Ganglion cysts are fluid filled lumps that typically appear near tendons or joints. The cysts commonly occur in the back of the wrist but may also develop in the back of the finger or at the base of the finger on the palm side.
Ganglion cysts are common and can grow out of tissue structures around joints. A ganglion cyst is often described as a ‘balloon on a stalk’ which is attached to a joint or tendon sheath. The balloon part is filled with clear and thick gel-like fluid, similar to the synovial fluid which lubricates your joints. Ganglion cysts can develop quickly and change in size but are often harmless and sometimes may completely disappear over time.
It is not quite known what causes ganglion cysts to form. The formation of the cysts are more prevalent in people between the ages of 15 and 40 years old. It is more common in women than men.
Anyone can develop ganglion cysts but they are more likely to occur in people with the following risk factors:
Larger ganglion cysts may appear as a visible or palpable lump but it’s not unusual for smaller cysts to be hidden deeper under the skin or between joints. Symptoms of a ganglion cyst may be pain, tingling and muscle weakness due to pressure from the cyst on surrounding structures.
A common area for ganglion cysts is the middle backside of the wrist, which may become painful when bending the wrist to the end point forwards or backwards.
Diagnosing a Ganglion Cyst
A diagnosis can be established based on appearance and location of the observable larger cysts. Your hand therapist or doctor may use a light to shine through the cysts (transillumination) to assist with the diagnosis.
Your therapist or doctor may recommend imaging tests such as ultrasound to observe for uniform dark appearances of the fluid in the cyst, which may assist with the diagnosis. Ganglion cysts are also visible on magnetic resonance imaging (MRI). X-rays will not show a ganglion cyst, but they may be useful in providing evidence of problems in adjacent joints, including arthritis and joint instabilities.
Many ganglion cysts can often appear, change size and disappear on their own without requiring treatment. If the ganglion cyst is painful, impacts the function of the upper limb, or has a bothersome appearance, there are different treatment options available.
Initial treatment of a ganglion cyst is non-surgical. Repetitive and heavy activity often aggravates the ganglion which may increase pain symptoms due to pressure on surrounding nerves. A hand therapist can make an orthosis or provide you with a brace to immobilise the affected joints to relieve symptoms. As your pain symptoms decrease, your therapist will prescribe a tailored exercise program to improve the movement, strength and function of your hand or wrist.
In some instances, an aspiration may be recommended if the size of the ganglion cyst causes significant pain or limitations on your daily activities. Aspiration is a procedure performed by a surgeon which involves puncturing the cyst with a needle and draining the fluid. Aspiration does not remove the root or stalk of the cyst. In many cases, the ganglion cyst returns after the procedure.
If symptoms are not resolved by non-surgical options, surgery may be recommended to remove the root of the cyst. This procedure is called an excision and involves the joint capsule or tendon sheath. Common symptoms after the procedure include mild discomfort, tenderness and swelling. Your surgeon will typically refer you to a hand therapist after the excision to support your recovery and return to regular activities.
There’s no known way to prevent a ganglion cyst. If you’re prone to developing these types of cysts, even with treatment, they can reoccur.
If a ganglion cyst returns and becomes bothersome, talk with a doctor or medical professional about the next steps to treat it or remove it.
The initial treatment of a ganglion cyst is non-surgical. If your ganglion cyst becomes symptomatic, consult with our therapists at Melbourne Hand Therapy today. Our hand therapists will be able to assess you and provide advice regarding the best treatment options. Melbourne Hand Therapy has strong professional relationships with excellent surgeons who can be consulted if surgical intervention is required.
The sooner you undertake treatment, the sooner you can return to your activities without symptoms. Book an appointment to see a Melbourne Hand Therapist today!