Ganglion Cysts – Wrist/Hand Lumps and Bumps

The wrist is a complex structure with multiple joints involving bones from both the hand and forearm. These bones are connected by ligaments lined with a synovial membrane, which secretes a lubricating synovial fluid for smooth movement. Ganglion cysts form from fluid-filled pockets that develop around these ligaments or between the bones. Often appearing as firm, spongy sacs, these cysts can vary in size and generally appear on the back of the wrist, though they can also occur on the palm or lower extremities like the ankle or knee.

While more common among women, the exact cause of ganglion cysts remains unknown. One theory suggests that joint trauma or stress can lead to cyst formation, especially in activities that put strain on the wrist, such as gymnastics or meat cutting. Another theory indicates that structural weaknesses in the joint tissues may allow synovial fluid to collect, creating a bulge as it accumulates.

Ganglion cysts can be as small as a pea or as large as an inch in diameter. Many are painless, but larger cysts may cause continuous discomfort, particularly with movement. Some people may experience tingling, pain, or numbness if the cyst presses against a nerve.

A ganglion cyst diagnosis is generally straightforward. A physician examines the cyst and assesses its tenderness. To confirm the diagnosis, needle aspiration may be performed to extract and analyze the fluid. Additional imaging, like ultrasounds or MRIs, can provide detailed views of the cyst and surrounding tissue, helping to identify any blood vessels or arteries involved.

Many ganglion cysts require no treatment and may resolve on their own. A wrist splint can help relieve pain, especially with activity. If needed, needle aspiration can remove cyst fluid, with anti-inflammatory medication injected afterward to reduce swelling. This procedure is often successful but may need to be repeated in some cases.

For cases where the cyst causes pain, numbness, or limits movement, outpatient surgery may be advised. Patients can also opt for cyst removal for aesthetic reasons. During surgery, the area is numbed, the cyst is removed, and a wrist splint is typically worn afterward. Occupational therapy may be recommended to regain wrist mobility and strength.