Often people develop a lump on the wrist or hand and wonder if it is something to be scared about. Do not worry, these lumps are most likely ganglion cysts. They might be painful, but they are benign and harmless. Some cysts might press on a nerve and cause pain, while others may interfere with joint movement. In such cases, the cyst needs to be drained or excised surgically.
Ganglion cysts are small, pea-sized, fluid-filled cysts which develop over joints and tendons. These are most common in the back of the wrist, and less common in the knee, ankles, fingertips, and base of the fingers in the palm.
Size of the cyst: Ganglion cysts are variable in size. They could be as small as a pea or as big as a golf ball. Repetitive movement of the affected joint or tendon may make the cyst larger. Sometimes, the cyst may become smaller or even go away by itself.
Lump characteristics: These cysts are round or oval, soft, and immobile.
Pain: These cysts are usually painless. However, they may press on a nerve and cause pain. Repetitive movement of the joint or tendon, where the cyst has developed, can also make the cyst painful and tender.
Muscle weakness: If the cyst develops on a tendon, it may affect the movement of the finger to which the tendon is attached.
Tingling sensation: If the cyst presses upon a nerve, it may cause tingling numbness.
The exact cause of ganglion cyst is unclear. However, some theories have been proposed to explain its development:
* It could be a blister formed due to injury or repetitive trauma of tendon or joint tissues.
* It may form due to leakage of synovial fluid from a joint.
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* It may form due to a defect in the tendon sheath or joint capsule which causes the tissue to protrude.
Physical examination: Usually, a physical exam is sufficient to diagnose ganglion cysts, Your doctor may also press the lump to check if it is tender.
Ultrasound: This can help detect if the cyst is fluid-filled or a solid mass. It can also help to determine if a defect in a blood vessel is causing the lump.
Other imaging tests: X- rays and MRI can help determine conditions such as arthritis or tumors.
A ganglion cyst doesn’t need to be treated, if it doesn’t cause symptoms such as pain, weakness, or tingling numbness. Your doctor may ask you to keep a watch on the cyst at home and consult if you develop any symptoms. Most ganglion cysts resolve by itself.
If the ganglion cyst is causing discomfort, your doctor may recommend these:
Aspiration of the cyst: In this procedure, the fluid from the cyst is drained using a syringe. However, the underlying structure of the cyst remains intact, thus, there is high chance of recurrence.
Surgery: When aspiration doesn’t help and the cyst causes severe symptoms, your doctor may suggest surgical removal. Surgery involves excising the cyst and the area around it which is attached to the joint.
Age and sex: Ganglion cysts are more common in women, and usually occur between 20-40 years.
Arthritis: People having arthritis of the small joints of the hand are more likely to develop ganglion cysts.
History of joint or tendon injuries: People who have had joint or tendon injuries in the past are likely to develop ganglion cysts.
Ganglion cysts are harmless, benign cysts and mostly resolve by themselves. You need not worry if you have developed it. However, if you have symptoms such as pain, weakness, or tingling, it is best to consult your doctor.
Usually, ganglion cysts do not require treatment. However, doctors do ask patients to keep a check on the cyst. If the cyst is left untreated, repetitive movement of the affected tendon or joint may increase the size of the cyst, causing more pain or rupture of the cyst.
Yes, in 30-50 percent of the cases, ganglion cysts disappear without any treatment, which may recur after some time. There are chances that the ganglion cysts recur after treatment too. Recurrence is less likely if the cyst has been surgically removed.
Massage may not be helpful in removing ganglion cysts completely, but some massage therapists do claim that massaging helps to shrink the ganglion cysts. However, before attempting any such treatment, please consult your doctor.