Ganglion Cyst - Hand Ganglion

A small, usually hard nodule lying directly over a tendon or a joint capsule on the back or palm of the hand. Occasionally the nodule may become quite large.

In the hand, a ganglion is a particular type of lump which shows up next to a joint or a tendon. Inside, it is like a balloon filled with a thick liquid. It may be soft or hard, may or may not be painful, and may get bigger or smaller on its own. It may also be referred to as a mucous cyst, a mucinous cyst or a synovial cyst.

BODY PARTS INVOLVED

• Back or palm of the hand.
• Tendon sheath (a thin membranous covering to the tendon).
• Any of the joint spaces in the hand.

Causes

The exact cause of ganglions remains uncertain. The most popular theory is that ganglions form after trauma or degeneration of the tissue layer responsible for producing the synovial fluid which normally lubricates the joint or tendon sheath. The cyst arises from accumulation of this fluid outside the joint or tendon sheath in a sac or cyst. However some other causes are :-

• A defect in the fibrous sheath of the joint or tendon that permits a segment of underlying synovium (thin membrane that lines the tendon sheath) to herniated through it.
• Irritation accompanying the herniated synovium, causing continued secretion of fluid.The sac gradually fills, enlarges, and become hard, forming the ganglion.

Signs & Symptoms

• Hard lump over a tendon or joint capsule in the hand. The nodule "yields" to heavy pressure because it is not solid.
• No pain usually, but overuse of the hand may cause mild pain and aching.
• Tenderness if the lump is pressed hard.
• Discomfort with extremes of motion (flexing or extending) and with repetition of the exercise that produced the ganglion.

Treatment

Follow your doctor's instructions. Instructions are supplemental.

Immediately after surgery:

• The affected area is usually immobilized in a splint for 1 to 2 weeks following surgery.
• If the wound bleeds during the first 24 hours after surgery, press a clean tissue or cloth to it for 10 minutes.
• A hard ridge should form along the incision.As it heals ,the ridge will recede gradually.
• Use an electric heating pad, a heat lamp, or a warm compress to relieve incisional pain.
• Bathe and shower as usual. You may wash the incision gently with mild unscented soap.
• Between baths, keep the wound dry with a bandage for the first 2 or 3 days after surgery. If bandage gets wet, change it promptly.
• Apply non-prescription antibiotic ointment to the wound before applying new bandages.
• Wrap the hand with an elasticized bandage until healing is complete.

After the Incision has healed:

• Use ice soaks 3 or 4 times a day.Fill a bucket with ice water ,and soak the injured area for 20 minutes at a time.
• You may apply heat instead of ice if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments and ointments.
• Take whirlpool treatments, if available.

MEDICATION

• Your doctor may prescribe pain relievers. Don't take prescription pain medication longer than 4 to 7 days. Use only as much as you need.
• You may use non-prescription drugs, such as acetaminophen, for minor pain.

Home Diet

During recovery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.

Prevention Tips

• Build your strength with a long-term conditioning program appropriate for your sport.
• Warm up before practice or competition.