Ganglion cysts are common lumps around the wrist and hand. They contain a jelly-like fluid connected to a joint or tendon sheath and may become more noticeable with activity or wrist position.
The appearance of a lump is not enough to identify every mass. A hand surgeon considers its location, consistency, symptoms and relationship to nearby nerves, vessels and tendons.
Symptoms
- A smooth lump on the back or palm side of the wrist
- Pain with wrist loading, gripping or repeated movement
- A lump that changes size or is more visible after activity
- Occasional pressure symptoms if the cyst is near a nerve
Observation is often reasonable
Some ganglion cysts become smaller or disappear without treatment. If the lump is not painful and the diagnosis is clear, observation with a plan can avoid an unnecessary procedure. It should include a reason to return, such as growth, increasing pain, altered sensation or reduced motion.
Aspiration and surgery
Aspiration removes fluid but does not always remove the connection that allows the cyst to refill. Surgical removal may be discussed for a painful, recurrent or function-limiting cyst, while recognising that recurrence and stiffness are possible.
The choice depends on the cyst’s location and its relationship to the joint, tendon, nerve and blood vessels. A procedure should not be chosen from the lump’s size alone.
When to be seen promptly
A rapidly growing, firm or fixed lump, a mass with skin changes, new numbness or a lump after significant trauma should be evaluated. These features do not prove a serious problem, but they should not be assumed to be a ganglion without examination.
Sources and further reading
Frequently asked questions
Can I pop a ganglion cyst myself?
No. Trying to rupture a lump can injure the skin, tendon, nerve or blood vessels and can introduce infection. A changing or painful lump should be assessed.
Do ganglion cysts always need to be removed?
No. Observation is often appropriate when the diagnosis is clear and symptoms are minimal. Treatment is considered when pain, pressure or function becomes a problem.