Cysts and Ganglions

As you might expect, most osteopaths see a lots of backs, necks, shoulders, knees etc in their everyday work. So patient’s frequently take the opportunity when being examined to ask, re a particular ‘lump or bump’ what do you think this is? These are frequently nothing to worry about, interesting, concerning or quite worrying, depends on location, appearance and many other factors. Those found on the arms, wrists and hands (and this blog’s topic) are frequently benign structures called cysts or ganglions.

Ganglions are fluid filled, smooth looking swellings that develop on or near tendons and joints, ranging from the size of a pea to a large Malteser and commonly filled with the lubricant liquid found in most joint, synovial fluid. On occasion there can be more solid contents but these are less common (cysts of various types). It’s not clear why ganglions form but they seem to occur when the synovial fluid that surrounds a joint or tendon leaks out and collects in a sac.

Ganglions can occur alongside any joint in the body but are most common on the wrist (particularly the back of the wrist) and the hand and fingers. They are frequently noticed more here because the arms are bony compared to other parts of the body and therefore the ganglion is pushed outward from the underlying bone making it far more noticeable.

Generally ganglions are harmless and only occasionally painful; under most circumstances they self-limit disappearing in months or years without intervention. They can be unsightly and this can then lead people to follow the old fashioned and very stupid advice of ‘whacking them with the family bible’ in the vague hope of divine intervention. To me this falls into the same category as blood-letting and rubbing a wart with a piece of steak then burying it in the garden. My advice would be, if it is troubling you see your doctor and do not undertake any ‘impact based interventions’ for the time being as it normally just makes the situation far, far worse.