The appearance of a ganglion cyst in the wrist nearly always takes a person by surprise. This benign tumor can grow so large that patients wonder if wrist surgery is their only option for relief.
Overview of Ganglion Cysts
The first sign of a ganglion cyst is a large bump around a joint or a tendon sheath, most often in a hand, wrist, or foot. The University of California, San Francisco says the fluid-enclosed bump is the most common type of soft-tissue mass that forms in the hands and the wrists. The female-to-male occurrence ratio is 3:1.
Although researchers have uncovered no specific cause, they know that up to 70 percent of these cysts appear between the second and the fourth decade of a person’s life.
In most cases, ganglion cysts are not painful when the hand and the wrist are at rest. However, Cedars-Sinai® notes that they can cause pain when they first develop or when the affected hand undergoes strenuous or repetitive use.
A ganglion cyst develops from tissues that surround a joint, among them joint linings, ligaments, and tendon sheaths, according to the American Association of Orthopaedic Surgeons (AAOS). It resembles a balloon at the end of a stalk. The exterior houses a thick, clear fluid.
When is Wrist Surgery Necessary?
Ganglion cyst size tends to mirror the level of wrist activity. While many of these cysts have no symptoms beyond their appearance, the pressure some exert on nerves can result in pain, a tingling sensation, or muscle weakness.
A hand doctor might order tests such X-rays or an MRI scan to finalize a diagnosis. When the cyst is bothersome, the first alternative is non-surgical treatment. AAOS cites three options:
- Observing the cyst: Doctors often recommending watching an asymptomatic ganglion cyst. If any unusual changes develop, further treatment is necessary.
- Immobilizing the cyst: Using a splint or a brace to reduce wrist activity sometimes relieves symptoms and causes shrinkage. As discomfort decreases, a physician might order exercises that expand the patient’s range of motion and strengthen the wrist.
- Aspirating the cyst: The physician uses a needle to draw fluid from a cyst that is causing considerable pain or limiting normal activities. Since aspiration does not remove the root of the cyst, it is not necessarily a permanent solution.
Doctors recommend surgery if conservative measures fail to cause sufficient improvement, if the cyst becomes infected, or if it affects nearby ligaments or bones. Excision of a ganglion cyst in the wrist is normally an outpatient procedure performed in a surgery center or a hospital.
After the procedure, the patient has temporary restrictions on lifting and wears a brace for up to four weeks. Most patients regain full use of the affected wrist and hand within six weeks after surgery.