What Can Cause of Lump on the Wrist?

Lumps can develop along the tendon and joints on the back of the wrist. There are numerous causes for its occurrence. In most cases, the condition is not severe and may not require treatment. If the lump is painful, medical attention may be needed.

1. Ganglion Cyst

   A Ganglion cyst is an oval or round fluid-filled sac that develops around the tendons and joints. It mostly develops on the back of the wrist and is not a cause of concern.

   A ganglion cyst is filled with slippery fluid and resembles a balloon. Its size increases due to rapid wrist movements. These are non-cancerous and painless and go away on their own without any treatment. But, according to United Kingdom’s National Health Service, this can take many years.⁽¹⁾

   The symptoms of ganglion cyst include:

   • Tingling
   • Muscle weakness
   • Pain
   • Difficulty in moving the wrist
   • Numbness

   What causes ganglion cyst is not known. It is believed to occur when the surrounding tissue of a joint or tendon swell.

   It can be diagnosed when a doctor applies pressure to the cyst to look for discomfort. The doctor can also recommend an x-ray or MRI to rule out any other condition such as tumor or arthritis.

   Treatment

   Mostly ganglion cyst is painless and would not require any treatment. If the cyst is inhibiting the joint movement aspiration, immobilization or surgery may be recommended. In aspiration, the doctor drains the fluid in the cyst with a needle or a syringe.

   Immobilization involves limiting the movement of the joint by using a splint or brace. This helps ease tension in the nerves, relieving pain.

   Surgery may involve the removal of the cyst when the above treatment is not giving any relief.

2. Carpal Boss

   Carpal boss is an overgrowth in the carpal bone in the wrist. This leads to a firm lump on the back of the wrist.

   This condition can result from repetitive movement or injury to the wrist.⁽²⁾

   Carpal boss does not cause any symptoms. However, there may be tenderness on moving the wrist when the lump gets bigger.

   A physical examination is done to diagnose carpal boss. The person is made to move the wrist in different directions to check the range of motion. X-rays and MRIs are done to examine the bones and tendons of the wrist.

   Treatment

   Carpal boss does not require any treatment. If the lump is tender or painful, the following treatment may be recommended:

   • Wearing a splint for wrist immobilization
   • Placing ice on the affected area
   • Taking over-the-counter medications
   • Injecting corticosteroids into the lump

   If the above treatment does not provide relief after 6 weeks, surgical intervention may be needed.⁽²⁾

3. Epidermoid Cyst

   Epidermoid cysts are small lumps filled with keratin underneath the skin. Keratin is a protein occurring naturally in skin cells. If it gets trapped under the skin, a cyst develops. These are painless cysts but can rupture and get inflamed, which can cause pain.

   The symptoms of epidermoid cyst include:

   • Swelling
   • Tenderness
   • Flushed skin
   • A benign lump under the skin

   Diagnosis of an epidermoid cyst involves examining the cyst and the surrounding affected area.

   Treatment

   Most epidermoid cysts may not require any treatment and may resolve on their own. ⁽³⁾ If the cyst rupture and is painful, treatment may be necessary.

   Common treatments of the epidermoid cyst are:

   • Antibiotics
   • Draining the cyst
   • Injecting steroids

4. Giant Cell Tumor of Tendon Sheath

   These are nodular tumors that occur in the tendon sheath.

   Giant cell tumor of tendon sheath is the most common benign tumor after ganglion cyst.⁽⁴⁾

   These are slow-growing tumors that are mostly painless.⁽⁵⁾ They can be painful in those experiencing locking and catching sensations.

   Giant cell tumors of tendon sheath are diagnosed by x-ray, ultrasound or MRI of the affected tendon or ligaments.

   Treatment

   Marginal excision is recommended to remove the tumors. Sometimes complete excision is suggested when it is associated closely with the synovium of the tendon sheath or the joint.

5. Rheumatoid Arthritis

   Rheumatoid arthritis is an autoimmune condition in which the immune system attacks the joints leading to pain and joint damage.

   Approximately 25% of people with rheumatoid arthritis have rheumatic nodules. These are firm to touch and may appear on the hand and wrist.⁽⁶⁾

   Rheumatoid arthritis may cause the following symptoms:

   • Inflammation
   • Stiffness
   • Pain in the joints
   • Swelling

   There are a series of tests performed by the doctor to diagnose the condition. These include:

   • Touching the joint that is affected
   • Moving the joint
   • Looking for inflammation, swelling, and redness
   • Blood test
   • Imaging techniques

   Treatment

   Disease-modifying anti-rheumatic drugs are given to treat and manage this condition. These slow down the disease and prevent joint deformity.

   Home remedies, dietary changes, and exercise can also be helpful in treating this condition.

   A lump on the wrist does not necessarily pose risk to health. However, some cases might require medical attention. It is best to consult a doctor if the lump is painful, seems infected, is growing rapidly, and causing tingling and muscle weakness.