths. Its size and consistency often vary. It is slightly movable but pretty hard to push inside the wrist: it is usually felt as tensed swelling due to the collection of dense fluids (gelatinous fluids which are normally used in that particular place for lubrication). Due to its tensed nature, it is mostly misunderstood as a bony swelling and people consult orthopaedic surgeons. Though it occurs mostly without any symptoms, it may turn painful at any time with other symptoms like numbness or neuralgic pain.
Patho-physiology – The wrist is a collection of many bones and joints. For using it in different ways, it is tied to lots of ligaments which form a waterproof sheath or capsule over this complex joint. Ganglions commonly arise from the scapho-lunate ligament of the wrist joint and they are usually connected by a stalk to an underlying joint capsule or ligament or tendon sheath. It is supposed to be a mucoid degeneration of peri-synovial connective tissue which is often induced by constant pressure or injury. They mainly consist of viscous mucin of hyaluronic acid.
Cause of ganglion – Nobody knows the exact or actual cause. There are many notions about its causative factor. Many suspect the cause with its incidences or coincidences on the sufferer i.e. people who
- Use the wrist more (computer data operators, players – tennis, badminton, table tennis, golf, etc.)
- Arthritic sufferers – Rheumatoid arthritis, gout, etc.
- Previous trauma or fracture of the wrist
- Has constant pressure on nerves
Incidence of ganglion
In this computerised world, data entry operators suffer from this condition as they works more with their wrist. Young women are affected more. It also occurs commonly in the second and third decades of life, but can occur at any age. It is mostly seen in the upper extremity, especially in the dorsum of wrist (75 per cent) and less commonly in the palmar aspect of the wrist (25 per cent). Also, it is more common in the right hand than the left, but may occur in both hands. In case of dorsal side ganglion, it mostly appears between scaphoid and lunate bones or between trapezium and trapezoid bones. In case of palmar aspect, ganglion occurs near the radial artery or at the base of the thumb. Its occurrence may be a sudden onset or a slow one. It also usually varies in size.
Recurrences – are very common, i.e., it can recur after weeks or months or even years.
Symptoms of ganglion
- Mostly there won’t be any symptom at all, except swelling.
- Swelling or mass in the wrist may vary in size from peanut size to golf ball size
- Sore pain or throbbing pain may occur while flexing the wrist
- There may be numbness in areas of that particular nerve when it gets compressed or affected
- Weakness of the fingers, when the corresponding supplying artery gets compressed
Tender swelling of the ganglion may interrupt with the movements of the wrist; also swelling itself (even without pain) can restrict movement
Dorsal protuberance is more prominent when there is palmar flexion, likewise palmar protuberance is more prominent when there is dorsi flexion.
Effects or complication of ganglion – depending upon the location of the ganglion, its effects or complication may differ. The main complications are restricted movements of the wrist. Unlike other tumours, which later grow into cancer, this never turns cancerous.
Diagnosis and investigations for ganglion – Simple examination of the wrist in full flexed and full extension position will easily help anyone with the diagnosis. Usually, there is no need to do any investigations for this complaint since it is clearly visualised in the wrist. But while opting for surgery to rule out other complications, investigation processes should be followed as routine. The plain radiograph is the fist line of investigation. If visualisation is not clear, CT scan or MRI should be done. After surgical excision, histopathology report should be sought for further analysis.
Treatment of ganglion
Usually many of the sufferers won’t take any treatment at all, since it does not hinder them with pain or disturb their lifestyle. Some of the ganglion gets resolved spontaneously even without any treatment. The resistant or persistent ganglion needs treatment. Some people used to press it inside with tight bandage or hardboard which may sometimes get ruptured. This procedure may cause reduction in the size of the ganglion. But this procedure should not be done, since it may cause injury to nerves or joints nearby.
In Allopathy, the treatment is usually given only when there are symptoms like pain, restricted movement, numbness, etc., or it is simply kept under observation. The ganglion enlargement can cause compression of nerves and arteries in due course. Regarding treatment, two types are commonly followed. They are
1) Aspiration – Aspirate the content under local anesthesia and make a tight splint for compression. This never cures the condition but works for the time being, i.e., 3-6 months. Some doctors inject steroids or scelorising agents for blocking pain and recurrences. But it is usually in vain. The common complications due to this procedure are neurological pain or numbness, allergic skin disorder, discolourations.
2) Surgical removal – Under local anesthesia, the tumour is surgically excised with surrounding capsule and its attachments. Nowadays arthroscopy is often used to excise it with a minimal scar. This type of treatment also cannot guarantee complete or long-lasting cure. Recurrence is common. Also care should be taken not to damage nerves, joints and arteries (i.e., in the case of dorsal ganglion excision, care for radial nerve, and in the case of ganglion of palmar aspect, care for radial artery). Complications of surgery usually include scar, restricted movement or stiffness, injury to nerves, arteries, tendons or joints which lie nearby.
Homeopathic approach to ganglion
Everyone knows well that Homeopathy treats tumours with medicines and not surgery. One such tumour is ganglion. It can be cured with Homeopathic medicines without any recurrences. But treatment should be followed till it subsides wholly or otherwise there will be recurrence as in other treatments.
Homeopathic medicines commonly used in the case of ganglion are Apis, Belladonna, Bryonia, Calc carb, Calc flour, Hecla lava, Lapis alb, Lycopodium, Rhus tox, Ruta, Silicea, Thuja, etc. These Medicines should be taken under the advice and diagnosis of a qualified Homeopath.
for new hope
Dr. S. Chidambaranathan, BHMS, MD (Homeo)
Laxmi Homeo Clinic
24 E. New Mahalipatti Road
Madurai, TN 625 001
India
Tel: +91-452-233-8833 | +91-984-319-1011 (Mob)
Fax: +91-452-233-0196
E-mail: drcheena@yahoo.com
(Disclaimer - The contents of this column are for informational purpose only. The content is not intended to be a substitute for professional healthcare advice, diagnosis, or treatment. Always seek the advice of healthcare professional for any health problem or medical condition.)