Ganglion Cysts

Ganglion cysts are fluid-filled sacs that commonly develop along the tendons or joints of your wrists or hands. They can also appear on your ankles and feet. These lumps can vary in size and often become more prominent with repetitive joint movement.

At Kimball Health Services, our orthopedic team led by our board-certified orthopedic surgeon Dr. Jeffery MacMillan, provides personalized care to address the discomfort and functional limitations caused by ganglion cysts. He performs a comprehensive diagnosis to determine the best course of action, whether it involves non-surgical options like aspiration or surgical removal of these cysts.

A ganglion cyst, also known as a bible cyst, is a small, fluid-filled lump that forms just beneath the skin. These cysts develop when there is a tear in the tissue covering a tendon or joint, causing the tissue to bulge and create a sac. 

Ganglion cysts are noncancerous and typically harmless, but they can cause discomfort, especially when located near certain joints.

Ganglion cysts commonly appear on specific parts of the body, including:

• Either on the front or back of your wrist
• Near any finger joint, either close to the palm or just below the fingernail
• Near the ankle or toes

In some cases, ganglion cysts are so small that they do not form a noticeable lump but still cause pain. These are called occult ganglions. 

Ganglion cysts are among the most common benign masses found in the soft tissues of the body, and many people experience them. Moving the joint near a cyst can increase swelling and discomfort, though the cysts are not dangerous.

The primary indication of a ganglion cyst is a bump beneath the skin, which can vary in size and shape. The bump may enlarge over time, especially with increased movement of the affected joint. 

Ganglion cysts are typically firm to the touch, though some may feel soft due to the fluid inside. It may resemble a bubble emerging from a joint. In some cases, ganglion cysts have a translucent appearance, allowing you to see through them at certain angles.

While the cyst may not cause any discomfort, some individuals might experience symptoms such as muscle pain, tingling sensation, numbness, or muscle weakness due to the pressure the cyst exerts, which can also lead to inflammation.

The exact cause of ganglion cysts is unknown. However, they may develop following an injury to a joint or tendon, leading to tissue leakage or bulging.

Certain factors may increase the likelihood of you developing a ganglion cyst:

• Sex: Females are three times more likely to develop ganglia than males 
• Age: Ganglion cysts typically appear between ages 20 and 50 
• Previous Injury: Joint injuries, such as tendonitis from wrist overuse
• Arthritis: People with arthritis in their hands are more likely to develop ganglion cysts, especially near the fingertips. However, having a ganglion cyst on a finger does not necessarily indicate current or future arthritis.

Our providers diagnose ganglion cysts, or bible cysts, through a physical examination. The appearance and location of the lump, such as on the wrist or fingers, are common indicators of ganglia. 

During the exam, he presses on the bump to assess discomfort or shine a light on it to check for translucency. He may also recommend an X-ray to check for underlying joint arthritis near the cyst.

In some cases, a biopsy may be performed, removing a sample from inside the lump for further analysis. Ganglia typically contain a jelly-like fluid rather than solid tissue.

If a ganglion cyst is not causing discomfort, it may not require treatment and could resolve on its own. Treatment might be recommended if the cyst:

• Causes pain, especially when pressing on a nerve or joint tissue
• Impedes certain movements or tasks, such as walking or gripping a pencil
• Affects your self-esteem due to its appearance

Treatment options for ganglion cysts may include:

• Anti-inflammatory medication: It helps reduce swelling and alleviate mild discomfort.
• Splint or brace: It provides support and limits movement of the affected area to decrease swelling and pain.
• Aspiration: It refers to a procedure where a needle is used to remove fluid from the cyst. Although it may provide immediate relief, symptoms may return as only the fluid is removed and not the entire cyst.
• Surgery: Surgery may be considered if other treatments fail to provide relief or if the cyst recurs. The entire cyst is removed during surgery, often including a stalk-like structure (root) attached to it. Our providers use open (traditional) techniques or arthroscopy (tiny incisions) for the procedure. 

Ganglion cyst removal surgery, known as a ganglionectomy, is typically an outpatient procedure, allowing you to go home the same day. Full recovery usually takes two to six weeks. Surgical removal significantly reduces the likelihood of the cyst returning, though recurrence occurs in about 5% to 15% of cases.

When you notice a fluid-filled lump or experience pain and restricted movement in the affected area, our compassionate team can help manage your ganglion cyst. 

As one of the top critical access hospitals in the nation, we pride ourselves on delivering high-quality, patient-centered care. 

In case of an emergency, call 911 or walk into our emergency department anytime. For appointments, call us at 308-235-1966 or request an appointment online. We're here for you whenever you need us.