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Wrist Ganglions

Wrist ganglions are bumps that appear on or near the tendons and joints in the wrist or hand. This condition can affect anyone and symptoms vary – the cysts are not usually painful but may cause a taut or tense feeling under the skin. There are several options to treat them.

What are wrist ganglions?

Wrist ganglions are cysts that appear as firm bumps beneath the skin. It is not known exactly why they occur. A ganglion cyst is formed by a clear, thick fluid that is there to lubricate your wrist joint (synovial fluid). Usually this fluid is sealed in a membrane. Our joints take a lot of pressure from daily activity, and if any of the fluid escapes, it can gather into a cyst that takes on a firm, jelly-like consistency.

Ganglion cysts can appear at the top of the wrist joint, underneath the wrist or near the base of the thumb. A related condition is mucus cyst, a similar looking bump that can occur on the fingers.

"Bible bumps"

The old fashioned name for wrist ganglions is "bible bumps". They are so called for the equally old-fashioned treatment of striking them with a Bible or large book, causing the cyst to burst beneath the skin. This is not a recommended course of action! See below for a range of treatments for ganglions that we can consider after assessment.

What causes wrist ganglions?

There is no definitive known cause for wrist ganglions forming. They are thought to be related to changes in the lining of the joint, but not related to arthritis. It only takes a tiny perforation in the synovial membrane for the fluid to begin to escape. You can picture this like a pinhole in a toothpaste tube; although the contents are thick, a small amount can squeeze out under the everyday pressures created in the wrist joint, and will not readily go back in. The proteins contained in this fluid can make it difficult for the body to disperse the leak; it may succeed only in drawing out the water, which leaves the remainder firm like jelly.

How can wrist ganglions be treated?

There are a number of options for treating wrist ganglions. Some cases respond to over-the-counter anti-inflammatory medications such as aspirin or ibuprofen. Sometimes, a custom splint can be provided to support the joint and help prevent ganglions from forming or reappearing.
It may be possible to drain the cyst with a needle; it depends on where it is located and whether it is recurrent. There may also be the option of a cortisone injection, although this is more effective when the cyst comes from a tendon rather than a joint.

There is also a surgical option, which can often take place under local anaesthetic and usually takes around 20 minutes. This removes the ganglion from the wrist and leaves you with a few stitches. There are optional elements to surgery which may reduce the likelihood of your ganglions recurring, although they also risk a little stiffness. We can discuss all these options after examination.