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July 6th, 2011
12:01 PM ET

Could bump on my wrist be a ganglion cyst?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Wednesdays, it's Dr. Otis Brawley, chief medical officer at the American Cancer Society.

Question asked by Rebecca from Toledo, Ohio

Something is wrong with my left wrist. When I bend it or touch the area or put pressure on it, it hurts really badly. Could this be a ganglion cyst? What should I do about it?

Expert answer:

A ganglion cyst, also known as ganglia, is a fluid-filled mass that can occur at any joint, but it most commonly found on the thumb and palm side of the wrist. Other less common sites for ganglion cysts include the base of the fingers, the top of the foot and, even less, the knee, shoulder and spine.

One can usually feel a ganglion cyst. It is usually palpable and painless but can be very painful when the cystic mass places pressure on nearby tendons or nerves. Occasionally, a ganglion cyst can cause a lot of pain, and the mass is not felt. This is called an occult ganglion cyst.

The cyst is filled with a gelatinous clear fluid. The walls of the cyst are tissue of the joint or tissues of a tendon at the joint.

The exact cause of ganglion cysts is not known. Ganglion cysts seem to travel in families, but some seem to be due to degeneration of tissues after repetitive movement. People who have ganglion cysts also tend to be prone to develop more of them.

A ganglion cyst is a common complaint usually handled by a general internist or family practice physician. Only the most complicated cases need to be referred to an orthopedic surgeon or a rheumatologist.

First, the health care provider will do an assessment. A mass or swelling of the wrist can be due to several things. Painful masses are most commonly caused by injury to the ligaments and soft tissues surrounding the joint or the bones that make up the joint.

If the pain and mass follow a traumatic injury, a physical examination and X-rays are needed to distinguish soft tissue injury from damage to cartilage or bone. If the symptoms develop without a history of trauma, X-rays and blood studies may be warranted to rule out rheumatic diseases of the joint.

A health care provider would typically use the following approach to make the diagnosis of a ganglion cyst.

• Transillumination, in which the light of a simple flashlight shines through the cyst. This can be done in-office and will distinguish the ganglion from a solid tumor.

• In patients with wrist pain, no clear transilluminated mass and normal X-ray studies, an MRI can differentiate most ganglia from other types of masses.

• Ultrasound is also used for detecting ganglion cysts in patients with wrist pain of unclear origin.

Untreated ganglia can spontaneously regress and spontaneously recur. Observation is appropriate for a non-painful ganglia that does not interfere with joint movement. When bothersome or symptomatic, treatments include:

• Inserting a needle on a syringe to aspirate or remove the fluid followed by injection of an anti-inflammatory such as a steroid. This works for about 80 percent of patients getting it.

• Injection of a drug, hyaluronidase, into the cyst followed by suction of the fluid out of the cyst. This is effective for 90 percent of patients getting it.

• Surgical removal of the ganglion is far more involved than aspiration, but it is very effective. Less than 5 percent of these patients have a recurrence.


soundoff (61 Responses)
  1. Mangala

    Homeopathy is the best cure for Ganglion cysts. Lot of my friends got cured with a single or two doses of Calcaria Flour.
    The cyst disappears like a magic within 2 weeks . Consult a Homeopath

    July 6, 2011 at 12:30 | Report abuse | Reply
    • Mike Varney

      Homeopathetic medicine is rarely if ever the best cure for anything.

      July 6, 2011 at 13:16 | Report abuse |
    • AndreaM

      I think you mean never, Mike. Unless the disease is dehydration, lol.

      July 6, 2011 at 18:11 | Report abuse |
    • jim d.

      homeopathy is sometimes dangerous. i used to work in a children's hospital and we'd see little kids who were hispanic and treated @ home with some homeopathic remedy and got lead poisoning from the treatment. one of them was bad enough to need chelation therapy.

      July 6, 2011 at 23:00 | Report abuse |
    • Allopath

      If you look at the extreme dilution performed to make a homeopathic "medication," it is very unlikely that a single molecule of the original compound remains. How essentially pure water can improve anything is beyond me. Homeopathy (other than nutritional and sanitary advice) is quackery.

      July 7, 2011 at 01:17 | Report abuse |
    • Carol

      I have had Rheumatoid Arthritis since I was 14 yrs old. I had a cyst come up about the size of a fifty cent piece on the top of my hand. My regular doctor drained it a couple times with a needle. The last time it came back I lost the use of 3 fingers in just a couple days. ALWAYS remove the cyst. It will continue to come back until you do. NEVER EVER let anyone tell you not to. It destroyed the tendons to those fingers. Thanks to a brilliant hand surgeon, Dr. William G. Newton in Lufkin, Texas, I was able to regain the use of those fingers a good deal. He took photos of my hand before surgery it was so distinct. Go see a rheumatologist.

      July 7, 2011 at 05:50 | Report abuse |
    • Cleareye

      You may as well cast some bones on the soil under a full moon.

      July 7, 2011 at 11:59 | Report abuse |
    • Mangala

      Homeopathy is teh best cure fo Ganglion cysts, Rheumatoid Arthritis, Styes, Chalazions and n number of medical conditions.
      People are willing to do unnecessary surgeries but do not have heart to try a very good proven alternate medicine..
      Buy Homeopath medicines from reputed stores
      ( Whole foods in USA) and you dont have to worry about lead poisoning. My son was cured of recurrent cHalazions with a single homeopathic dose and I personally saw a permanent cure for Gangalion cysts

      July 7, 2011 at 14:28 | Report abuse |
    • catz

      The homeopathic remedy Ruta Gravis worked for me. It and Calc Flour may be listed in the remedy section. One being a cell salt and the other a remedy made from the ruta plant. Anyway, I had a ganglia on the back of my hand and I took the Ruta as recommended and it went away. I also take the Calc Flour often for other symptoms, these two remedies you will find to be synonymous if you do extensive reading with regard to remedies. I have read and studied them for over 35 years.

      July 27, 2011 at 16:09 | Report abuse |
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      March 3, 2013 at 22:21 | Report abuse |
  2. FearTheHype

    Or one can employ the old wives method of treatment, which is to smash it with a hard object like a book. I had mobility impairment and recurring pain, once or twice a year that lasted for several days, in my right wrist. At times the pain was so bad I could not even shake hands. The last time the pain occurred a bump also formed. I smashed the bump several times, over two days, against anything hard. The result: Pain gone, mobility impairment gone. My right wrist now behaves almost identically to my left wrist. No pain in the wrist during push-ups: none. Best thing I ever did, without paying a few hundred dollars to a doctor (who in the past has been unable to identify the source of the pain).

    July 6, 2011 at 12:31 | Report abuse | Reply
    • davetharave

      I'm gonna try that right away.

      July 6, 2011 at 16:51 | Report abuse |
    • carol

      Agreed – that seemed to be an excellent use of the old family bible! Whack, and done. My grandfather (who was a physician) followed that treatment after my father (also a physician) tried various and sundry other more 'medical' treatments. I'm surprised, actually, that the back of the wrist wasn't even mentioned, since that is a fairly typical location. And no, after many years, the ganglion has not returned.

      July 6, 2011 at 18:35 | Report abuse |
    • Shari

      It works without fail. I get them on the inside of my wrists and they come back over time. The first time I found one, I went to my doctor who proceeded to whack my wrist with a textbook he had on hand. Now, when they get bothersome, my kids fight over who gets to whack me with a book!

      July 7, 2011 at 00:56 | Report abuse |
    • KC

      In the old days these cysts used to be called "bible lumps" for just that reason!

      July 7, 2011 at 02:17 | Report abuse |
    • BA

      Yes – when I got one as a teen or young adult, my father said the family cure was hitting it with a Bible. Not sure we used a Bible, but it was a big, heavy book and worked like a charm (and no recurrence in decades).

      July 7, 2011 at 10:15 | Report abuse |
    • jagmania65

      are you kidding? whacking it is probably what caused the bump in the first place!

      July 7, 2011 at 12:43 | Report abuse |
  3. J Richards

    Strange the article didn't mention the book method. I have known a number of people who had this method used by a doctor.

    July 6, 2011 at 13:56 | Report abuse | Reply
    • KS

      Same here, J, relatives and even a couple of doctors have told me to either have mine aspirated, or go home and "whack it with a Bible."

      July 6, 2011 at 16:16 | Report abuse |
    • PrincessBride

      I had friends recommend the Bible method, but considering the cyst developed after the trauma of breaking a finger, I really didn't want to risk breaking anything else by having someone whack the back of my hand with a big heavy book! I had mine removed, and in two years have had no occurrence at that site – but now have one on the other hand. Do at least have the cyst examined by a health care professional though, as there are a very small minority of cases where these can be cancerous tumors rather than (relatively) harmless cysts.

      July 7, 2011 at 11:08 | Report abuse |
  4. Julie C.

    I have had several of these cysts develop on my wrist during the course of childhood. One was resolved with a good smack from a book, another regressed on its own, and another ruptured when I caught a basketball, which forced my hand back against the cyst. As with any lump in question, it is always best to check with your doctor.

    July 6, 2011 at 14:07 | Report abuse | Reply
  5. CMURPH

    I had a one of these cysts on my right wrist. After having an MRI, I went to an hand/wrist surgeon and had it drained, but that only provided temporary relief. He advised me to only have surgery when I absolutely couldn't take the pain anymore. I reached that thresehold and had the surgery. It took about 12 years, but the cyst did return. I guess I am in the 5 % that can "reoccur". The pain comes and goes, but I am able to live with it at this point. Strangely enough, my sister had the same type cyst on the same wrist, and she opted for the book method. It's only been a few years, but her's has not reoccured at this time.

    July 6, 2011 at 14:17 | Report abuse | Reply
    • Stephanie R.

      I, too, must be in this 5%. I've had two removed (both the same spot, my left wrist) and the bump, again, started reappearing about two years ago. Now, it's gotten so bad, I'm thinking about getting this one surgically removed, also. Hate. It.

      July 6, 2011 at 14:51 | Report abuse |
    • Lin

      I'm in the 5% too, have had surgery twice. (At least they were able to recycle the scar.) It's been 13 years since the last operation, but I think it's coming back.

      July 6, 2011 at 15:06 | Report abuse |
  6. Cindy S.

    I had one surgically removed from my left wrist in January, actually a re-removal after it returned after 15 years. Frequently, surgery may be the only viable option. Needle aspirations often don't resolve the problem as the sac remains and can re-fill. As for the book dropping technique, it can actually cause further, more serious damage to the hand. That said, I also learned that often the cyst can adhere to an artery, complicating the removal of the cyst. They actually lacerated an artery trying to remove my wrist ganglion. Because this was a removal of a recurring cyst, they had to cut deeper, too, so recovery was longer and slower than I expected. Seven months later, I've pretty much healed and returned to all normal activities with a full range of motion and no pain.

    July 6, 2011 at 14:33 | Report abuse | Reply
    • fulton hoang

      Successful cases
      1. My post deliveryman suffered right wrist injury because of fifteen years carrying heavy mail. Wearing a wrist cast, having a pinto bean size cyst emerged on his right carpal tunnel. With qi, the cyst was gone within 10 minutes without operation. It was a magic touch! Believe it or not!
      Fulton hoang, MSOM, surgeryalternate@hotmail.com

      July 7, 2011 at 00:26 | Report abuse |
  7. Bible Bump

    I had one of these bumps show up on my head around the temple area. You could imagine my surprise when my doctor called it a "bible bump" and said that farmers out here in the midwest get them often. They are called this because back in the day the Bible was typically the biggest book in the house, and they were advised to use the good book to give it a whack! My doctor told me this, then stated he probably wouldn't advise a smack to the head using a big book. He then stated that he could put me on meds if I wanted him to in the future, but why don't I "go home a think about it". Now I wouldn't advise smacking yourself with a bible for anything other than your particular religious beliefs but, as of the next day I had no bump thanks in part to the backside of a Goody hairbrush.
    Possible side effects: decent headache the following morning, but at least I didn't look like I'm trying to grow a horn.

    July 6, 2011 at 15:04 | Report abuse | Reply
    • Chris

      "Goody hairbrush"?
      You doing product placement in your posts?

      July 6, 2011 at 16:17 | Report abuse |
    • Bible Bump

      Only because I had the word "Goody" temporarily stamped on my forehead for a few days after the whack...I'm kidding of course- but it was a Goody hairbrush! I wanted you to feel like you had all the details, and lets face it, if Goody worked to knock the devil horn out of me- it may work for you too!

      July 7, 2011 at 11:52 | Report abuse |
  8. Mama2KOA

    I had one on my left big toe years ago. The podiatrist tried the aspirate and steroids with a tight bandage route. It came back. Then they tried surgery. On my last post-op visit we noticed some swelling along the incision and guess what – it was back. I had surgery again, shaved off half of my top toe bone to find the "root" of the cyst and removed it again. That was in 1998 and it's never been back. Of course, the left side of my big toe is completely numb but at least it doesnt look like it's growing a second head.

    July 6, 2011 at 16:12 | Report abuse | Reply
  9. Teddy

    I had a ganglion cyst on my right wrist for about 3 years. From time to time a pain would flare up in my wrist but for the most part it was bearable. I met with a few doctors who did not want to surgically remove it because of all the tiny bones located in that area of your wrist. They had suggested the book thing but I did not really want to do that. Then I got an opinion from another doctor who told me to cut out all caffeine and chocolate. I took this advice and within 3 months the cyst was completely gone and has not come back. It has been 5 years.

    July 6, 2011 at 16:21 | Report abuse | Reply
  10. Repeat

    I got these frequently when I was doing repetative work. My mom was a nurse and told me the same thing as Bible Bump's doctor – hit it with a large book. I never took her up on the offer, but after a while they went away. I haven't gotten one in a LONG time, since I have stopped the repetative work. They are painful though!!! First time I got one I swore up and down I broke my wrist.

    July 6, 2011 at 16:22 | Report abuse | Reply
  11. tarheelgirl39

    I had my first ganglion cyst in my left wrist when I was in the 6th grade. The first time I had it checked out the doctor tried to pop it by squeezing it and needless to say that didnt work. So he told my mother as long as it didnt bother me to leave it alone. Well in time it got bigger and did start to bother me so the next visit they drained it and a few days later it was back. When I turned 18 I had it surgically removed and my surgeon told me that at the time (1989) it was the biggest ganglion cyst he had ever removed from someone my age. Since that time I've had two other cysts that appeared on my right wrist. I took a needle and drained them both and after that I havent had one since. My daughter is 13 and she had a very small one that appeared on her left wrist but after seeing the doctor it went away no procedures necessary.

    July 6, 2011 at 16:41 | Report abuse | Reply
  12. tarheelgirl39

    I am 40 years old now and I still have pain time to time in my left wrist as if the cyst was still there.

    July 6, 2011 at 16:45 | Report abuse | Reply
  13. Oni

    I had a very painful ganglion cyst years ago that was misdiagnosed several times by my family doctor, until I moved and was referred to a specialist who did diagnose it. Prior, the other doctors told me to do exercises to strengthen my wrist, which did not help at all. Eventually, I accidentally hit my wrist against something and it hasn't come back since (10 years). But it can hurt a whole lot.

    July 6, 2011 at 17:36 | Report abuse | Reply
  14. AndreaM

    I get them. When they're not painful I don't bother them, but if it's hitting the nerve, I wait till it gets to be decent sized then take a horse-size dose of an anti-inflammatory pain killer and have my fiancee smack it a couple times with a large hardcover book. Harry Potter works well. It will make you see Jesus, but it works.

    July 6, 2011 at 18:14 | Report abuse | Reply
  15. ben s.

    I had one removed surgically from my left wrist in 1989. It didn't come back until about 4 years ago, at which time I saw a specialist to have it removed again. It'd grown to be pretty big and was interfering with my wrist movement and was causing pain if played basketball, etc. He advised against having surgery again because 1. surgery has risks 2. it'd probably come back again anyway. So he drained it with a needle; it came back a couple months later. I took matters into my own hands after reading about ganglions online and whacked it with a hardcover dictionary. It stayed away until last year. I whacked it again with a dictionary and it stayed away until a couple months ago.............I'm getting my dictionary out now.

    July 6, 2011 at 18:39 | Report abuse | Reply
  16. FL555

    Yep, the book trick worked for me. Had a huge ganglia cyst on the top of my wrist. So, I got a large hardbound book, positioned my hand and arm horizontally on a board and then slammed the book with a hammer! Mission accomplished. It was painless for me. My hand and fingers were swollen for about a day because the fluid had to go somewhere. That was over 10 years ago, with no subsequent cystic episodes.

    July 6, 2011 at 22:07 | Report abuse | Reply
  17. jim d.

    they used to call these things a "preacher's bump"

    July 6, 2011 at 22:52 | Report abuse | Reply
  18. content_pessimist

    You people are all gross with all those cysts growing on your body.

    July 6, 2011 at 23:53 | Report abuse | Reply
  19. nathan

    a singer named lederhosen lucil has a great song about this... you should all check it out

    July 7, 2011 at 01:22 | Report abuse | Reply
  20. DSW

    I also had one of these. It was on the back of my right wrist and it had occured 3 times. The first two times it went away on its own during yoga class or bootcamp (basically when I applied enough pressure on it). The last time, it hung around for a while and I asked my husband to smash it with a large book...it was slightly painful but it is gone! I made sure to rub the area after it was gone to help the fluid dispersed and I applied ice for the pain.

    July 7, 2011 at 08:43 | Report abuse | Reply
  21. Donna

    I had a ganglion cyst on my left wrist. One day my five-year-old (at the time) son threw himself against me, I put my hands up, he rammed against that wrist, there was a large pop, excruciating pain, and bam, that was it. It was gone. No more pain, and I could move it completely. My doctor said in the old days they would have smashed a giant Bible against it. It's never come back in 13 years. And look at that list of expensive medical tests that would be done...

    July 7, 2011 at 08:54 | Report abuse | Reply
  22. Linda

    I had one 15 years ago on the top of my hand/wrist after spraining it. The chiropractor said to use a heavy book, but just to put it on top of the cyst and apply pressure, not to actual SMASH the book down. It hasn't come back.

    July 7, 2011 at 09:35 | Report abuse | Reply
  23. florencia

    stop masturbating you people!!! See what happes....naughty !

    jokes aside, i prob got 3 cyst removed, 2 lerft wrist (the same one came back 2 x every 4 yrs) and another one appeared on my right one.... total of 3 in the last 4 yrs. my doc removed them with the needle like they explained above. they always come back, sometime i feel it even though its NOT there anymore (for now...)
    at times my hands/wrists gets swallen when i lift heavy things, for example, when i moved to a new apartment, OMG, my arms, wrist, hands were sore horribly, had wear a bandages for almost a week....
    If you work in from of a computer then ur screwed! its the worst!...thats where i get the pain from... and I DO take sick days when that occurs because...its DUE to the load of work and technically IN MY CASE these cyst are a result of my work... so sick days SHOULD AND MUST be taken.
    That also includes massages therapies, yoga and chiro... it ends up affecting your entire arm and travels throught your neck and shoulder blade if you dont treat it.
    wish you luck you all my cyst brothers and sisters....

    DO NOT use the stupid book method.... unless u wanna tear some artery or crack a bone, tendon or something... do it properly.

    peace out

    July 7, 2011 at 10:12 | Report abuse | Reply
  24. maggie

    I had a ganglion cyst a few years ago that went away, then came back this winter. It was sitting on the tendon that controls my right thumb and was interfering with both the tendon and the nerves that ran to my thumb, palm, and fingers. My doctor sent me to a hand surgeon, who advised surgery, because my palm, thumb, and first two fingers were almost completely numb and I was losing my ability to grip.

    The surgery was very short – I was awake probably 30 minutes after I went into the OR – and after a few days of resting and taking painkillers I was basically fine. Very little discomfort. I was knitting again within 5 days, the bruises went away within a week, and I was lifting weights within three weeks. This was three months ago, and the scar is almost gone.

    I wouldn't recommend surgery for everyone, but I needed it to continue functioning normally.

    July 7, 2011 at 11:07 | Report abuse | Reply
    • florencia

      Maggie, the tendon, nerves that ran to my thumb, palm, and fingers have started to bother me last couple of months even after the non surgery procedure (needle) they did... should I address this to my doctor? the cyst is gone but the numbness reocurr from time to time.....not necessarily when im typing but even when i sleep or try to open (twist) stuff, or open the water faucett.... its worrying me a little...

      July 7, 2011 at 11:21 | Report abuse |
  25. Carol

    I had a ganglion cyst years ago on my left wrist, I was working on saturdays for an Osteopath, so showed it to him and he lifted a small book from his desk and said hit it several times a day with the book and it will disappear gradually. It did and about ten yrs. later it started to show again and I did the book thing, and it's never reappeared. I think it came from a strain, because I had a small Christmas tree, and many packages I was holding onto waiting for a bus and the tree started to fall as I got into the bus and I strained to hold onto to everything from falling out the door of the bus. A few months after the cyst appeared.

    July 7, 2011 at 11:27 | Report abuse | Reply
  26. Apul Maa'Deek-Aoud

    That bump is an RFID chip implanted while you slept so the gov't can track your every move.

    Cut off your hand quick.

    July 7, 2011 at 12:30 | Report abuse | Reply
  27. Fupped Duck

    Homeo don't play that

    July 7, 2011 at 13:14 | Report abuse | Reply
  28. Mo

    I had a cyst on both of my wrist in the same location, My doctor drained them with a needle but both came back a few years later I had surgery on the left wrist no problems since. I recommend the surgery.

    July 7, 2011 at 13:56 | Report abuse | Reply
  29. Jessica

    Drink aloe vera juice. One or two ounces a day will cure the ganglion cyst as well as many other health issues. That's how I cured mine. Much better than surgery or being stuck with needles or hitting yourself with a heavy book!

    October 8, 2011 at 11:54 | Report abuse | Reply
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  33. OCTAVIUS

    a guy at work told me that in the old days they'd hit these with a book. So, I flicked the bump on my wrist with my idex finger. Not that much force, and it totally disappeared instantly! really excited about this. another guy at work had surgery on his. My bump was small, and just appeared 3 days ago.

    so, maybe that's why it was so easily destroyed.

    February 29, 2012 at 20:10 | Report abuse | Reply
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  37. Mike

    I have had a ganglion on my wrist which grew large and hard over time (many years) until it looked quite unpleasant. I havenʻt treated it however being a hemochromatosis sufferer I recently gave up alcohol after being a regular drinker. I now take green tea extract and focus on foods that will be good for my liver. Miracle! My ganglion shrank right down leaving just a soft area.
    Toxins in the body?

    November 21, 2012 at 02:27 | Report abuse | Reply
  38. Lena

    I've had 3 in my right wrist in the last five years I'm 21 and I had the first one drained I quite literally bit the others and they popped I actually popped the third one tonight lol.... nom nom didn't really hurt just a little tender at the spot

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