Description
Ganglion cysts are the most common mass or lump found in the hand. A ganglion cyst is a non-cancerous tumor or swelling that most commonly appears on the back of the wrist but can also be found on the front of the wrist or at the base of a finger. These fluid filled cysts are composed of a clear, thick, colorless, jelly-like substance. The cyst may feel firm or spongy to the touch. Often, this is dependent on its size. They do not spread but they may appear, disappear and change size quickly. One large cyst or several smaller ones may appear.Treatment is usually not needed for ganglion cysts, but if the cyst is painful, interferes with hand or wrist function or is cosmetically unappealing, there are treatment options available.
Symptoms
- Visible lump that appears along the ligaments and tendons of the hand or wrist
- Pain, tingling and muscle weakness can develop from a ganglion cyst that is putting pressure on a nerve
Causes
- It is not known what triggers the formation of a ganglion.
- Often occur after an injury
- Arthritis
Risk Factors
- Women
- Individuals 20-40 years of age
- Gymnasts who repeatedly apply stress to the wrist
- Previous injury
- Osteoarthritis
Prevention
- Avoid repetitive stress to the wrist
Diagnosis
- Your doctor will discuss your current symptoms, review your medical history and perform a physical examination of your hand and fingers.
- X-rays: Used to rule out other conditions, such as arthritis or a bone tumor.
- Magnetic resonance imaging (MRI) scans or ultrasounds may be ordered to identify additional cysts that are not easily visible.
Treatment
There are surgical and non-surgical treatment options.
The initial treatment for ganglion cysts is non-operative. However, if the ganglion is still present or symptoms are not relieved from non-operative treatment methods, the cyst may need to be removed surgically. This procedure is called an excision. Even after surgical excision of the ganglion, there is a chance that the cyst could return.
Non-operative Ganglion Cyst treatment
Initial treatment is non-surgical.
Since many ganglion cysts shrink and become painless without any treatment, a physician may just want to observe its progress. If, however, the cyst is deemed unsightly, becomes painful, or makes it difficult for one to use the hand, a doctor may decide to treat it, or if necessary, remove it surgically.
- Non-steroidal anti-inflammatories (NSAIDs)- Pain relief
- Anti-inflammatory injection, such as cortisone, to help alleviate the irritation.
- Aspiration-In order to shrink the cyst, a doctor may simply remove the fluid with a needle.
- Non-steroidal anti-inflammatories (NSAIDs)- Pain relief
- Anti-inflammatory injection, such as cortisone, to help alleviate the irritation.
- Immobilization- A wrist brace or splint may be recommended to rest the wrist and decrease pressure on the nerves. This may relieve symptoms and cause the ganglion to shrink.
- Physical therapy- As your symptoms improve, exercises may be recommended to improve your range of motion and strength.
Goal
- Reduce the patient’s symptoms and provide better quality of life
Benefits
- Minimally invasive treatment options
Recovery
- Patients that have the cyst aspirated may experience immediate pain relief
Complications
- Recurrence of cyst after aspiration
Outcomes
- Even after aspiration of the ganglion, the ganglion could return.
