Ganglion Cyst: Hand

Ganglion Cyst: Hand

A ganglion cyst is a firm, fluid-filled lump that can suddenly appear on the front or back of the wrist or at the base of a finger. They are the most common type of mass or lump on the hand. These cysts grow from normal tissue in the wrist and fingers. They range in size from a pea to a peach pit. Ganglion cysts are common. But they don’t spread, and they don’t become cancer. They can occur after an injury. But many times it isn’t known why they grow. Ganglion cysts can change in size, and may go away on their own.

Back view of hand showing dotted line around ganglion cyst on wrist.

What are the symptoms of a ganglion cyst?

A ganglion cyst is sometimes painful, especially when it first occurs. Constantly using your hand or wrist can make the cyst enlarge and hurt more. Some hand and wrist movements, such as grasping things, may also be difficult.

How does a ganglion cyst develop?

Your wrist and hand are made up of many small bones that meet at joints. Tendons attach muscles to the bones at the joints. The tendons allow the joints to bend and straighten. Both tendons and joints are lined with tissue called synovium. This tissue makes a thick fluid that keeps the joints and tendons moving easily. Sometimes the tissue balloons out from the joint or tendons and forms a cyst. As the cyst fills with fluid and grows, it appears as a lump you can feel.

Where do ganglion cysts occur?

A ganglion cyst can occur anywhere on the hand near a joint. Cysts most commonly appear on the back or palm side of the wrist, or on the palm at the base of a finger. Your healthcare provider can usually diagnose a cyst by examining the lump. They may draw off a little fluid and order an X-ray to rule out other problems.

How is a ganglion cyst treated?

Your healthcare provider may just watch your ganglion cyst. Many shrink and become painless without treatment. Some go away altogether. If the cyst is unsightly or painful, or makes it hard for you to use your hand, your healthcare provider can treat it. Or, if needed, it may be removed surgically.

Nonsurgical treatment

To shrink the cyst, your provider may remove (aspirate) the fluid with a needle. If the cyst hurts, your provider may also give you an injection of an anti-inflammatory medicine, such as cortisone, to ease the irritation. Your hand may then be wrapped to help keep the cyst from recurring.

Surgery

If the cyst comes back after treatment, your surgeon may remove it surgically. A part of the tissue that lines the joint or tendon is removed along with the cyst. This helps prevent another cyst from forming. But it's still possible for the cyst to come back after surgery. Usually, only your hand or arm is numbed, and you can go home a few hours after surgery. Your hand may be in a splint for several days. You can usually go back to your normal activities 2 to 4 weeks after surgery.

Ganglion Cyst: Foot

Ganglion Cyst: Foot

A ganglion cyst is a fluid-filled swelling of the lining of a joint or tendon. Ganglions can form on any part of the foot. But they most often appear on the ankle or top of the foot. Ganglions tend to change in size and often grow slowly.

Side view of bones of lower leg and foot showing ganglion cyst.

Causes

Repeated irritation can weaken the lining of a joint or tendon. This can lead to ganglions. Bony outgrowths (bone spurs) and arthritis may also cause ganglions by irritating the joints and tendons.

Symptoms

Ganglion cysts often form with no symptoms. But the ganglion may put pressure on the nerves and the overlying skin. This can cause tingling, numbness, or pain. Ganglions sometimes swell. Their size can change with different activities or a change in weather.

How are they diagnosed?

Ganglion cysts are sometimes mistaken for tumors. So it’s important to have a complete exam done. Tests may be done to confirm the diagnosis.

Health history

Your healthcare provider will ask you questions. These include how long you’ve had the ganglion and what kind of symptoms you’re feeling. They may ask if it’s changed in size or if its size varies based on your activities.

Physical exam

Your healthcare provider may do a translumination exam. This involves shining a light through the swelling. You can often see through a ganglion, but not through a tumor. When your foot is pressed (palpated), a ganglion feels spongy and the fluid moves from side to side.

Tests

If a bone spur or arthritis is suspected, X-rays may be needed. Fluid removal (needle aspiration) may be done. It also helps to decrease pain. To confirm a ganglion, MRI may be done. This reveals images of soft tissue and bone. Sometimes, special dyes may be injected into the area to show the outline.

How are ganglions treated?

Ganglion cysts may be hard to treat without surgery. But nonsurgical methods may be helpful in relieving some of your symptoms.

Nonsurgical care

  • Pads placed around the ganglion can ease pressure and friction.

  • Fluid removal may also relieve symptoms. This is done with a needle. A steroid may be injected at the same time. But ganglions may come back.

  • Limiting movements or activities that increase pain may bring relief.

  • Icing the ganglion for 15 to 20 minutes may relieve inflammation and pain for a short time.

  • If inflammation is severe, your healthcare provider may treat your symptoms with medicine.

Surgical treatment

Surgery may be needed if a ganglion is causing ongoing or severe pain. The entire ganglion wall is removed during the procedure. Some nearby tissue may also be removed.

After surgery

You may feel pain, swelling, numbness, or tingling for several weeks following surgery. You should be able to walk soon afterward. But your foot may need to be wrapped or in a cast, boot, or hard shoe. See your healthcare provider if you notice any future problems. Surgery is often successful. But there is a chance that the ganglion will come back.