Wrist Ganglions

What are wrist ganglions?

Wrist ganglions are non-cancerous lumps also known as bible cysts that mainly appear on the back of the hand at the wrist joint, but occasionally appear on the palm side of the wrist.

They are frequently oval or round, filled with a clear, jellylike fluid. Small ganglion cysts can be the size of a pea and large ones can measure to an inch in diameter. Sometimes, cysts can be so small, they can’t be felt, and size of cysts can change getting larger when you use the joint in a repetitive motion.

Ganglion cysts are usually painless, but if a cyst presses on a nerve (even if the cyst is too small to feel), they can still cause pain, numbness, tingling or muscle weakness.

They can develop in less common areas including:

The base of the fingers on the palm
The fingertip just below the cuticle

There are two types of ganglion cysts:

Dorsal wrist ganglion cyst: cyst on top of the wrist
Volar wrist ganglion cyst: cyst on the palm side of the wrist

The cause of ganglion cysts is unknown, and they appear and can also disappear on their own. Excessive use of the affected joint, can cause the cyst to grow.

Risk factors

Ganglion cysts can occur in anyone but are most predominantly seen in women between the ages of 20-40.

People who suffer from osteoarthritis in the finger joints closest to their fingernails are at increased risk of developing cysts near those joints.

Joints of tendons that have suffered an injury in the past also have an increased risk of developing ganglion cysts.

Treatment

There are two options to treat wrist ganglions:

Draining fluid out of the cyst using a needle and a syringe in a process called aspiration
Removing the cyst surgically

Aspiration

Aspiration is the first treatment option for wrist ganglions as it is less invasive than surgery. It can usually be carried out in the outpatient department so you will be able to leave the hospital afterwards.

Your doctor will use a needle and syringe to extract as much fluid as possible from the ganglion.

Sometimes steroid medication is injected into the ganglion to help prevent re-occurrence, although there is no current evidence to suggest that this reduces the risk of it returning.

Approximately half of all ganglion cysts return after aspiration treatment, and in this case, your doctor will assess whether surgery is recommended.

Surgery

There are two different types of techniques used in surgery to remove a ganglion:

Open surgery – this is where your surgeon makes a cut about 5 cm in width over the site of the affected joint or tendon.

Keyhole surgery – is also known as arthroscopic surgery where small incisions are made and a tiny camera called an arthroscope is inserted into the joint so your surgeon can see inside the joint using instruments that pass through the cuts and then remove the cyst.

Both techniques can be performed under local anaesthetic where you will be awake during surgery, and only the area where the ganglion is will be numbed, so you will not feel anything.

Depending on where the ganglion cyst is affecting the joint or tendon, your surgeon may decide general anaesthetic where you will be asleep for the duration of the procedure, is the best option for you.

Your recovery

Your surgeon will stitch the wound and put a dressing in place, this helps to keep it clean and reduce the risk of infection.

You shouldn’t experience any pain with your wound, but if you do feel some discomfort, you will be given painkillers after the operation to help make you more comfortable.

Your surgeon may require you to wear a sling for a few days after your procedure to keep the hand and wrist immobilised to reduce the risk of swelling and discomfort and against any accidental knocks. To help keep the joints flexible, move your hand and fingers frequently.

You may experience some bruising around the wound after the operation, but this should clear up after a few days.

Complete recovery after having a wrist ganglion removed is between 2-8 weeks. During this time, limit the use of the affected joint and avoid any activities that may irritate your wound. Ice packs can help alleviate discomfort, but you must wear a splint for a week after surgery to limit movement and take the stress off the joint to aid healing.

Whatever your hand or wrist condition is, we can help.

Mr Randeep Mohil provides clinics across Lancashire and Cheshire.

Please call us on 01625 466158 or email info@northwesthandsurgeon.co.uk

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Lancashire Clinics

The Beardwood Hospital, Blackburn
Clinic days: Monday evenings (alternate) and Thursday mornings
Website: The Beardwood Hospital
Ramsay Fulwood Hospital, Preston
Clinic days: Monday and Tuesday evenings (alternate)
Website: Ramsay Fulwood Hall

Ramsay Euxton Hall Hospital, Chorley Clinic days: Tuesday evenings (alternate) Website:Ramsay Euxton Hall

Cheshire Clinic, Northwich Clinic days: Friday morning (alternate) Website: The Cheshire Clinic

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Wrist Ganglions

What are wrist ganglions?

Risk factors

Treatment

Aspiration

Surgery

Your recovery

Whatever your hand or wrist condition is, we can help.

Get in touch