Ganglion cysts are common lumps found in the hand and wrist, typically located near joints or tendons. They most frequently appear on the top or palm side of the wrist, at the base of the finger on the palm side, and on the top of the finger’s end joint. These cysts often resemble water balloons on a stalk and are filled with clear fluid or a gel-like substance.

Causes

The exact cause of ganglion cysts is unknown, although they may develop in response to joint or tendon irritation or mechanical changes. They can occur in individuals of any age. The size of these cysts may fluctuate or they might even disappear on their own, and they can be either painful or asymptomatic. Importantly, ganglion cysts are benign and do not spread to other parts of the body.

Signs and Treatments

Ganglion cysts are usually diagnosed based on their typical location and appearance. They tend to be oval or round, and their consistency can range from soft to very firm. Cysts found at the base of the finger on the palm side are typically small, firm, and tender to pressure, such as during gripping. Trans-illumination—where light passes through the lump—can help confirm the diagnosis. In some cases, x-rays may be ordered to check for related joint issues. Cysts on the far joint of the finger are often associated with arthritic bone spurs, may cause thinning of the overlying skin, and can result in a lengthwise groove on the nail just beyond the cyst.

Treatment

Non-surgical treatment is often the first approach for ganglion cysts. If the cyst is painless, it may simply be observed, as many cysts resolve on their own. For cysts that cause pain, limit activity, or are otherwise problematic, treatment options include:

• Splinting and Anti-inflammatory Medications: These can reduce pain during activities.
• Aspiration: A needle is used in an office setting to drain the cyst’s fluid, which can temporarily relieve pressure though recurrence is common.

If non-surgical treatments fail or the cyst recurs, surgical options are available. Surgery involves removing the cyst along with a portion of the joint capsule or tendon sheath. Both traditional open surgery and arthroscopic techniques are effective for treating wrist ganglion cysts, though recurrence can still occur. Your surgeon will discuss the best treatment plan based on your specific situation.