A ganglion cyst is a noncancerous (benign) lump, filled with a thick, jelly-like fluid, that most commonly develops along the tendons or joints of your wrists or hands. They can also appear on your ankles and feet. Imagine a small balloon on a stalk, growing out of the tissues that surround a joint—that’s essentially what a ganglion cyst is.
These cysts can vary in size, from as small as a pea to as large as a golf ball. They can also change in size, sometimes growing larger with increased joint activity and smaller with rest. While they are the most common type of soft tissue growth on the hand and wrist, they are not cancerous and will not spread to other parts of the body.
Many people with ganglion cysts experience no symptoms other than the appearance of the lump. However, if the cyst presses on a nearby nerve, it can cause:
- Pain
- Tingling
- Numbness
- Muscle weakness
Even if a cyst isn’t painful, its appearance can be a source of concern or self-consciousness for many individuals.
Common Symptoms and Causes
Symptoms of a Ganglion Cyst
The most obvious sign of a ganglion cyst is the visible lump. This lump is typically:
- Round or oval in shape
- Soft or firm to the touch
- Stationary, as it is attached to a joint capsule or tendon sheath deep under the skin
The size of the cyst can fluctuate, and it may even disappear completely on its own, only to return later.
What Causes a Ganglion Cyst?
The exact cause of ganglion cysts remains unknown. The leading theory is that they are caused by trauma, either a single event or repetitive micro-trauma, which damages the tissue of a joint capsule or tendon sheath. This damage allows the synovial fluid—the fluid that lubricates your joints—to leak out and collect in a sac, forming the cyst.
Common Risk Factors
While anyone can develop a ganglion cyst, some factors can increase your risk:
- Age and Sex: They are most common in women between the ages of 20 and 40.
- Osteoarthritis: People with wear-and-tear arthritis in the finger joints closest to their fingernails are at a higher risk of developing ganglion cysts near those joints (these are often called mucous cysts).
- Joint or Tendon Injury: A past injury to a joint or tendon makes it more susceptible to developing a ganglion cyst.
- Repetitive Stress: Certain activities or occupations that involve repetitive wrist movements, such as gymnastics, can increase the risk.
Diagnosing a Ganglion Cyst in San Francisco
If you have a lump that you suspect is a ganglion cyst, it’s always best to have it evaluated by a medical professional. At California Pacific Orthopaedics, our specialists can typically diagnose a ganglion cyst with a simple physical examination.
During your appointment, your doctor will:
- Discuss your medical history and symptoms.
- Examine the lump, applying pressure to check for tenderness.
- Perform the transillumination test, shining a light through the cyst to confirm it’s filled with fluid rather than being a solid mass.
In some cases, your doctor may recommend imaging tests to rule out other conditions, such as arthritis or a tumor. These tests can include:
- X-rays: While they won’t show the cyst itself, they can reveal underlying issues like arthritis.
- Ultrasound or MRI: These imaging studies can provide a clear view of the soft tissues and can be useful for diagnosing hidden (occult) ganglion cysts.
Ganglion Cyst Treatment at California Pacific Orthopaedics
For many patients, ganglion cysts require no treatment at all. If the cyst is not causing pain or interfering with your daily activities, your doctor may recommend a “watch and wait” approach. Many cysts will disappear on their own over time.
However, if you are experiencing pain or are bothered by the appearance of the cyst, we offer several treatment options.
Nonsurgical Treatments
- Immobilization: Activity can cause a ganglion cyst to grow and become more painful. Wearing a brace or splint can help to relieve symptoms and may even cause the cyst to shrink by reducing the production of synovial fluid.
- Aspiration: This is a simple in-office procedure where your doctor will numb the area and then use a needle to drain the fluid from the cyst. While aspiration can provide immediate relief, it has a high recurrence rate because the “root” of the cyst is not removed.
Surgical Treatment
If nonsurgical treatments are ineffective, or if the cyst returns, your doctor may recommend a surgical excision. This is a minor outpatient procedure performed to remove the entire cyst, including the stalk that connects it to the joint or tendon sheath.
- What to Expect During the Procedure: The surgery is typically performed under local or regional anesthesia. Your surgeon will make a small incision over the cyst and carefully remove it.
- What to Expect After the Procedure: You will likely wear a splint for a week or two after surgery to support the joint. Full recovery can take anywhere from two to six weeks.
Surgical excision is the most effective treatment for ganglion cysts, with the lowest rate of recurrence.
Your Next Steps
You don’t have to live with the discomfort or self-consciousness of a ganglion cyst. The specialists at California Pacific Orthopaedics are here to provide you with expert diagnosis and a personalized treatment plan. If you’re in the San Francisco area and are concerned about a lump on your hand, wrist, or another joint, we encourage you to schedule a consultation with one of our experienced orthopaedic surgeons.
