Carpal ganglion: What is it and how does it affect our health?

The ganglion is a benign cyst filled with clear sticky fluid that protrudes from an adjacent joint (usually the wrist joint) and may affect joint movement or cause pain from pressure on adjacent soft tissues or nerves.

Large ganglia are not tolerable from an aesthetic point of view, while they may cause pain during movement or even deformity of the nails.

The positions that usually appear are:
-On the dorsal surface of the phalangeal joint of the fingers
-On the back of the wrist (70 %)
-On the dorsal and palmar side of the wrist
-At the base of the fingers
-Intraosseous, in the bones of the wrist

It is unknown why ganglia form. The prevailing theory is that they may be due to injury or degenerative changes in the tissues that produce synovial or joint "lubricating" fluid. The size of the ganglia can fluctuate, depending on how much we tire our hand.

Symptoms

The ganglion can be completely asymptomatic and is likely to progressively regress even without treatment. But many times it can be painful, or press on the median or ulnar nerve, causing numbness or weakness in the fingers. Characteristically, the symptoms do not worsen. Internal ganglia may cause more severe symptoms, despite their small size.

Treatment

Ganglia in the wrist region may subside with transient immobilization. Ganglion puncture is a temporary solution to the problem. In this, the gelatinous fluid of the ganglion is removed and a pressure bandage or splint is applied. However, they usually reappear.

The ganglion can be permanently cured by surgical removal which usually does not require hospitalization and is removed under local anesthesia. The removal of the ganglion is done through an incision just above the swelling and is removed along with its stalk. In finger ganglions it is important to remove the osteophytes that are often associated with the formation of the ganglion. Post-operatively, a light pressure bandage is applied to the ganglia involving the fingers, while immobilization with a plaster splint is applied to the wrist ganglia. Physiotherapy treatment is deemed necessary to restore joint mobility, especially in the ganglia that emerge from the wrist joint.

The usual recovery time after surgery is two to three weeks. Reappearance of ganglia, in cases where the removal is complete, is rare.

Photo: teta.gr – With information from onmed