What is it?

A ganglion cyst is a benign (not cancerous) tumor that occurs near joints or tendons, for which there is a readily accepted treatment. Ganglion cysts are most commonly called “lumps” in the wrist, hand and fingers. The cysts are soft sacs filled with a clear jelly-like fluid. A ganglion cyst can be seen in any age group, and occur more often in women. When found in the fingers, near the nail, they are called a mucous cyst. The cyst may fluctuate in size; at times they may even seem to disappear.

What causes it?

Fluid from a joint or around a tendon gets trapped, forming a balloon-like structure that appears as a swelling or bump. The lump can get larger with use of the joint or tendon it is attached to; often getting tender as its size increases. The actual cause is controversial; some appear after an injury or with arthritis, most have no apparent cause. Any pain can usually be resolved with treatment.

How is it diagnosed?

A non-painful lump or bump found adjacent to a joint or tendon is usually a ganglion cyst. If the cyst is aspirated, a clear jelly-like fluid is found. The lump may get tender with use. Fluctuation in size is also consistent with ganglion cysts. X-rays are usually normal in the uncomplicated ganglion cyst. A ganglion cyst in the fingers are sometimes called mucous cysts and can be associated with arthritis. MRI is occasionally useful to localize small, suspected ganglions.

What are the symptoms?

The lump itself is the usual reason a ganglion cyst is noticed. There is typically no pain at rest, but the cyst may be tender with activity. Occasionally, numbness or tingling is associated with ganglions, especially with the larger ones. Common locations include the wrist or in the fingers.

What are the treatments?

Ganglion cyst treatment can begin with observation and possibly splinting. Alternatively some can be drained with a needle. The ones in the fingers tend to recur after drainage; therefore, surgery is the standard treatment of a ganglion or mucous  cyst, in the fingers. Ganglions in the hand or finger are removed in the office under a local anesthetic. This is not only less costly than surgery in the hospital or operating room, but is equally effective and safe. Wrist ganglions are removed in the operating room in either the hospital or outpatient surgery center.

What are the results of surgery?

After surgery for ganglions in the fingers or hand, a bandage is worn for a week until it is time to remove the sutures.  With ganglions in the wrist, a brace is worn postoperatively for 3-4 weeks, and lifting restrictions will be required.  A short course of occupational therapy is sometimes recommended to hasten recovery of flexibility and strength following surgical treatment. Return to work or other activities is usually shortly after surgery, but depends on the physical requirements of your job or activities. Full use of the hand/wrist should be regained within 4-6 weeks after surgery. After ganglion surgery, more than 90% are satisfied, with a less than 5% recurrence of ganglion cyst or mucous cyst.