A ganglion is a noncancerous tumor or swelling on the top of a joint due to fluid leaking out of the joint. The size of the cyst can vary over time and can be found anywhere on the hand but are most commonly located on top of the hand by the thumb or on the thumb side of the wrist. Although not dangerous to a person’s health, the growth needs to be checked out by a doctor because it could be: lipoma or a giant cell tumor, an infection, a bone spur, or the symptom of another condition. Due to the fact that ganglion cysts rarely go away on their own treatment is recommended. There are many methods to treat the cyst, both surgically and non-surgically. The most common nonsurgical way to rid the hand of the cyst is to smash the wrist ganglion cyst with a hard object like a book. This bursts the sac releasing the fluid. Another option is a surgical treatment in which doctors make an incision directly over the swelling and the cyst is carefully removed. The ganglion cyst is a sac filled with fluid that comes from the tendon sheath or joint capsule forming a lump under the skin. Although they are the most common in the wrist, they may also form on the foot.
There is no known cause for why a ganglion cyst develops but they are common among gymnasts who repeatedly apply stress to the wrist. The cyst is made up of a clear, thick, fluid that is found in the joint. They may arise because micro-trauma from a single event.
The most common symptom is a swelling over an area of the joint that grows with time. Because the cyst forms over the joint, the sac can put pressure on the nerves which can cause pain. Other symptoms include:
- A noticeable, soft bump that does not move over the joint area.
- A sense of weakness in the affected area.
- Tingling or burning sensation if the cyst touches a nerve.
- Pain or aching if the cyst is pressing against a tendon or joint.
Ganglion Treatment Options
To start, your orthopedist will use conservative, nonsurgical treatment, which leaves the shell and stalk intact, meaning it may reform and reappear. Nonsurgical therapy may include:
- Observation - Ganglion cysts are not malignant and may disappear on their own, and simple monitoring can determine whether anything usual has grown.
- Immobilization - Physical activity can make the cyst grow as pressure is placed on the nerves. A brace or splint can help relieve pain and other symptoms.
- Physical therapy - A hand therapist can help you regain strength in the wrist and improve range of motion.
- Aspiration - The fluid can be drained from the cyst if it causes pain and limits activities. The cyst is numbed and then punctured with a needle to drain it.
Surgical treatment can remove the ganglion cyst. This outpatient procedure includes removing part of the joint capsule or tendon sheath which is involved. Sometimes patients opt for surgical removal for the following reasons:
- Persistent pain.
- The cyst interferes with range of motion or everyday activities.
- Numbness or changes in sensation.
- Unsightly appearance.
- Damage to the ligaments or bones of the wrist or fingers.
The procedure involves cleaning the area with antiseptic liquid, then injecting a local anesthetic to numb the area, or a regional anesthetic to numb the upper extremity. A tourniquet is wrapped around the upper arm to decrease blood flow to the hand and wrist, and an incision is made to the site of the ganglion. The surgeon makes sure not to cut any nerves, tendons, ligaments or blood vessels as the ganglion sac and connective tissues are manipulated. Once the sac is removed, the incision is stitched closed and bandaged. Some patients will need to wear a splint to immobilize the area as it heals, and this will usually be removed within 3-5 days after surgery to prevent stiffness.
Risks of Surgical Treatment for Ganglion
Although the sac itself poses no risks other than pain and weakness from the affected area, medical treatment is still suggested. Even if the cyst is removed, there is no guarantee that the treatment will prevent the cyst from returning.
Is swelling and pain from a wrist ganglion causing constant pain? Time to get treatment that works, and lasts! To find out more about the causes and symptoms of wrist ganglion, as well as treatment options, call our West Medical offices at (855) 690-0565.
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