Lumps and Bumps on the Hand, Wrist and Fingers Info

Finding a new lump on your hand or wrist is unsettling, but the great majority are benign, meaning not cancer. Most are one of a small number of common, harmless growths, and many need no treatment at all. This page explains the lumps we see most often, what each one feels like and where it tends to sit, and the features that mean a lump should be checked sooner rather than later. A new lump is always worth showing your GP or a hand surgeon, even when it does not hurt.

Ganglion cysts (the commonest lump)

A ganglion cyst is the most common lump on the hand and wrist. It is a smooth, round swelling filled with a thick, clear jelly that has leaked from a nearby joint or tendon sheath. Ganglions often change size, can ache with activity, and sometimes disappear on their own. Pressing a small torch against one often makes it glow, because it is full of fluid rather than solid.

They turn up in a few typical places:

• The back of the wrist (the most common spot) and the front of the wrist on the thumb side.
• The base of a finger on the palm side, as a small, firm "seed" the size of a dried pea, arising from the tendon sheath.

Many ganglions can simply be watched. If one is painful or in the way, the fluid can be drained with a needle (it may come back), or the cyst can be removed surgically. See wrist ganglion removal and the small flexor tendon sheath ganglion at the base of a finger.

Giant cell tumour of tendon sheath

A giant cell tumour of tendon sheath is the second most common hand lump. It is a firm, rubbery, slow-growing nodule, usually on a finger or thumb near a joint, and it is benign rather than cancer. Unlike a ganglion it is solid, so it does not glow when a light is held against it, and it can slowly come back after removal. There is a dedicated page on giant cell tumour of tendon sheath.

Lipoma (a fatty lump)

A lipoma is a soft, squishy, slow-growing lump made of ordinary fat. They are harmless and most often sit in the palm or forearm. A small lipoma can simply be left alone. It is usually only removed if it grows large, becomes uncomfortable, or, rarely, presses on a nearby nerve and causes tingling or weakness.

Mucous cyst (over the end joint of a finger)

A mucous cyst is a small fluid-filled cyst that forms over the end joint of a finger (the joint nearest the nail). It is closely linked to wear-and-tear arthritis of that joint, so it is more common with age. As it grows it can thin the skin over it and press on the nail bed, leaving a lengthwise groove or ridge in the nail. A mucous cyst is often watched, but it is usually removed if the skin over it is breaking down, it keeps leaking, or it is painful. More detail is on the mucous cyst page.

Carpal bossing (a bony lump on the back of the wrist)

Carpal bossing is a hard, fixed lump on the back of the wrist, where the long bones of the index and middle fingers meet the small wrist bones. It is a small bony spur from a wear-and-tear joint, so, unlike a ganglion, it does not move or change size. It is usually harmless and simply watched, though a firmly fixed bony lump is worth confirming with your doctor.

Less common causes

Other, less common lumps include an epidermoid inclusion cyst (which can form after a small cut buries skin cells under the surface), lumps arising from a nerve or blood vessel, and, rarely, a growth that needs prompt specialist attention. This is why any lump with the warning features below should be checked.

When to see someone

Most hand and wrist lumps are benign, but see your GP or a hand surgeon promptly if a lump:

• is growing quickly, or is larger than a couple of centimetres
• feels hard and fixed to the deeper tissues rather than moving freely
• is painful at rest or at night, or causes numbness, tingling or weakness
• has skin changes over it, or starts to bleed or break down
• appears alongside feeling generally unwell or unexplained weight loss

Even a painless lump is worth showing your doctor. A short examination, sometimes with an ultrasound scan, usually identifies what a lump is and whether anything needs to be done.