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What is Carpal Ganglion Cyst?

Subconsciously, we use our hands regularly throughout the day. For example, we flex our wrist to pick up objects, or we twist it to wring out clothes. The wrist composes of many muscles and tendons, working together systematically. Within the wrist, fluid lubricates the joints which enables them to move smoothly and more conveniently.

The effect of the carpal ganglion cyst (CGC)

The continued use of the wrist, can sometimes cause the leak of the aforementioned lubrication fluid as it accumulates at the back of the wrist. This accumulation will increase over time. In addition to this , when squeezed, it will feel like a hard water-bag. Consequently, it will enlarge if it is forcefully flexed or if the wrist is bent backwards. Unfortunately, the cyst can become increasingly bigger, due to fact that the leak of the fluid is substantially more than the out flow or the resorption rate. When the cyst grows in size, it forms a noticeable lump which can lead to an individual becoming self-conscious and will often make them feel uncomfortable.

Furthermore, as the cyst develops, it will start to put additional strain on the tendon as it presses against it, causing the inflammation of the tendon. Something positive that can be drawn from this is that it is not dangerous; it is a normal tumor, and it will not turn out to be a malignant tumor.

The Prevention of Carpal Ganglion Cyst

The best way to prevent the lump from forming, is to prevent the leaking of the joint lubrication fluid into the wrist which causes the cyst to develop. If the wrist is not used properly and is overexerted by being used too frequently or being bent too far back then this will also cause added inflammation. In some extreme cases, a hole will form and the leak will discharge from the cyst, due to the accumulation of the fluid. Therefore, if an

individual feels pain from or develops inflammation, it is recommended that they visit a doctor as soon as possible.

Initially , when the cyst is relatively small in size, patients are recommended to refrain from using the wrist as much as possible throughout the day. Additionally taking anti-inflammation medicine should reduce the size of the cyst. In some cases where the cyst has increased in size it may be necessary to use a syringe to extract the fluid from the cyst, in order to reduce its size. The drawback is that there is a high chance of the cyst recurring.due to the fact that the syringe can only remove outside fluid Both the tissue that surrounds the cyst and the hole that is causing the leak still remain. Therefore, there is a high chance that the fluid will accumulate again and the swelling will return to create a new undesirable lump.

If the size of the cyst becomes too large then an operation to remove the whole cyst is necessary. There are two disadvantages to this. Firstly, the operation will leave a scar which is, of course, much more more visible than when the fluid is extracted using a syringe. Secondly, there is still a chance that the cyst can return as there could be parts of the tissue that surrounded the cyst left behind. Also, the needle stitch, used to seal the leak, could cause a new leak hole. Unfortunately, as many as one out of every five patients will develop a new lump.

After learning of the potential recurrence of the lump, some patients will often decide that further treatment, by the method of either the syringe extraction or through an operation, cannot be justified. If this is the case, once patients have had confirmation that the lump is CGC and nothing more serious then they will often decline treatment and learn to live with it.

CTS (Carpal Tunnel syndrome) are commonly found in middle aged women. The symptom starts with the numbness of the finger tip when used continuously for a period of time e.g driving, holding the cooking spatula or even holding the cell phone. The fingers often found with the symptom are the index, the middle and the ring fingers. After having the symptom on and off for some time, without having the right treatment, the numbness will increase in degree followed by streaking pain from the wrist that spreads up to the forearm.

Suffering from numbness of the hand or hands can be a worrying symptom. Sufferers can find the fear of permanent damage or loss of feeling to be particularly worrying, understandably.

Carpal Tunnel Syndrome

(Numbness at the tips of the fingers from the narrow Carpal Tunnel)

Nerves in the hands can be compared to the electrical wiring in a house. Like the wiring in a house, where the electricity is supplied from a source to the fittings (light switches, power outlets, etc.), the hands, like arms, legs and rest of the body receive signals from the brain stimulating muscles and skin, enabling movement and allowing us to feel and touch the world around us.

Every time we move, our muscles contract and release, pulling our bones, enabling us to move. While undertaking low movement activities such as working in front of the computer or driving long distances, the muscles around the neck become inflamed. Pain accumulates little by little without any awareness of the individual. When we do finally feel the pain, it can be a chronic pain at the nape and the shoulder blade. It can feel like the sprain of the neck similar to that felt after slipping off the pillow or sleeping in an uncomfortable position, limiting neck movement and preventing turning of the neck all the way. Some turn to massages for relief. The massage will squeeze and unwind the muscles and it will feel like the sunken, stiffened shoulders are relieved. However, a massage is only a temporary relief. If the condition has been neglected for a long time and not corrected at the cause, the pain will be far more severe and can progress to the failure of the neck muscles. At this stage the patient cannot straighten his neck even for one minute. The pain will be so intense that the patient is unable to manage the pain. Some will suffer headaches, pain in the eye sockets, and suffer from nausea and migraines. Finally, patients can suffer shooting pains down the arms and legs and experience numbness in the hands.

Recently there has been a new, revolutionary way of thinking towards the treatment of bowed-legs. Patients can wear specially designed shoes that are tailored to a patient’s particular needs and can therefore produce a change to the legs / knee structure. These custom made shoes, featuring patient specific insoles, can adjust the structure of the horizontal plane and the angle and the length of the legs. Fortunately, they can be fit as soon as the child is able to walk. Furthermore, they are also effective in elderly patients, where they can provide increased support in weaker areas.

It’s quite common for toddlers to appear mildly bow legged. In fact, toddlers can often have bowed legs that may even interfere with walking. Fortunately, bow legs usually begin to straighten once the child starts to walk and it can be thought of as a natural occurrence that the child will usually grow out of. Adolescents occasionally have bowed legs if the degree of deformation is rather severe which can cause a flaw in their appearance.

“The operation to straighten both knees at the same time with the new MHTO Method”

Frequent questions from patients who have bowlegs or knock-knees on both sides from a young age are:

• Can the operation be done on both sides on the same day?
• Is there a difference between knock-knees and bowlegs?
• Will there be a difference if the operation is done on one side at a time?
• And the most important question is: Has this kind of operation (same-day-both-knees) been practiced in Thailand?

The operation on both knees at the same time