What is a Ganglion?
A ganglion is a lump on the back of your wrist which are cysts (collections of fluid) that vary in size and firmness. They may be soft and squishy, but sometimes feel hard like a bone. The smaller the ganglion usually the more painful because of the level of fluid pressure inside the cyst. Larger ganglions may even be completely pain-free. Ganglions are safe and harmless although the pain may be uncomfortable and limit your ability. You may be able to see ganglions if you bend your wrist forward, and it may be difficult to fully lean on your wrist because the ganglion gets squashed in this position.
What causes ganglions?
Ganglions may be caused by the following theories:
- After an injury or trauma to a joint or ligament in your hand
- May form due to a bulging out (herniation) of the joint capsules that surround each of the joints in your hand
- Repetitive use of your hand, fingers or wrists
If you are a guitarist, violinist or hairdresser you have more of a chance of a ganglion forming.
How do I know if I have a ganglion?
You may have a ganglion if you experience/have the following:
- A lump on the back of your wrist.
- The lump may appear and disappear over time, fluctuating in size. This could be due to your activities.
- The lump is more prominent when your wrist is flexed forward.
You can be diagnosed by a GP or physiotherapist where they will perform an examination. You may be asked to complete an ultra-scan if necessary.
How can physiotherapy help with ganglions?
Ganglions do not require treatment and usually 50% of ganglions resolve without any intervention. Treatment is needed when ganglions are causing you pain, limiting the use of your wrist or hand, or causing compression of a nearby nerve. Physiotherapy can help you by:
- Splinting – Can help to reduce the pain of a ganglion.
- Strapping techniques – This may allow you to continue a higher level of loading activity. Your physiotherapist will be able to teach you how to strap your wrist correctly.
- Activity modification – It is important to avoid activities that cause you pain. Your physiotherapist will be able to suggest examples depending on your circumstances.
- Exercise – Your physiotherapist will give you exercises that you can complete at home.
In a small percentage of people with wrist ganglions, steroid injection, aspiration (needle drainage) or surgery is required.
What can I do at home?
It is important to ensure you understand your physiotherapist instructions and advice. You should ensure you avoid activities that cause you pain, strap or put your wrist in a wrist splint and complete necessary exercises.
How long will my recovery be?
Symptoms are generally short-lived as ganglions come and go. Approximately 50% of all wrist ganglions will get better without treatment within a couple of years. For painful ganglions, a splint will be necessary to reduce pain.
If it is decided to have your ganglions surgical removed then physiotherapy or hand therapy will normally be needed for 6–8 weeks to ensure you regain your full range of movement, strength and functional use of your hand, as well as to prevent the ganglion from recurring.
If you would like to find out more please call us or book an appointment here.
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Reference: Australian Physiotherapy Association 2019, Your Body, viewed 19 November 2019, < https://australian.physio/>.