Hand swelling and the treatment of finger cysts

Swelling and/or cysts on the hand and fingers can be bothersome and in some cases, quite painful! Learn from Dr Stephen Lipscombe, a consultant hand and wrist surgeon, about how cysts are treated.

How common is it for the hands and fingers to swell up?

It is unusual for the hand and fingers to swell.

What are the possible causes of the hands swelling up?

Patients describe a sensation of swelling with carpal tunnel syndrome, which eases during the day. Systemic inflammatory disorders less commonly cause swelling hands. Isolated dactylitis (which is more typical in diabetes patients) can produce dramatic swelling in single digits.

Are cysts on the fingers dangerous if left untreated?

Cysts are not dangerous but can be troublesome on the fingertips. They interfere with daily function as they catch on items, cause pain and the skin can break down with mucous discharge.

How are hand and finger cysts treated?

Some will settle spontaneously. Cysts that don’t settle and cause problems can be managed with needle aspiration if the skin is in good condition - accepting the higher risk of cysts recurring if this method is used. In some cases, surgical removal may be necessary.

What happens during surgical removal of cysts?

This is completed as a minor theatre procedure under local anaesthetic. The patient is awake and can eat and drink beforehand.

A fine needle injects local anaesthetic around the base of the finger, causing tingling and then numbness, and then an elastic tourniquet is placed along the finger. A small skin flap is elevated overlying the cyst. The cyst is then removed and the origin of the cyst (typically found from the underlying joint) is also removed to reduce the chance of another cyst forming.

What is recovery like?

Sutures (stitches) and a tissue adhesive are used to close the wound and a light finger dressing is applied along the finger. Later in the day, the patient can take simple painkillers and the light dressing can be removed after two days. Once the light dressing has been removed, the patient can continue with regular activities, including showering. The sutures are removed after two weeks.

Can cysts grow again in the same place after surgical removal?

Having occurred spontaneously, cysts can recur after surgical excision, but this is uncommon: it’s estimated that this happens in five per cent of patients.

To receive first-class patient care from a highly experience hand and wrist surgeon, visit Mr Lipscombe’s profile and arrange your video or face-to-face consultation.