How Do Ganglion Cysts Form?


Though benign, ganglion cysts can be painful and limit your wrist’s mobility. If painful, you might want to consider treatment options.

Ganglion cysts are small sacs filled with a jelly-like substance that most often appear on the back of the wrist. Typically, these cysts don’t cause pain and dissolve on their own. However, if the nodule bumps up against a nerve or interferes with the joint’s mobility, you may want to seek treatment.

These benign cysts form within the tendon sheath — the connective tissue between muscle and bone — eventually ballooning into a mass that may grow up 2.5 centimeters in diameter. Because ganglion cysts develop from a tendon, they’re filled with the same thick fluid that smoothes the joints.

No cause for ganglion cysts has yet been determined, although it’s believed that damage to the joint capsule or tendon sheath forces the joint tissue to protrude in a pronounced nodule. The condition is common among people aged 15 to 40, and it affects more women than men. Older people suffering from arthritis may see ganglion cysts surface at the end of the finger.

Without a definitive cause, you can’t prevent a ganglion cyst from forming. If you think you have a ganglion cyst or if the bump is painful, limits your mobility, or causes a tingling sensation, a hand specialist can recommend one of several therapies.

Treating a Ganglion Cyst

Your doctor may perform a series of tests to detect a ganglion cyst, beginning with applying pressure on the sac to assess whether it’s causing you significant discomfort. A light beamed at the cyst will determine if it’s fluid-filled or a solid mass. An X-ray, ultrasound, or MRI may also be used to check if it’s a ganglion cyst or another condition, such as arthritis or a tumor.

In the majority of cases, ganglion cysts don’t require treatment if the bump isn’t causing severe pain or you can still freely move your wrist. In time, the cyst may disappear, so your doctor will simply observe the cyst to monitor its growth. If you decide to have it treated, you’re likely undergo one of three procedures:

  • Immobilization: Putting on a brace or splint immobilizes the joint, which reduces the possibility of the cyst irritating a nearby nerve with repetitive movements. This treatment is only temporary and should last only until the cyst shrinks in size. Wearing the splint for too long may weaken the surrounding muscles.
  • Aspiration: In this procedure, a needle is inserted into the cyst and the fluid is drained out. Ganglion cysts at the top of the wrist are usually treated by aspiration. However, after aspiration, the cyst may recur because the tendon sheath where the cyst grew is still intact.
  • Surgery. After other methods have failed to eliminate the cyst, your doctor may suggest surgery. Known as an excision, surgery for a ganglion cyst removes both the sac and the tendon sheath to which it’s attached. After the swelling and pain from the surgery subsides, you’ll regain full use of your hand within two to six weeks. There is a slight chance of recurrence even after surgery. Depending upon the severity of the cyst, you may need physical therapy.

At-home treatments for painful ganglion cysts include taking over-the-counter pain medication and covering the bump with a warm compress. Do not try to drain, or “pop,” the cyst yourself; doing so could lead to an infection. Hitting the bump with a heavy object, like a book, will not make it disappear and could harm your hand.

We’re The Hand Specialists

At the Florida Hand Center, our practice focuses solely on disorders of the hand and wrist, including ganglion cysts. If you think the painful bump on your wrist is a ganglion cyst, we’ll diagnose the condition and plan your treatment program. Contact us today for an appointment.