Advice from a Hand Doctor on Ganglion Cysts

Although the large bump might be painless, it’s hard not to notice a ganglion cyst.  Many patients are surprised to learn that ganglion cysts are actually tumors.  When these unattractive lumps appear, people sometimes wonder exactly what to do about them.  Although the growths often disappear on their own, some require treatment by a hand doctor.

Important Facts About Ganglion Cysts

A ganglion cyst most frequently appears on the back side of the wrist, according to Medscape.  Fortunately, about 95 percent of hand tumors are benign.  Of these, approximately 60 percent are ganglion cysts.

The American Academy of Orthopaedic Surgeons notes that these fluid-filled cysts are the most common lump that develops in a hand.  They can quickly appear, disappear, and change in size.

A ganglion emerges from a joint and looks similar to a balloon at the end of a stalk.  It actually grows out of other tissue such as tendon sheaths, joint linings, and ligaments–all types of tissues that surround joints.  Thick fluid inside the cyst resembles that produced by the body to lubricate its joints.

Whether they appear on the wrist, a hand joint, or at the end of a finger, most ganglion cysts shrink after rest.  With activity of the wrist, most enlarge.

Researchers have yet to pinpoint the cause of a ganglion cyst.  These growths most frequently appear in individuals 15 to 40 years old.  Women are more at risk than men are.  The cysts are particularly common in gymnasts.  Hand doctors associate those that appear at a finger’s end joint with arthritis.

Treatment Options from a Hand Doctor

If a cyst presses on nerves running through a joint, pain, muscle weakness, and tingling could develop.  When a cyst becomes painful, interferes with body function, or upsets a patient due to its appearance, hand doctors can offer several types of treatment.

Physicians make a diagnosis after taking a medical history and performing a physical exam that includes probing the cyst.  Imaging tests such as X-rays, MRI scans, or ultrasound are sometimes helpful.

Initial treatment is conservative:

  • Watching the cyst for any changes
  • Immobilizing the area with a splint or a wrist brace, sometimes followed by wrist-strengthening exercises
  • Aspirating the cyst to drain fluid

If these steps are not successful, a hand surgeon might recommend excising the cyst, a procedure known as a ganglionectomy.  This surgery requires removal of the cyst along with a portion of the structure that forms the root of the growth.  This is the associated tendon sheath or joint capsule.

Doctors perform this surgery on an outpatient basis.  Most patients regain the full use of their hand and/or wrist within about six weeks.  The Cleveland Clinic reports that while a ganglion cyst might return after treatment, the recurrence rate is only around 5 percent.