Ganglion Cyst of the Hand

Do you have an abnormal lump on your hand? You may have a ganglion cyst. Ganglion cysts are noncancerous lumps that often occur along the tendons or joints.

Ganglion cysts can cause pain or may be unsightly. If the ganglion cyst is causing problems and does not disappear over time, your doctor may provide you with a brace, drain the cyst or surgically remove the cyst.

A ganglion cyst is a noncancerous lump that typically occurs adjacent to the tendons and joints in the hand. Small ganglion cysts can be pea-sized and large ones can be about an inch in diameter. The cyst may grow larger with wrist activity or smaller with rest.

Symptoms of a Ganglion Cyst

While most ganglion cysts appear small and are painless, symptoms can include:

  • Pain
  • Localized lump or swelling
  • Tenderness when pressure is applied
  • Immobility as a result of the location of the cyst

A ganglion cyst rises out of a joint and is filled with a thick, gelatinous fluid similar to the fluid that lubricates the joints. They can develop both on the top and underside of a wrist, the end joint of a finger and at the base of a finger.

While doctors can’t verify why ganglion cysts occur, most theories suggest they arise within the connective tissue and are caused by repetitive trauma. They occur most often in women ages 15 to 40.

What Treatments Exist for a Ganglion Cyst?

Most ganglion cysts are painless and don’t require treatment. Oftentimes, a board-certified hand specialist will monitor a ganglion cyst before suggesting a treatment option.

Nonsurgical treatment options

If the ganglion cyst is causing pain, your hand specialist may immobilize your wrist. They will give you a brace or splint to wear because activity can make the cyst get larger. As the cyst shrinks, it may release pressure on the nerves and relieve the pain.

Sometimes, a board-certified hand specialist will recommend aspiration, using a needle to drain the cyst. With aspiration, the area around the cyst is numbed and the cyst is punctured with a needle so that it can be drained. The doctor may inject a steroid into the cyst after it is drained to decrease the chances of the cyst occurring.

Surgical treatment options

If nonsurgical treatments fail, a doctor may suggest surgery. During the surgery, the doctor will make a small incision in order to remove the cyst. Surgery can usually be completed in about 20 minutes. Arthroscopic treatment options are available for cysts in the wrist joint.

After an examination and a review of your past medical history your spine surgeon or his physician assistant will order x-rays to determine the cause of your pain. An MRI of your spine may also be ordered to determine if there is nerve compression and determine more accurately which level within your spinal column is affected. In some cases your spine surgeon may order a nerve study called an electromyography (EMG). This tests the specific nerves to determine which nerves are being affected. After diagnostic testing is completed your physician will determine your treatment plan.

What to Expect After a Ganglion Cyst Removal Surgery

A patient will likely be able to go home the same day they have ganglion cyst removal surgery. The site of surgery may be tender, discomfortable and swollen. Patients typically return to normal activities without pain two to six weeks following surgery.

After ganglion cyst removal surgery, patients most often report complete relief from any pain or discomfort. Rarely, the cyst will recur after surgery.

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