Wrist Ganglion Treatment | Thames Shoulder & Elbow

A ganglion is a harmless, fluid-filled cyst. The majority (80%) occur in the wrist, although they can also develop at the base of the finger or on the finger itself where they may appear as a pea-sized swelling. They typically develop between the ages of 20 and 40 and are three times more likely to occur in women than in men.

Symptoms of ganglions

A ganglion is a smooth, round or oval swelling that can become quite large and painful and may even affect the movement in your joint if they are pressing on nearby nerves. They normally develop on the joints of the wrists, or along the tendons. In some cases, there may be no symptoms other than the visible appearance of the cyst, in other cases the ganglion is deeper down on the wrist and can’t be felt on the surface of the skin but is a cause of pain. Ganglions can change in size, growing as you move your joint. They are the most common type of swelling in the wrist and hand and occur at the back or front of the wrist, at the base of the finger where they can cause discomfort when gripping, or on the joint at the end of the finger where they may cause a furrow in the fingernail. As well as pain, you may experience numbness, tingling or weakness in the muscle.

Causes of ganglions

A ganglion develops when the synovial fluid that normally surrounds a joint or tendon leaks out and collects beneath the skin, forming a swelling. The precise cause of the leak may not be known but it could be the result of some kind of trauma or due to underlying arthritis. You may be particularly at risk if you have osteoarthritis in your finger joints or if you damage the wrist joint or tendons of your hand.

Diagnosing a ganglion

To diagnose a ganglion cyst, your doctor will carry out a physical examination and ask about the symptoms and how and when they developed. You will not normally need any kind of diagnostic scan unless the diagnosis is unclear – for example, if the doctor can’t clearly feel the ganglion from the surface of your skin, or is concerned about the possibility of arthritis or a tumour. X-ray, MRI or ultrasound may be used to confirm the diagnosis if this is the case.

Treating a ganglion

Around half of all ganglions clear up on their own without treatment so your doctor will normally recommend a ‘wait and see’ approach in the early stages. You can take painkilling medication to help you manage any pain or discomfort. Your doctor may suggest wearing a splint or brace, as joint movement can cause the ganglion to increase in size. However, splinting can weaken nearby muscles so this is not recommended long-term. We also advise against piercing the skin at home to try and drain the cyst as this can result in an infection.

If you have had the ganglion for several months or you are experiencing significant pain or loss of movement in your wrist, your doctor may recommend draining the cyst with a needle and syringe (called aspiration). If the ganglion is deeper inside and hard to feel from the surface this may be the best course of action, and the aspiration is performed under guidance of ultrasound to be sure that the needle is correctly placed. Afterwards, they may inject a dose of steroid medication to help prevent it from returning. However, the chance of the ganglion coming back after aspiration is relatively high, especially if it was quite large to begin with.

Alternatively, you may have the ganglion surgically removed. Your surgeon will make an incision over the ganglion to remove it away from the skin and other surrounding structures like ligaments and tendons. Depending on the size and location of the ganglion you may be offered either local or general anaesthetic. You may need to wear a sling for a few days after surgery to elevate the hand to minimise swelling, and to protect your arm from accidental knocks.

If you have been diagnosed with a ganglion cyst or are concerned about a swelling on your wrist or fingers, contact us. We can advise on diagnosis and/or treatment options.

Orthopaedic Consultant & Surgeon | London

Thames Shoulder & Elbow are able to provide advice and support to anyone experiencing symptoms affecting the upper limbs (shoulder, upper arm, elbow, forearm and wrist).

Telephone: 020 376 15987

Email: admin@thamesshoulderandelbow.co.uk

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