Benign bumps

Ganglions are non-cancerous and can be controlled with timely treatment and care

Man holding wristsMany people have a bulb-like growth on their wrists. These small sacs are filled with fluid and are called ganglions. Sometimes, ganglions also appear on the feet, the ankles, the knees, or the shoulders. If you have such a growth, do not panic though; ganglions aren’t cancerous.

Ganglions generally grow out of a joint or a tendon and are of varying sizes—very small to even bigger than a cherry. In most cases, they appear suddenly and may get bigger in size as the activity increases and more fluid gets collected. Sometimes, they may even shrink, break and disappear on their own.

Anyone between the age of 15 and 40 can get a ganglion; children usually do not get one, and if they do, it disappears on its own.

Causes

Experts do not know the exact cause of ganglions yet. In most cases, they may be caused due to:

  • Inflammation or irritation of the tendon sheath or joint capsule
  • Injury
  • Overuse or repetitive movement
  • Arthritis of the hands is a cause for ganglions. It usually affects the joint nearest the fingernail.

Symptoms

Ganglions are usually painless and do not cause other symptoms. In some people, the bump is tender to touch with some pain. The pain worsens with activity or pressure. Sometimes, it may put pressure on the nearby nerves, thus causing a tingling sensation in the fingers, the hand, or the forearm. In rare cases, ganglions can weaken grip or affect movement in the joints.

Diagnosis

Physical examination is the best diagnosis. Most doctors feel the ganglion and shine a light alongside it. If the bump is a ganglion, the light shines through it, thus confirming diagnosis. However, in cases where the doctor suspects arthritis or an injury, an X-ray may be suggested. If it persists, then the fluid may be removed and examined.

Treatment

Ganglions that are painless do not require treatment; they go away on their own. But if they cause pain or limit movements, treatment may be needed. Some people may also opt for treatment due to aesthetic reasons.

Some treatment options include:

  • Using a wrist or finger splint intermittently for some weeks. This limits movement and reduces fluid accumulation in the area. But be careful to not use the splint too tight as it may hamper blood supply to that area.
  • Massaging/rubbing the area gently often during the day may remove the fluid out of the lump. But, do not rub it too hard or smash it as it may injure the wrist.
  • Draining fluid from the bump with a needle.
  • Injecting hydrocortisone [corticosteroid used to treat arthritis pain and inflammation] into the joint for the ganglion that occurs with arthritis. This may reduce inflammation and the chance of it reappearing.
  • Surgery.

Research shows that ganglions on the wrist return in almost nine out of 10 people. So, that’s normal. As long as the ganglion does not interfere in your daily activities, you may ignore it. But report it to the doctor as soon as the pain increases and it starts hampering normal functioning.

This was first published in the March 2012 issue of Complete Wellbeing.

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Sanjeev Jain
Sanjeev Jain is a Joint Replacement Surgeon, M.S. Orth, M. Ch. Orth [UK], FASIF [Germany] Fellowship in Joint Replacement, Adult Reconstruction, and Sports Medicine [USA]. He is a full-time consultant orthopaedic surgeon at Dr L H Hiranandani Hospital, Mumbai.

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