That mysterious bump that suddenly appeared on the back of your wrist may be concerning, but it’s likely a ganglion cyst. These small, fluid-filled lumps develop under the skin near a joint, most commonly on the wrist or fingers.
Ganglion cysts are not cancerous or harmful, but larger cysts may press on the joint and cause pain or make movement difficult.
A ganglion cyst grows out of the tissues that surround a joint. The balloon-like cyst attaches to a stalk of tissue and can range from very small to the size of a quarter. Ganglion cysts may become larger or smaller, often depending on how you use your hands or wrists. Activity tends to increase cyst size, while rest decreases it.
Ganglion cysts most often form between the ages of 15 and 40 and usually develop on the back of the wrist or the finger. The cause is unknown, but repetitive stress on the joint may play a role.
Most ganglion cysts look like lumps or bumps under the skin and are soft to the touch. Often, this is the only symptom. However, if the cyst presses on the nerves, it may be painful or cause muscle weakness, which can interfere with normal use of the hand or wrist. These cysts can make activities like cooking, working at a computer, driving and playing sports difficult.
“Whether a ganglion cyst requires treatment depends on how it affects you,” says Kalpit Shah, MD, a hand surgeon at Scripps Clinic Jefferson in Oceanside, Scripps Clinic Torrey Pines and Scripps Clinic Encinitas.
“If a cyst causes pain, or hinders the function of the hand or wrist, we’ll want to treat it. In some cases, people are bothered by the way cysts look, even if they aren’t causing problems, and want treatment.”
The first step to getting treatment for a ganglion cyst is making an appointment with your primary care doctor. They will examine the area and may press on the cyst to determine if it is painful. Because ganglion cysts are filled with fluid and tumors are solid, your doctor also may try to shine a light through the mass to help confirm that it is a cyst.
If your cyst is small and becomes larger with activity, your doctor may ask you to perform activities that increase the size to better evaluate it. In some cases, your doctor may order advanced imaging studies, such as an ultrasound or MRI.
Your doctor will likely recommend several non-surgical ganglion cyst treatments to try. If your cyst is not painful and is not causing other symptoms, your doctor may just recommend keeping an eye on it for any changes. Often, ganglion cysts go away on their own over time without any treatment.
Cysts that become irritated or painful with activity may benefit from rest. Your doctor may recommend wearing a brace or splint to rest your wrist or hand and, ideally, shrink the ganglion cyst to relieve painful symptoms. Once you are feeling less pain, you can try exercises at home to strengthen the area and improve range of motion and flexibility.
Acupuncture may help relieve ganglion cysts, possibly by breaking the cyst wall and allowing the fluid to be reabsorbed by the body.
Ganglion cysts that are very painful or severely restrict movement may be drained through a procedure called aspiration. Your doctor will numb the area around the cyst, puncture it with a needle, and remove the fluid.
“Aspiration can provide relief, but because it does not remove the stalk of the ganglion cyst, the cyst will more than likely return,” says Dr. Shah. “If that happens, it may be time to consider excising the cyst and the associated stalk through surgery.”
Surgery for a ganglion cyst removes the base of the stalk and some of the tissue around the joint. It is usually performed under local anesthesia as an outpatient procedure, so patients can go home the same day.
You may have tenderness and swelling after the excision, but strong pain medications are rarely needed. Depending on the type of work you do and how you use your wrist and hand, you may need to take time off to recover. Most people can return to normal activities two to six weeks after surgery.
“Ganglion cyst surgery is usually very effective for cysts that cause symptoms and don’t respond to other treatments,“ says Dr. Shah. “If you have a ganglion cyst that is bothering you, either because it is causing problems or is unsightly, have it evaluated and learn about your treatment options.”