About ganglion cyst
A ganglion cyst is a fluid-filled sac that grows out of a joint lining or the sheath around a tendon. The fluid inside is thick and clear, similar to the natural lubricant in joints. Ganglions are the most common lump found in the hand and wrist.
They most often appear on the back of the wrist, the palm side of the wrist near the thumb, the base of a finger, or near the last knuckle of a finger. They can change size, growing with activity and shrinking with rest, and some disappear on their own.
Ganglions are not cancer and do not spread. Treatment is usually driven by pain, pressure on a nerve, or how the lump looks and affects daily use of the hand.
Common symptoms
- A round, smooth, firm or rubbery lump on the wrist or finger
- A lump that changes size over time
- Aching or pressure, especially with wrist bending or gripping
- Tingling or numbness if the cyst presses on a nearby nerve
Common causes and risk factors
- Joint or tendon sheath fluid pushing out through a weak spot
- Repetitive wrist or finger stress in sports or work
- Arthritis in the small finger joints, especially near the fingertip
- A previous joint or tendon injury
How we diagnose it
Our physicians examine the lump and check how it relates to nearby joints, tendons, and nerves. Diagnostic ultrasound at the exam table confirms that the lump is filled with fluid, shows where it connects, and helps separate a ganglion from other soft tissue masses or blood vessel problems. An X-ray may be ordered for cysts near the finger joints to check for arthritis, and an MRI is reserved for lumps that look unusual on ultrasound.
How Propel treats ganglion cyst
Many ganglions need no treatment at all, especially if they are painless. Watching the cyst over time, adjusting aggravating activities, and a short period in a wrist brace can help when it is sore. Some cysts shrink or go away without any intervention.
For a painful or bothersome cyst, we can drain the fluid with a needle under ultrasound guidance, which allows us to avoid nearby nerves and blood vessels. Cysts can refill after drainage, and if one keeps returning or causes ongoing problems, referral to a hand surgeon for removal is a reasonable next step.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about ganglion cyst
- Should I smash my ganglion cyst with a book?
- No. Hitting the cyst can injure the wrist or hand and often does not keep the cyst away. Needle drainage in the office is a safer choice.
- Is a ganglion cyst dangerous?
- Ganglion cysts are benign and do not turn into cancer. Ultrasound helps confirm the diagnosis so any lump that looks different can be checked further.
- Why did my ganglion cyst come back after it was drained?
- The connection to the joint or tendon sheath often stays in place after the fluid is removed, so the sac can refill. Surgery removes that connection, though cysts can occasionally return even after surgery.