A ganglion (ICD code: M67.4) is commonly known as a ganglion cyst. However, this term is misleading, as a ganglion is not excess bone growth.
A ganglion is a benign cyst that forms on a joint, joint capsule, or tendon.
A cyst is defined as an outward protrusion of the synovial membrane. Since this protrusion is connected to the joint cavity, a cavity filled with joint fluid (synovial fluid or synovia) is formed, which is palpable from the outside through the skin as a lump that is usually located directly under the skin. The ganglion is easily movable, soft, and painless.
Viewed from the outside, a ganglion resembles a bump ranging in size from a few millimeters to centimeters. A ganglion can grow to the size of a pea or a cherry.
Internally, that is, at the site where the ganglion forms beneath the skin, it consists of a stalk and a bulge in the capsule.
A ganglion is generally benign—meaning there is no risk of it becoming malignant. Therefore, a ganglion is not a tumor.
Ganglion on the wrist © Yulia | AdobeStock
Ganglions occur particularly frequently in the hand area. The classic ganglion on the wrist accounts for the majority of all cases. Often, the swelling is located on the back of the hand, where it appears as a rounded bulge.
In general, a ganglion can develop anywhere where joints or tendon sheaths are subjected to stress.
A ganglion on the foot is less common but can be particularly bothersome due to pressure from shoes. Regardless of its location, the lump is usually found in the immediate vicinity of joints.
Ganglions
In addition, medical professionals distinguish between
- arthrogenic ganglia, which affect the joint, and
- tendinogenic ganglions, which develop in a tendon sheath (tendon sheath ganglion).
Ganglions most commonly develop on the hand. © Henrie / Fotolia
The development of a ganglion may have individual causes; the exact causes remain unclear to this day. In most cases, such a cyst develops due to improper use or overuse of the joint or weak connective tissue.
Weak connective tissue makes it easier for tears and bulges to form in the tendon sheath or joint capsule. Synovial fluid then leaks out and collects in the resulting bulge. The fluid cannot drain back, and a ganglion forms.
People of all ages can develop a ganglion cyst. Women seem to be affected more frequently due to their often looser connective tissue.
There are certain risk factors for a ganglion. These include, for example:
The exact causes of a ganglion vary from patient to patient. Often, no single trigger can be identified. However, a combination of mechanical stress and individual tissue structure is believed to be a possible cause.
It is also noteworthy that women are affected more frequently than men. Overall, studies show that women are significantly more affected than men, which is likely due to differences in connective tissue.
How can a ganglion be prevented?
Repetitive movements promote the development of a ganglion. Therefore, certain sports, hobbies, or manual activities are particularly prone to causing a ganglion.
Prevention is possible through a healthy lifestyle. This helps avoid pathological changes in the musculoskeletal system from the outset. This includes healthy movement patterns and a sensible balance between rest and physical activity.
Monotonous or one-sided activities can increase the risk of developing a ganglion, especially on the wrist.
Many people first notice a ganglion as a visible or palpable lump. The typical symptom is a firm, elastic swelling that feels like a solid rubber ball when pressed lightly.
Not every ganglion causes discomfort. Often, it is merely a cosmetically bothersome change.
However, depending on its size and location, a ganglion can cause discomfort. This is especially true when the ganglion grows, as it increases pressure on surrounding structures.
For example, a ganglion that exerts pressure on tendons can severely impair the mobility of joints and muscles. The ganglion can also compress nerve pathways and blood vessels. If the ganglion presses on a nerve, those affected may experience abnormal sensations or numbness.
In these cases, the ganglion can cause pain and impair the function of the affected area.
In addition, the swelling can affect a joint’s range of motion. Some patients experience limited mobility during everyday activities. In advanced cases, the ganglion can significantly reduce mobility, thereby causing pain and restricted movement.
A ganglion grows slowly, so symptoms often develop gradually. However, there are also situations in which a ganglion is not visible. Such deeper-seated ganglions can also cause symptoms and often go unrecognized at first.
How can you recognize a ganglion yourself?
A ganglion can be seen with the naked eye as a small bump. These additional signs are typical of a ganglion:
- It is always firm and feels like a solid rubber ball that yields slightly to pressure but retains its shape.
- It cannot be moved at all or only slightly because it is directly attached to the affected tendon or joint.
- The skin and tissue surrounding a ganglion are neither reddened nor warm, as a ganglion is not an inflammatory condition.
If you notice these symptoms—especially neurological deficits—you should have your symptoms evaluated by a doctor. Consult your primary care physician or see an orthopedic surgeon directly. It is advisable to consult a specialist—for example, a hand surgeon if the ganglion is located on the hand.
The diagnosis of a ganglion begins with a detailed medical history and physical examination. The medical history alone often provides important clues about possible causes of a ganglion.
During the clinical examination, the doctor assesses the size, consistency, and nature of the swelling. In addition, the doctor checks whether blood vessels or the function of the affected joint are impaired.
Ultrasound is particularly useful for further evaluation. This examination helps determine whether the lesion is filled with fluid or contains other tissue structures.
In specific cases, an
MRI is also performed. This allows other conditions to be ruled out and the extent of the lesion to be assessed more precisely.
Furthermore, the following abnormalities are investigated:
Treatment for a ganglion depends on symptoms, size, and location. If a ganglion causes no symptoms, treatment is often not necessary at first.
Since some ganglions resolve on their own, observation may be sufficient at first. Supportive measures such as bandages, physical therapy, or targeted exercises may also be considered.
This conservative form of treatment is intended to reduce strain on the affected area. Whether a ganglion resolves depends on various factors. Sometimes a ganglion resolves completely within a few months without the need for further intervention.
You can support conservative treatment with ointments and rubs. Horse ointment or arnica creams, for example, have proven effective. Since a ganglion does not result from inflammation, you do not need to apply any special anti-inflammatory agents.
If symptoms persist, other treatment options are available.
One option is aspiration. In this procedure, the fluid is removed or suctioned out of the ganglion using a needle. Draining the fluid initially reduces the swelling significantly. However, fluid may accumulate again, which is why this procedure is not always a permanent solution.
If symptoms are severe or the ganglion recurs, surgical treatment may be advisable. In this case, the ganglion is surgically removed.
The procedure is usually performed on an outpatient basis and can be carried out using open or minimally invasive techniques. The goal is to completely remove the ganglion, including its connection to the joint capsule. Treatment can be performed either surgically or non-surgically. Surgery is an effective treatment option, especially when the ganglion causes pain or impairs joint function.
The course of a ganglion varies from person to person. Many cases remain unchanged for a long time, while others resolve spontaneously.
It is not uncommon for a ganglion to recur, even after successful treatment. This is particularly true if the underlying stressors persist.
Although a ganglion is generally benign, a medical evaluation should be conducted if pain occurs or the cyst enlarges. This is especially true for lesions on the hand or foot.
Internationally, ganglions are also referred to as ganglion cysts.
Ganglion cysts are typically treated by specialists in orthopedics and trauma surgery. Depending on the location, hand surgeons or foot surgeons may also be consulted.
In particular, if you have a ganglion on your wrist, a ganglion on your foot, or a recurrent ganglion, it is recommended that you consult a specialized center.
There, the diagnosis of a ganglion, the appropriate treatment, and long-term follow-up care can be planned on an individual basis.
A ganglion is harmless—nevertheless, it is advisable to seek a medical examination if you suspect you have a “ganglion cyst.” This allows for a diagnosis to be made and appropriate treatment to be initiated.
What is a ganglion?
A ganglion is a fluid-filled, benign cyst that develops on a joint or tendon.
Why does a ganglion form?
The exact causes of a ganglion are not fully understood. Triggers include overuse, changes in the joint capsule, injuries, and weakness of the connective tissue.
Can a ganglion go away on its own?
A ganglion often resolves on its own without treatment.
Does every ganglion require surgery?
Treatment for a ganglion depends on the symptoms; many ganglions do not require surgery.
Can ganglions cause pain?
Yes, especially if a ganglion presses on a nerve; it can cause pain, tingling, or numbness.
What is the difference between a ganglion and a "Überbein"?
The term “benign tumor” is the colloquial name for a ganglion. It is not an extra growth of bone, but rather a fluid-filled sac.
