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Danielle asked...

I have a bone that sticks out on my hand. Is it a ganglion cyst?

I have a lump on the top of my hand – like a bone that sticks out. I was wondering what it was and if this is common?

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The answer

The lump on your hand could be a few things:

  • A ganglion cyst is a swelling filled with fluid that forms around your joints or tendons. They can occur in any joint but most commonly appear on the wrist, hand or fingers. In fact, more than 50% of lumps and bumps in the hand are ganglion cysts. The cysts are smooth and can range in size.
  • A carpal boss is an overgrowth of bone on the back of the hand where the middle or index finger bones meet your wrist, similar to a bone spur. A carpal boss is not a tumour but can be misdiagnosed as a ganglion cyst. They are solid and cannot be moved.

I would suggest you consult your doctor so they can accurately diagnose the lump on your hand. This may involve further investigation, such as an X ray, MRI scan or blood tests. Depending on the findings, they will advise you on appropriate treatment (if required). In the meantime here are some facts about ganglion cysts and carpal bosses and the treatment options available, which we hope you find useful.

Ganglion cysts

Ganglions are usually harmless and can be left untreated if they’re not causing you any pain or discomfort. They sometimes disappear by themselves, although this can take a while.

If you are in pain or can’t move your hand, you can have your ganglion cyst treated. There are two main treatments:

  • Aspiration – the cyst is drained with a needle and syringe. This is usually the first port of call for treatment as it is a fairly simple procedure. Sometimes the cyst can return in which case you may need surgery.
  • Surgery to remove the cyst. This can be open or keyhole, and is usually done under local anaesthetic (it can also be performed under general, though, it depends where the cyst is). There are more complications and recovery needs for surgery so it is a good idea to chat to your doctor about all your options.

Carpal boss

It’s not known exactly what causes a carpal boss, although some people think it can be due to injury or repetitive use. Sometimes a carpal boss is painful, especially when you move the wrist up or down, but sometimes it isn’t.

Again, a carpal boss is harmless so if it isn’t causing you any pain or discomfort you can leave it untreated. If it’s bothering you, treatment options include:

  • Resting the wrist and using a splint to support it and stop you moving it
  • Applying ice to the joint
  • Painkillers, if these are safe for you to take
  • Steroid injections into the boss
  • Surgery to remove the boss. This is a last resort if other treatments have failed and it is causing problems or you’re in a lot of pain and it can take a while to recover - sometimes weeks or even months.

Answered by the Health at Hand nurses  

Sources and further reading

Ganglions - AXA PPP healthcare

The best ways to look after your joints - AXA PPP healthcare

Bone spur (osteophyte) – NHS Factsheet

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