| What are they? |
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| This is a condition where a joint lining squeezes thru the joint toward the skin, and a balloon of joint fluid forms. The first symptom of this is usually pain in the wrist or wherever the ganglion is, but many may be painless lumps. |
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| Where do they occur? |
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They are usually on the back of the wrist, but they can be near any joint in the body. They are often also seen on the front or side of the wrist, on the fingers, and the shoulder. The knee and foot are also commonly involved.
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| What causes them? |
| The cause is not certain, but generally believed to be a degeneration of either the joint or the ligaments around the joint. Overuse might cause them, and it may make them worse. |
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| Do they get worse or cause damage? |
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| Ganglions usually get larger and smaller for awhile, but eventually they stop changing size and get firmer. The ganglion itself doesn't cause tissue damage, but it may rub on nearby structures such as tendons or nerves, and this "mass effect" can cause pain that might not go away. |
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| What is the treatment? |
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| Bracing is sometimes effective for this condition. Medicines like aspirin, Tylenol, Motrin and other anti-inflammatories may help with the symptoms. An injection given in the ganglion after the fluid is withdrawn by your doctor can often resolve this problem. Sometimes 2 or even 3 injections with fluid removal might be necessary. Surgical removal is very effective for this condition. |
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| Do I need surgery? |
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| Many patients do not need surgery for this, as they often respond well to medicines and injections with fluid removal. |
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| What type of surgery are we talking about? |
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| If injections with fluid removal, bracing, and medicines don't work, surgery may be recommended. It is an outpatient surgery, meaning you go home the same day as surgery. It is done with local anesthesia, meaning you don't have to go to sleep. Patients don't feel anything and are very comfortable due to the sedative drugs given. It takes about 30 minutes, and is done through a very short incision which is often invisible after it is healed. After the surgeon incises the skin, the ganglion is removed, and the joint it is coming from is often inspected. A high percentage of patients have resolution of the problem after surgery, and there are very few complications, making this a very safe and effective procedure. It is unusual for the ganglion to come back. |
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| Is surgery safe? |
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| Your surgeon will discuss the risks with you, but it is a very safe and effective procedure. |
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| How long would I be out of my job after surgery? |
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| You will be sent home with a splint (brace) on your hand and wrist. You should move your fingers the day of surgery, as this helps prevent and reduce swelling and stiffness. The stitches are removed in the office in less than 1 week. Jobs with clerical or light-type of work can be resumed within 1-2 weeks, heavier duty-type jobs such as manual labor can be done after 2-4 weeks in most cases. Many people have returned to their jobs the day after surgery - it really depends on the job type more than anything. |
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