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Alaska Hand-Elbow-Shoulder is home to Alaska's premier upper extremity surgical specialists. We provide care for orthopedic injuries and conditions of the hand, wrist, elbow, and shoulder as well as fracture care and sports medicine. Call AkHES today to schedule your appointment.

Ganglion Cyst

What is a Ganglion Cyst?

A ganglion cyst is a soft or firm, fluid filled mass that forms under the skin. The ganglion grows out of a joint, like a balloon, through the connective tissue between the joint and tendons (1 and 2). The most common place for a ganglion cyst to appear is on the back of the wrist, but it can also appear on the front of the wrist or at the base of a finger on the palm. Ganglion cysts commonly change in size or may “disappear” for a period of time and return. Ganglion cysts do not spread and do not become cancerous. The causes of these cysts are not known, although injury and repetitive wrist or finger motion may be a factor. The diagnosis is usually based on the location and appearance of the cyst. Occasionally, it may be necessary to get an x-ray, ultrasound or MRI to rule out other conditions.

Signs and Symptoms:

Ganglion cysts are usually painless but may be annoying. Some pain may be associated with repetitive movements of the wrist or fingers, and may limit range of motion.

Figure 1:  Ganglion Cyst on Wrist

Figure 1: Ganglion Cyst on Wrist

Figure 2: Ganglion Cyst Location

Figure 2: Ganglion Cyst Location

Conservative Options:

Because ganglion cysts are not cancerous and may disappear with time, the physician may recommend waiting and watching for any changes. To shrink the cyst, the practitioner may use a needle and massage the cyst to remove the fluid, followed by steroid injection (3).

Figure 3: Needle Aspirating Ganglion

Figure 3: Needle Aspirating Ganglion

Surgical Options:

If the cyst does not respond to conservative treatment, surgical intervention may be necessary. In removing the ganglion cyst, the surgeon will also remove a section of the tissue lining the joint or tendon to help prevent formation of another cyst. A splint is often used for 4-6 weeks during healing.

Post Operative Rehabilitation:

Following Surgery:

  • Expect a surgical bulky dressing to be kept in place for 10-14 days.
  • Early thumb and finger motion is encouraged.
  • Elevate and ice for at least 3 days.
  • Continue to elevate as often as possible until your next clinic visit. (Elevate above your heart.)
  • Shower with a plastic bag covering the splint and seal with tape.
  • Take your pain medication as needed and as prescribed. Call if any problems or questions arise.

10-14 Days Post Op (at therapy):

  • Dressing and sutures will be removed.
  • Wrist range of motion exercises initiated and encouraged, especially volar flexion.
  • Continue thumb and finger range of motion exercises to avoid stiffness.
  • Therapist will fit patient with a volar wrist splint to be worn until 4-6 weeks post op.
  • Begin to use hand for light daily activities.
  • If necessary, continue to attend therapy until a full range of motion is obtained.

4-6 Weeks Post Op:

  • Follow up appointment in clinic with P.A. or M.D. at 4 weeks.
  • May resume heavy lifting activities upon healing of the incision site.
  • Discontinue splint as directed.

8 Weeks Post Op:

  • Follow up appointment in clinic with P.A. or M.D.
  • PRN follow-up in future.