Ganglions

What is a ganglion?

A ganglion arises out of a joint like a balloon. It grows out of the tissues surrounding a joint and is filled with a thick, slippery fluid, similar to the fluid that lubricates your joints. Ganglion cysts can develop in several of the joints in the hand and wrist including:

  • The top or underside of the wrist

  • The end joint of a finger

  • The base of a finger

It is not known what causes ganglions, but they are more common in women between the ages of 15 and 40 or in gymnasts who consistently apply pressure to their wrists.

Symptoms of a ganglion

Most ganglions cause a physical lump, however in some cases the ganglion can remain hidden underneath the skin (occult ganglions). Many produce no other symptoms, however if the ganglion is putting pressure on the nerves that pass across the joint, it can cause pain, tingling and/or muscle weakness.

How Ben can help?

Diagnosing a ganglion

  • Physical Examination: Ben will apply pressure to your cyst to assess the tenderness or discomfort you are feeling. He may also shine a light through the cyst to confirm that it is indeed a ganglion, which is translucent due to it being filled with fluid, and not in fact a solid tumour.

  • Imaging tests: While X-rays cannot distinguish ganglion cysts, they may be used to rule out other conditions, such as arthritis of the hand, arthritis of the wrist, or a bone tumour. MRIs or ultrasounds may be used to find an occult ganglion that is not externally visible, or to distinguish the cyst from other tumours.

Treating a ganglion

Non-surgical treatment

  1. Immobilisation

    Activity can cause the cyst to increase in size and therefore Ben may recommend a wrist brace or splint to minimise movement, which in turn can relieve pressure on surrounding nerves. Following this, strengthening exercises may be recommended to improve the range of motion in the affected joint.

  2. Aspiration

    When the ganglion is causing a great deal of pain, it is recommended that the fluid is drained from it in a procedure known as aspiration. This is most commonly recommended for ganglion cysts on the top side of the wrist as this area is free from major nerves and arteries. The area around the cyst is numbed and then the ganglion is pierced with a needle and the fluid is removed.

    Aspiration is often unsuccessful because it fails to remove the root of the ganglion and hence it will often grow back, similar to a weed.

Surgical treatment

Ben will usually recommend surgery if non-surgical treatments have been unsuccessful. The surgery is called an excision and involves removing the cyst as well as the root from which it arises. It may mean removing part of the impacted joint capsule and/or tendon sheath to ensure the entire ganglion is captured but this rarely, if ever, causes any permanent disability.

Patients can usually go home on the same day as their surgery. There is usually some tenderness, discomfort and swelling after surgery, but usual activities can typically resume within 4 to 6 weeks.

  • Ben operates at multiple hospitals across Melbourne’s bayside and peninsula region, including:

    • Linacre Private Hospital, Hampton

    • Peninsula Private Hospital, Langwarrin

    • The Bays Private Hospital, Mornington

    He can discuss your preferences in person during your consultation.

  • Ben will see you for a post-operative appointment usually 2 weeks after your surgery. During this appointment he will asses your wound and check that healing and mobility is progressing as expected. There will be no cost for this appointment.

    As well as this, Ben will usually refer you to a hand therapist, who focuses on rehabilitation after an injury, and will work with you to improve function of the affected area.

  • You can usually start driving again 4-6 weeks after the operation. However, every surgery is different, so Ben will provide individualised advice as part of the initial consultation.