“Hit it with a dictionary….that’s what grandma said.” Your first encounters with ganglion cysts may have gone something like that. Ganglion cysts are the most common non-cancerous soft tissue tumors of the wrist and hand. About 60-70% of ganglion cysts occur on the back or dorsum of the wrist and may cause some discomfort when compressed during certain sports or while wearing tight bracelets or watches. They are more common in women although we are not sure why. It is thought they are caused by an injury to the synovium, a protective lining of the wrist joint or to the articular cartilage between the bones. Whatever the exact cause, once things are injured, a thick “viscous” jelly-like substance builds up in the joint region and fills up a surrounding sac-like pouch. Over time this increases in size until it becomes an annoyance.
Other types of cysts including bone cysts and rare cancerous growths can also occur at the wrist but they are remarkably uncommon compared to the ganglion cyst. Once a ganglion has been appropriately diagnosed by your healthcare provider, then you can focus on what you want to do about it. The options range anywhere from do nothing to having it removed by surgery and everything in between. Since it is not dangerous to have a ganglion, we initially focus more on function and any pain associated with the cyst, rather then on “getting rid of it” right away. Often the ganglion will resolve on its own over time and be re-absorbed. We initially treat any irritation with ice, activity modification and medications where appropriate. In a majority of cases this is sufficient to make the cyst painless. During racquet sports we may use taping to support the wrist and reduce irritation. If the ganglion is too bothersome either due to cosmetic appearance or pain, we will drain it with a syringe; however, the rates of re-accumulation are from 50-70%, so it is not our first route of treatment.
To learn more about ganglion cysts or to schedule a consultation, contact us.