Dr Steve Carter
What are ganglion cysts?
Ganglion cysts are noncancerous lumps that occur in the wrists and affect people of any age. It is a common condition that can usually be found on the top of the wrist or on the wrist's tendon sheath. In older people with arthritis, ganglion cysts can develop on the end joints of the fingers.
Ganglion cysts usually appear as soft lumps on the wrist that don’t move. They can, however, get smaller or bigger and even disappear occasionally. Sometimes, ganglion cysts can affect the mobility of the wrist by causing numbness and pain. The patient often presents with a deep-seated pain in the wrist and can't, for example, do things like a pushup.
The cause of ganglion cysts is not exactly known, but Dr Carter believes that it is linked to the build-up of pressure in the joints, almost like a hernia in the joint. The condition, however, is thought to be linked to injury and flaws in the tendons or joint capsule of the wrist.
How ganglion cysts are treated
Severe ganglion cysts that cause pain or affect a person's ability to write and do other activities like sports need to be treated. Though old fashioned treatment involved hitting the ganglion cyst "with the family Bible", Dr Carter will first observe the cysts' behaviour before deciding on a way forward. This is done because ganglion cysts can sometimes go away on their own.
While a cortisone injection might be given to relieve pain or pressure in the wrists caused by a ganglion cyst, in serious cases where the cyst is large and painful, Dr Carter will perform surgery to remove it. During this same-day procedure, an incision is made to remove the cyst along with its root that is part of the joint capsule or tendon sheath. This is performed under either local or general anaesthetic. The operation is generally 30 minutes in duration. The patient can drive a car and type on a computer from the day after the surgery. It generally takes 4 weeks to regain full mobility.
Even with surgery, however, there is a risk of the ganglion cysts reoccurring. This is generally quoted as about a 5% chance, but at The Cape Hand Clinic there is a less than 2% chance of this happening.