AT BEL AIR CENTER FOR PLASTIC AND HAND
The development of ganglion cysts is very common. These fluid-filled sacs form lumps inside the hand, especially around the top and bottom of the wrist, the base of the fingers and the top side of the last finger joint. They are not harmful, but can be painful. In some men and women, ganglion cysts simply go away on their own, while others require surgery to correct.
Understanding Ganglion Cysts
Like other cysts, ganglion cysts are tough sacs filled with fluid. They appear most often in the joints and tendons in the hand and wrist, but can develop in other areas of the hand and wrist as well. Ganglion cysts are very common, occurring mostly in women between the ages of 20 and 40. They can appear suddenly, or they may grow slowly over a long period of time, and may increase in size in response to joint movement and repetitive activity.
There is no known cause for ganglion cysts, although they sometimes appear in response to joint or tendon irritation. When the cysts develop at the end of a finger joint, they are typically associated with arthritis of that joint. This happens more often in women over the age of 40.
In the majority of cases, ganglion cysts don’t require any treatment because they are painless on their own. They can change in size to grow larger or smaller, or even disappear entirely. However, if the cyst growth presses on the nerves nearby, ganglion cysts can cause muscle weakness, tingling and pain. Even without causing pain, larger cysts may cause appearance concerns. Ganglion cysts aren’t dangerous or cancerous, and often go away on their own without treatment.
Surgical Treatment for Ganglion Cysts
Initial treatment for ganglion cysts may begin with observation only. This depends on the severity and size of the cyst, and whether there is any pain. Without symptoms, most surgeons prefer to wait and see if surgery is necessary. Since physical activity can cause cyst growth, which puts more pressure on surrounding nerves, a splint or brace can help reduce joint pain and allow the cyst to shrink back down in size. It’s common for your surgeon to recommend hand therapy to improve the range of motion and strengthen the area as pain improves.
For large or painful ganglion cysts, your surgeon can drain the fluid from the cyst. This is called aspiration, and is common if the cysts interfere with daily activities or cause a lot of pain. To aspirate the cyst, the area is first numbed with a topical anesthetic. Next, the tough outer shell of the cyst is punctured and the fluid is removed using a needle.
Ganglion cysts grow like a water balloon on a stem. While aspiration does make the balloon part of the cyst smaller or fully disappear, it doesn’t remove the stem portion. This means the balloon, or cyst, is more likely to grow back. When this happens, surgery is recommended to fully remove the cyst, including the root portion. The part of the joint or tendon sheath where the root of the cyst connects may be removed as well. This surgery can be performed openly or with an arthroscope.
Recovery and Results
Depending on the treatment approach, recovery time after removing a ganglion cyst varies. Aspiration alone often requires just wearing a hand splint to prevent irritation that might lead to regrowth. Surgery using an arthroscope is less invasive than traditional surgery, and has a faster healing time. Open surgery requires the longest healing time compared to other treatment options; however, even with surgery, most patients are back to their normal routine in just a few weeks. Bel Air Center for Hand Surgery helps men and women from Harford County and surrounding areas in Maryland and Pennsylvania improve their quality of life by minimizing painful symptoms and restoring function.