Carpal ganglion cysts most commonly develop along the wrist but are neither cancerous nor dangerous. They are caused by tissue surrounding a joint bulging out of place which can contain joint fluid. While they are most frequent on the back of the wrist, they may also develop on the front, with some patients experiencing pain when the cyst is touched or jolted due to frequent movement at the wrist.

Characteristics

These cysts vary in size, from peanut-sized to no larger than 2.5cm in length. Some cysts develop quickly but their growth is generally gradual, with most cysts being more visible when the wrist is flexed. The cysts are generally round, like a small water balloon or rubber ball, and they are usually painless and unrelated to a previous injury. They may be painful when the wrist is being used a lot and, if left untreated, they could grow to the point where they place pressure on nerves in the region, resulting in pain or numbness.

Causes of carpal ganglion cysts

These types of cysts have no known cause, although a history of heavy wrist usage, including frequent lifting of heavy objects or weights is thought to be the cause in some cases.

Treatment

1. Non-surgical techniques: If the patient is not experiencing any pain and the cyst shows no sign of growth, there may be no need to remove the cyst surgically as they are non-cancerous.
2. Aspiration: If patients are experiencing anxiety because of their cyst, medical staff may use a needle to drain the fluid from within it, thereby easing their worries, although the likelihood of the cyst recurring is 70–80% in such cases.
3. Surgery to remove the cyst: Surgeons will need to remove not only the cyst but also the stalk attaching it to the joint in order to reduce the chances of the cyst recurring. The likelihood of recurrence following surgery is 3–5%.

Should patients experience cyst growth or pain and numbness at the wrist, they should seek medical attention. The doctor will then need to analyze the cyst carefully to ensure that it is not being caused by any other condition.


Authors: Dr. Surachai Rattanasaereekiat is an orthopedic surgeon at Orthopaedic Center Bumrungrad. Dr. Surachai is currently a hand and trauma Specialist at Bumrungrad, specializing in upper extremity and trauma fracture surgery.