Ganglion Cysts are very common swellings (lumps) that sometimes grow in the hand and wrist. Ganglions in the hand generally occur in 4 characteristic sites:
Ganglion cysts usually arise from joint linings or tendon sheaths.
Although there is usually no specific cause for ganglions, there may have been an injury before the appearance of a cyst. These cysts can be painful, especially when they first appear and with constant or strenuous use of the hand. Ganglions may fluctuate in size and may disappear spontaneously.
An ultrasound may confirm the diagnosis when a ganglion is very small. Often no tests are required.
There are a number of options in the treatment of Ganglions:
· ‘Wait and See’ - some ganglions resolve spontaneously.
· Wrist Brace – this will reduce the pain and symptoms associated with the Ganglion
· Injection with cortisone and bursting or draining the ganglion. This is not very effective for wrist ganglions but is of use particularly for flexor sheath ganglions.
· Surgery: Indicated if the cyst is painful, limits activity, or its appearance is unacceptable and other treatments have failed. It aims to remove not only the cyst but also the stalk and a small flap of the capsule or ligament from which the ganglion is arising. It is generally performed in hospital as a day only procedure. The major problem with this surgery is that approximately 10% of ganglions recur following resection.
If you have a painful wrist or hand, or think you have a Ganglion, arrange to have a Physiotherapist check it for you. Call us on (02) 4746 3373 to make an appointment.