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Wrist Ganglion Cyst

Lumps on the Back of the Hand

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Updated May 16, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

A wrist ganglion cyst is a swelling that usually occurs over the back of the hand or wrist. These are benign, fluid-filled capsules. Ganglion cysts are not cancerous, will not spread, and while they may grow in size, they will not spread to other parts of your body.

Ganglion cysts arise as outpouchings from fluid filled areas such as the fluid within the small joints of the wrist, or fluid within the sheath that surrounds the wrist tendons. When the fluid, called synovial fluid, leaks out from these spaces, it can become a sack-like structure.

The fluid within the ganglion cyst is identical to the normal fluid found within a joint or within a tendon sheath. The fluid is gelatinous, and looks and feels like hair gel.

Lumps and Bumps of the Hand and Wrist

It is important to have this type of lump checked by your doctor to ensure it is simply a ganglion cyst. While most lumps and bumps of the hand and wrist are ganglion cysts (by far the most common), there are other conditions that have different treatments. Other type of tumors such as a lipoma or giant cell tumor, infections, carpal bossing (bone spur), and other conditions can cause lumps around the wrist.

Treatment of a Ganglion Cyst

Sometimes, wrist ganglion cysts go away with no treatment, or they may linger around or even grow larger. The cysts typically form a type of one-way valve such that fluid enters the cyst easily, but cannot escape. When the ganglion cyst becomes large enough, it will begin to put pressure on surrounding structures. This pressure can cause painful symptoms, and is usually the reason these ganglion cysts are removed.

There are several methods of treatment for a wrist ganglion cyst. Putting a needle into the ganglion cyst and aspirating the fluid may work. However, the gelatinous fluid within the cyst does not always come through a needle very well. Furthermore, this treatment leaves the cyst lining behind, and the ganglion cyst will return about 50% of the time.

Another alternative, that some call traditional, others call a bit barbaric, is to smash the wrist ganglion cyst with a hard object such as a book. This pops the cyst, and ruptures the lining of the cyst. While many people are familiar with this treatment, it is not considered acceptable as there is the potential for other damage from the trauma of the treatment.

The treatment for a persistent or painful ganglion cyst is to remove it with a surgical procedure. During surgery, the wrist ganglion is completely excised, including the sac that surrounded the fluid. In addition, the connection to the joint or tendon sheath that supplied the fluid can be occluded. While this usually is effective, a small percentage of removed wrist ganglion will still return.

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