Ganglion Cysts & Wrist Pain

Do you have recurring pain in your hand or wrist? Did you assume it was carpal tunnel syndrome or some form of tendinitis? In fact, it could likely be a ganglion cyst in your wrist joint--an affliction that's more common than you might think.

For me, it took over 10 years of on-and-off pain until I finally discovered the cause: that I had a recurring ganglion cyst in my right wrist. Since finding this out, I've learned a lot about these cysts and what options there are to reduce the pain they cause.I 'm putting out this information in hopes of helping others identify the source of their pain, and thus be able to seek and apply the appropriate treatment to alleviate or minimize the pain.

First, you're probably wondering what a ganglion cyst is in the first place. According to the American Academy of Orthopaedic Surgeons (AAOS), ganglion cysts, often referred to as "Bible Bumps", are fairly common fluid-filled sacks that form in wrist (and sometimes finger) joints. The cysts were given the funny nickname because they used to be temporarily "cured" with a firm whack from a heavy book (such as a bible). The AAOS describes these cysts as non-cancerous, balloon-shaped sacks of a jelly-like joint fluid (also called synovial fluid) that are usually attached to a tendon somewhere in the afflicted joint. Additionally, because of their location on a tendon around many small bones and nerves, they often cause significant pain and can restrict joint movement. I find that when the cyst in my own wrist flares up, I can only bend my wrist back about half as far as I normally can.

As to how or why they exist, no one really seems to know. According to Elisa Aumont, MD, Consulting Staff at the Department of Emergency Medicine, University of Mississippi Medical Center on her article at WebMD.com, trauma may be a possible trigger. She also states that they are more common in women than men, and that 70% of ganglion cysts occur in people 20-40 years old.

So, if you're wondering whether your hand or wrist pain is due to a ganglion cyst, here's how to find out. With ganglion cysts, the pain is typically in the wrist or on the back of the hand, states Aumont. This is different than the main symptom of carpal tunnel syndrome, which usually manifests through pain in the palm (as discussed in the article "Carpal Tunnel Syndrome Fact Sheet" published by the National Institute of Neurological Disorders and Stroke).

Ganglion cysts can go unnoticed for long periods of time because they might be hard to see unless you bend your wrist all the way down. This can of course be pretty painful to do. To see the cyst, bend your wrist forward so that you can look at the top of your hand just in front of the wrist joint. Is there a bump that forms when your hand is bent forward? That bump is likely a ganglion cyst. See the websites listed below under "sources"--they have excellent photos of various ganglion cysts.

If you don't see a bump with your had bent forward, try bending it back and checking the underside of your wrist. In some cases, the ganglion cyst will manifest on the bottom of the wrist. According to the AAOS, the bump may be fairly sensitive when you apply pressure, especially if it's directly on top of or positioned up against a nerve or tendon. Also, it may help to compare the wrist you're having pain with to your other one so you can see the normal bumps present in the wrist joint to make sure you're actually seeing a ganglion cyst.

If, upon examination, you think that you do in fact have a ganglion cyst, head to your doctor to discuss treatment options. Typically, once your doctor confirms that it is a ganglion cyst via x-ray or other means of diagnosis, the first course of action will be to drain the cyst using a method called "aspiration", says Aumont. This will be done by drawing out the synovial fluid with a needle--a fairly quick and painless procedure. However, Aumont states that in some cases the cyst forms again at a later time and, should this happen, your doctor may recommend having an orthopedist remove the cyst via surgical means.

Always check with your doctor in order to verify your condition. If you can't see your doctor sometime soon, pick up a wrist brace at your local drugstore. The brace will help prevent excessive joint movement and reduce pain until you can get a diagnosis and appropriate treatment.

Sources
1. American Academy of Orthopaedic Surgeons, "Ganglion (Cyst) of the Wrist." Your Orthopaedic Connection.
2. Elisa Aumont, MD, Consulting Staff, Department of Emergency Medicine, University of Mississippi Medical Center, "Ganglion Cyst." WebMD.
3. National Institute of Neurological Disorders and Stroke, "Carpal Tunnel Syndrome Fact Sheet." National Institute of Neurological Disorders and Stroke.