What is Wrist Ganglion?
A ganglion is a cyst of extra fluid from a joint or a tendon and is particularly frequent around the wrist and hand. A ganglion cyst could be a sign of irritation in an underlying ligament, tendon or joint with often mild problem.
A ganglion cyst is also called as Bible cyst. Wrist ganglions are lumps that develop frequently in the wrist and the hand and occur closest to the tendons or the joints. Wrist ganglions most frequently take place at the top of the ending joint of the finger, the base of the finger attached with the side of the palm, the top of the wrist and the palm side of the wrist. Wrist ganglions usually look like a water balloon on a stem and filled with gel or clear fluid. The main cause of the cyst on the wrist is still not known but the suspected reasons could be the incidence of mechanical changes and tendon or joint irritation. The cysts on the wrist may change their size and may also disappear totally. These cysts on the wrist can either be painful or not. The condition of the wrist ganglion is completely not cancerous relieving the risk of spreading in other regions.
- Wrist ganglions develop very frequently in women than in men.
- Wrist ganglions may usually occur in individuals between 20 to 40 years.
- Wrist ganglion forms mostly around the joint of the wrist as a small painless bump.
- Wrist ganglion is more likely to be formed over a joint or tendon in the hand in the wrist.
Types of Wrist Ganglion:
The wrist ganglions may broadly be classified into two types.
Dorsal Wrist Ganglion: This type of ganglion is more frequent in young females and creates discomfort while bending the wrist backwards specifically exerting pressure on the wrist such as performing pushups. Dorsal wrist ganglion develops from a ligament and is more frequently seen in individuals suffering with loose joints. This could also occur in the elderly people suffering with wrist osteoarthritis.
Volar Wrist Ganglion: This type of ganglion takes place on the front side of the wrist and more usually happens to the middle aged individuals. These are related to mild degeneration in the base of the thumb and few of the joints in the wrist occasionally followed by pain in the joints.
Apart from this there are ganglions that may form in the fingers as well.
Pulley or Seed Ganglion: This type of ganglion usually develops at the base of the fingers near the palm creating discomfort while gripping an object such as a steering wheel. Pulley or seed ganglion could result in some stiffness in the finger and sometimes triggering may also be experienced.
Mucous Cyst: This kind of ganglion takes place behind the nails that develops from the terminal joint of the finger. Joint degeneration again is the cause for this type of cyst on the wrist. Mucous ganglion could lead to furrowing of the nail of the finger because of compression on the bed of the nail. These type of cysts on the wrist again contain jelly like substance.
Causes of Wrist Ganglion:
- The main cause of wrist ganglions is still not known, however there are few reasons suspected to cause them:
- Stress or trauma at the joints of the wrist could cause degeneration and the development of wrist ganglion.
- Wrist ganglion could frequently occur in people participating in strenuous activities of the hand like meat cutting or gymnastics.
- In few cases the previous injury of the wrist when again gets injured leads to the formation of the wrist ganglion cyst.
- The formation of the wrist ganglion cysts could be the reason for structural flaws in the tissues of the joint.
- Ganglions form when the synovial fluid gets collected in between the joints. The more the fluid develops it creates a lump on the weakened area of the tissues.
Signs and Symptoms of Wrist Ganglion:
- Fluctuating pain in the wrist with sometimes no pain at all.
- Increase in pain with activity or movement of the affected joint.
- Occasional swelling.
- Tingling, weakness or numbness could also be experienced in few cases when the cyst is connected to a tendon or is compressing a nerve or a tendon.
- Wrist ganglion cysts may sometimes be caused without any symptom except the development of an area of swelling or a bump.
- Wrist ganglion may develop either slowly or may grow rapidly.
- Ganglion may sometimes disappear or decrease in size, only to form again at a later date.
Treatment for Wrist Ganglion:
- Most of the wrist ganglions can be treated without surgery. These cysts on the wrist are simply observed and followed in most of the cases where they are painless. Generally medical intervention is done only if the ganglion is painful or limits the activity or for cosmetic reasons.
- Anti-inflammatory medications and splints to help with activities and pain.
- Fine needle aspiration to extract the fluid from the cyst. This can easily be performed in office settings.
- Surgery for wrist ganglion or removal of cysts on wrist may be recommended in some cases where nonsurgical treatment fails to provide any relief. Surgery involves removal of the cyst on wrist along with a portion of the tendon sheath or joint capsule based on the severity. Surgery for wrist ganglion or removal of cysts on wrist or can be performed in two ways that is traditional or open technique or arthroscopic techniques. Surgical treatment of wrist ganglion is usually successful, however, there may be some instances where the ganglion may reoccur.
Exercises for Wrist Ganglion:
Active Range of Motion Exercise for Wrist Ganglion: This exercise is performed by placing the palm on the table and rotating the forearm in order to rest the palm on the table with the help of the thumb. Then rotate the hand towards the direction of the thumb. This is called as wrist ulnar or radial deviation, which comes under the group of active range of motion as an individual performs this exercise alone without taking any help.
Passive Range of Motion Exercise for Wrist Ganglion: This exercise is performed with the help of a therapist. First lie down flat on the bed with the arms by the side. Following this the therapist will move the wrist forward and backward, sideways, and in full circles in all directions for range of motion. This exercise is called passive range of motion exercise as the patient does not carry out this exercise on his own.
Free Weight Wrist Flexion and Extension Exercise for Wrist Ganglion: This exercise is performed using light weights. Sit comfortably on a chair with the forearm having the cyst placed on the table. Now hang a dumbbell in this hand suspending it over the edge of the table. Flex and extend the wrist towards and away from the body repeating it few times. This exercise is performed for strengthening the wrist joints.
Isometric Flexion and Extension Exercise for Wrist Ganglion: This exercise is performed by sitting on a chair and placing the affected hand's forearm on the thigh and applying pressure with the help of other hand's palm on the affected hand. Repeating this exercise multiple times could assist in wrist strengthening. Weights are not used in this exercise. This may either be performed individually or with the assistance of a therapist.
Exercises for wrist ganglion cyst must be performed twice or thrice regularly to get rid of the pain. These exercises are performed by individuals suffering with this issue or have undergone a surgery to acquire back the flexibility and strength of the wrist.
Tests to Diagnose Wrist Ganglion
A medical practitioner or a doctor generally diagnoses a wrist ganglion cyst just by looking and palpating the mass or swelling present on the hand in the wrist or for that matter even the cysts in the fingers. To confirm the diagnosis, a needle is inserted into the mass to extract the fluid, and the diagnosis for ganglion cyst is confirmed if the cyst is filled with fluid.
An MRI or ultrasound may be used to analyze the severity or extent of the ganglion cyst though these tests are usually not required.