Health & WellbeingGeneralA ganglion or a carpal boss?
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A ganglion or a carpal boss?

By Melina - Assistant Editor Mar 12, 2019

There is a lump on the back of my hand – what could it be?

The AXA PPP healthcare Health at Hand nurses cover the difference between a ganglion and a carpal boss.

A lump on the top of the hand could possibly be a ganglion cyst or a carpal boss. So what is the difference?

Ganglion Cyst

A swelling filled with fluid that forms around the joints or tendons a ganglion cyst makes up over 50% of lumps on the hand. They can occur in any joint but are most common on the hand, wrist or fingers. A ganglion cyst is smooth and can vary in size.

Carpal Boss

A carpel boss is not a tumour but is frequently confused with a ganglion cyst. It is an overgrowth of bone on the back of the hand where the middle or index finger bones meet your wrist and is similar to a bone spur. A carpal boss is solid and cannot be moved.

If you have a lump on your hand then your first port of call should be your GP for an accurate diagnosis. This may include an X-ray an MRI scan or blood tests. Your GP will then be able to advise on the most appropriate treatment for you (if any).

Treatment options for ganglion cysts

If they are not causing you any pain then ganglions can be left untreated. They are usually harmless and will sometimes disappear by themselves in the course of time.

However, if you are in pain, or movement in your hand is hindered by the ganglion then there are 2 main treatments available:

  • The first option is aspiration of the cyst – this is where the cyst is drained with a needle and syringe. This is a fairly simple procedure but occasionally the cyst may return so it may have to be followed with surgery.
  • The second option is surgery – this is where the cyst is removed either through open surgery or keyhole. This is usually carried out under local anaesthetic. As with any surgery there may be complications and there will be more recovery time involved.

Treatment options for a carpal boss

It is not clear why these appear but it is possible they are as a result of injury or repetitive use. A carpal boss is not generally painful and can be left untreated but if it is causing pain then there are a few treatment options:

  • It can help to rest the wrist and use a splint to support it
  • It is safe to apply ice to the joint
  • Over the counter painkillers may help if these are safe for you to take
  • Your GP may recommend steroid injections into the boss
  • If all other treatments have failed then surgery may be offered – however it may take weeks or even months to recover.

Read the NHS Factsheet on Bone spurs (osteophyte) here.

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Melina - Assistant Editor

Hi I'm Melina, a mother of 3 teenage children and with a particular interest in all things health related. I run a busy household and smallholding alongside my work with Silversurfers, which currently includes dogs, fish, hens, ducks and pigs!

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