Ganglion

Plymouth Orthopaedic and Sports Injury Clinic

What is it?

A lump found commonly on the back or front of the wrist. Ganglia may also occur at the base of the finger.

Symptoms

The lump may be associated with aching in the wrist. Certain movements or pressure may increase the pain. A ganglion at the base of the finger may be tender when gripping objects. The ganglion may get bigger and smaller at different times and sometimes they disappear completely without treatment.

What causes it?

A ganglion is a non-cancerous collection of fluid or jelly. The exact cause of them is unknown. A small tear to the lining of the wrist joint or tendon sheath may allow some fluid to escape which collects under the skin as a lump. Ganglia may occur as a result of trauma to the hand or wrist.

Treatment

Historical – the bible (or other large books) has been used to hit the ganglion, causing it to burst under the skin. This method is painful, has variable success and a very high recurrence rate and so is no longer recommended!
Leave alone – a ganglion may disappear without any specific treatment. 
Aspiration – A needle and syringe can be used to draw the fluid out of the ganglion. This has a 40% success rate, but there is at least a 60% chance of the lump returning.
Surgery – the lump can be removed. The success rate is over 80%, with less than a 1 in 5 chance of the lump returning. A wrist ganglion is removed under a general anaesthetic as a day case procedure. A finger ganglion may be removed under local anaesthetic.

Lumps and Bumps

  • Any tissue in the hand may grow or become prominent, causing a lump.
  • It is very rare for lumps in the hand to be cancerous
  • Many can be left alone. Surgery to remove them is usually done as a day-case procedure under local anaesthetic
  • If a lump is growing rapidly and/or becoming more painful, a doctor should see it to decide on the best course of action.