Ganglion Cyst

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A ganglion cyst is a fluid-filled sac that usually forms close to the joints and tendons of the hand. This article explains how they can be identified and the various treatment options.

Contact the expert hand and wrist specialists at JIS Orthopedics for advice on how to treat ganglion cysts and many other orthopedic conditions. You can find us in New Albany and St. Clairsville, Ohio.

What Are Ganglion Cysts?

Ganglion cysts are formations of mass or a lump in the hand. They are usually harmless and are not cancerous.

A ganglion cyst emerges from within a joint, resembling a balloon attached to a stem. Its growth starts from the tissues surrounding a joint, including ligaments, tendon sheaths, and joint linings. This balloon-like mass contains a dense, lubricating fluid inside, similar to the substance found in your joints.

Ganglion cysts most often occur on the back of the wrist but can develop in several of the joints of the hand and wrist. You can develop a ganglion cyst in the following areas:

Either the top or underside of your wrist
The base of your finger
The end joint of your finger
Near your fingernail (also called mucous cysts)

What Causes a Ganglion Cyst?

The specific cause of ganglion cysts is unknown. However, the cysts may form in the presence of joint or tendon irritation, arthritis, mechanical changes, or injury. They are also found in the following situations:

Most common in younger people between the ages of 15 and 40.
Women are more likely to be affected than men.
They are common among gymnasts who repeatedly apply stress to the wrist.
Ganglion cysts that develop at the end joint on the nail side of a finger (also called mucous cysts) are typically associated with arthritis in the finger joint and are more common in women between the ages of 40 and 70.

What Are the Signs and Symptoms of a Ganglion Cyst?

The most obvious sign of a ganglion is a visible lump; however, some smaller ones can be hidden under the skin (occult ganglions). You may have other symptoms associated with a ganglion if the cyst is pressing against the nerves of the joint. In this case, you may experience a tingling sensation, pain, or even muscle weakness.

How is a Ganglion Cyst Diagnosed?

A ganglion cyst is diagnosed by considering medical history, physical examination, and imaging tests.

Medical History and Physical Examination

Your doctor will want to know how long the cyst has been present, the changes in size, and assess the amount of pain that it’s causing. The doctor will also test to ensure the cyst is not a tumor. Cysts tend to be translucent.

Imaging Testing

Your doctor may recommend the following imaging tests:

X-rays: These rule out other conditions like hand or wrist arthritis or bone tumors.
Magnetic resonance imaging (MRI) scans or ultrasounds: These tests allow doctors to see soft tissues, including ganglion cysts. These may be used to identify occult ganglions or distinguish cysts from other tumors.

How to Treat a Ganglion Cyst

Many ganglion cysts do not require treatment. However, if the cyst hurts, if it affects function, or if you are unhappy with how it looks, there are several treatment options available. If you have a large cyst that’s not painful, you may want to remove it for aesthetic reasons.

Non-Surgical Treatment

Some non-surgical treatment options include the following:

Observation: Your doctor may recommend a watchful waiting approach if you experience no pain or significant symptoms. Ganglion cysts are typically non-cancerous and may resolve on their own.
Immobilization: To relieve symptoms and reduce the cyst’s size, a wrist brace or splint may be used. This is because activity usually encourages the cyst’s growth. As the pain subsides, your doctor may prescribe wrist-strengthening exercises.
Aspiration: In cases where you experience intense pain or significant functional limitations, fluid drainage (aspiration) may be performed. However, aspiration often fails to provide a lasting solution, as it doesn’t remove the root or connection to the joint or tendon sheath. Often, the ganglion cyst returns.

Surgical Treatment

If your symptoms persist or if the ganglion returns after aspiration, your doctor may recommend surgery, known as an excision. Surgery involves removing the cyst and addressing the stem from which it arises.

Removing a portion of the joint capsule or tendon sheath is sometimes necessary to ensure complete root removal. Even after excision, there’s a slight possibility of the ganglion returning.

Recovery After Surgery

You will usually go home on the same day after excision surgery. You may experience some post-operative tenderness, discomfort, and swelling. Most individuals can resume normal activities within 2 to 6 weeks following the procedure.

Book a Visit with a Specialist Today

If you have any concerns about a ganglion cyst, its symptoms, or potential treatments, please don’t hesitate to contact us at JIS Orthopedics. We have locations in New Albany and St. Clairsville, OH, and are here to assist you in understanding and managing this condition.

Don’t let discomfort or uncertainty hold you back from seeking help. Your well-being is our top priority, and we’re here to support you every step of the way.

Medically reviewed by AJ Julka, MD