Has your hand hit a hard object recently? Have you noticed a painful bump on your hand or wrist? This lump may be a ganglion cyst that needs definitive treatment. Ganglion cysts occur in the hands of 70% of people between 20 and 40 years of age, and more often in women. Although this cyst is often benign, it can be bothersome when performing daily activities. In the following guide, we review the procedures involved in removing a ganglion cyst. We also provide some basic information about ganglion cysts and how to find a specialist. At the end of this article, we explain what care is needed after ganglion cyst removal. What is a ganglion cyst? The normal functions of our body are made possible by the presence of systems such as the skeletal and muscular systems. Bones and muscles are connected by tendons between them. Sometimes small fluid-filled balls form on the tendon. These small fluid-filled sacs are ganglion cysts. Ganglion cysts occur not only on tendons but also on joints. These cysts are one of the most common types of hand problems. In most cases, ganglion cysts are created in the wrist joint and on the hand. There is also a possibility of their formation in the inner part of the wrist. It is possible but rare for ganglion cysts to develop in other areas of the body. Other areas of the body where ganglion cysts may develop include: - The outer part of the knee - The outer part of the ankle - fingertip, subcuticle (mucous cysts) - The base of the fingers, the side of the palm - On the leg Ganglion cysts may appear as one large mass or a group of smaller masses attached to a single stalk in the tissue. Ganglion cysts often disappear after a while, but, if they cause pain and discomfort, it is possible to remove the ganglion cyst. Symptoms of ganglion cyst Ganglion cysts are lesions that cause discomfort or pain due to occupying space, depending on the size or location. The pain, if present, will be a constant, nagging pain that in some cases radiates up the arm. Ganglion cysts are sometimes so large that they limit the range of motion of the hand. Cysts, if attached to the flexor tendon, make it difficult to grasp objects or move fingers. A frequent complaint of ganglions at the distal level is pain when extending the wrist, such as pressing the hand to rise from a seated position or pressing the hand to come up in a yoga plank position. Read more: What is hand arthritis? + Symptoms and treatment in Shiraz Risk factors for the development of ganglion cysts Certain lifestyles or occupations put people at higher risk for developing ganglion cysts. Age and gender are also risk factors. Next, we will discuss in more depth about the risk factors for the development of ganglion cysts. Ganglion cysts are more common in women. Age is also an effective factor and most cases are between the ages of 20 and 40. Arthritis is one of the main risk factors for ganglion cysts. In osteoarthritis, joint cartilage is damaged or worn out. Even if you don't have osteoarthritis, joint or tendon injuries can cause ganglion cysts. Certain lifestyles and occupations also cause ganglion cysts. Jobs that require people to do a lot of manual work pose a greater risk. Among these jobs, we can mention the jobs behind the table, musicians, gardening and construction workers. Athletes also suffer from ganglion cysts more often than others. Some athletes get injured during training due to overexerting their joints. For example, female gymnasts are prone to ganglion cysts. Causes of ganglion cysts No one knows the exact causes of ganglion cysts. Often, these cysts grow in the lining of a tendon or joint and look like a small drop of water on a stem. It seems that these cysts are formed by bulging tissues around the joint. Sometimes, as a result of small tears in the membrane of the tendon or joint capsule, the fluid passes through the tear and is compressed. Some doctors consider a ganglion cyst to be comparable to an internal "blister". They believe that they are caused by the body's reaction to trauma, injury or overuse. Injury to the hand or wrist increases the risk of developing a ganglion cyst. Repeated injuries usually do not cause cysts immediately. Sudden formation of ganglion cyst is usually caused by single injuries. The best way to prevent ganglion cysts is to prevent hand injuries at home. Try to make your hands and wrists resistant to injury by exercising and warming up before and between working hours. Rest your hands after intense work. Diagnosis of ganglion cyst Obtaining a complete history and physical examination are very important for diagnosis. In more complex manifestations, they confirm whether the contents of the mass are solid or liquid using ultrasound. If the mass is cystic, they take a sample of the contents of the cyst by needle aspiration to confirm the ganglion cyst. MRI is used to check for smaller, hidden ganglion cysts that are not visible to the naked eye. MRI is also performed for pre-surgical investigations, especially in cases where there is a possibility of a ganglion cyst being connected to a tendon or the symptoms are similar to another complication such as carpal tunnel syndrome. Of course, MRI has its own limitations. In some cases, a ganglion cyst cannot be detected by MRI, and for this reason, surgery is the best way to both diagnose and treat a ganglion cyst. After the cyst is removed, it can be sent to a pathologist to confirm the diagnosis. Read more: Hand physiotherapy in Shiraz Ganglion cyst treatment Ganglion cysts are mainly treated by removing the mass. The following methods are used to remove ganglion cysts or relieve symptoms: ### Aspiration Aspiration is a more conservative method of removing a ganglion cyst. This procedure involves splinting the wrist followed by the use of local anesthetic. A small needle is inserted and then the fluid is removed with it. Aspiration should be slow because pulling the piston suddenly will cause more damage inside the joint. After aspiration, steroids are injected to prevent inflammation. Aspiration is effective in removing the cyst, but there is a possibility of its recurrence. ### Surgery Surgical removal of the ganglion cyst is the most common method to completely remove the cyst and prevent its recurrence. In the surgical method, the wrist cyst is removed during a minor operation. In excision, to prevent the growth of new cysts, the surgeon also removes the capsule of the cyst. First, local anesthesia is injected in the target area to prevent pain. Then, the surgeon makes a small incision to insert the arthroscope and view the inside of the joint. After the location of the cyst is determined, a small instrument is inserted to remove the lump. The procedure is performed in an outpatient surgery center, and the surgical incision usually heals within one to two weeks. ### Non-steroidal anticoagulants NSAIDs such as ibuprofen, naproxen, and aspirin reduce inflammation and pain. Ganglion cyst natural treatment Non-pharmacological treatments may be used to reduce pain and inflammation. Using a warm compress for 15 minutes and three times a day relieves the discomfort caused by this condition. Misconceptions about ganglion cyst treatment should be ignored as it may cause more harm. Avoid immersing the infected object in the mass to prevent infection.