8 Causes of a Lump on the Wrist or Hand

A lump on your hand or wrist is likely benign (not harmful). A bump that feels like bone is likely a carpal boss. A moveable wrist bump is typically a ganglion cyst. A lump on the palm of your hand may be Dupuytren's contracture.

If you notice a hand or wrist bump, have it evaluated by your healthcare provider. In rare cases, a bump on your fingers, hand, or wrist could be a giant cell tumor, enchondroma, or soft tissue sarcoma.

Ganglion Cysts

The most common cause of a hand or wrist bump is a ganglion cyst. 

It occurs when a pouch forms in the lining of the small joints of the wrists, hands, or fingers. Joint fluid leaks into the pouch, filling it like a water balloon. The result is a visible lump or bump on your hand or wrist.

Ganglion cysts are typically round or oval. They can be soft or firm like a marble and may be moveable. Ganglion cysts are often painless unless they compress a nerve. When that happens, you may experience discomfort, tingling, and muscle weakness.

Ganglion cysts can also form pouches in the sheath covering a tendon or knuckle joint. This type is called a mucous or myxoid cyst.

The initial cause of a ganglion cyst is unknown. Some experts believe that a previous trauma or arthritis may trigger it. Once you have a ganglion cyst, however, exercising or using the joint where a cyst is located can cause it to get bigger over time.

Treatment

Treatment for a ganglion cyst can involve surgical or non-surgical options. However, in most cases, your healthcare provider may simply ask you to wait and observe the cyst to see if it goes away on its own.

If the cyst remains, non-surgical treatments include:

• Splints
• Anti-inflammatory medication
• Aspiration to remove fluid and decompress the cyst

If the cyst is persistent or if it comes back, surgery may be required. Surgical treatments are generally successful.

There are two ways to get rid of a ganglion cyst on the wrist:

• Arthroscopic excision: A minimally invasive technique employs the use of a tiny camera that allows a surgeon to cut the stalk (which connects the cyst to the joint or tendon) so the cyst disappears over time
• Open excision: The stalk is removed without the use of the camera. A larger incision is required for this procedure.

Giant Cell Tumor

A hard painless wrist bump at the lower end of the lower arm bone could be a giant cell tumor of the tendon sheath.

A giant cell tumor is not a true tumor but a mass that arises from the tendon lining (sheath) or synovium, the soft tissue inside a joint. They tend to grow slowly and are not painful at first.

As it gets bigger, it can cause joint pain that increases with activity but decreases with rest. Giant cell tumors can grow to become extremely painful. They are easily removed but can grow back.

These tumors are quite rare, though, with only one in a million diagnosed each year. They mostly affect young adults and are more common in people assigned female at birth.

Treatment

The goal of treating this condition is to remove the tumor and prevent damage to the bone. The best treatment for a giant cell tumor depends on factors including your symptoms, your age, and your current health status.

Treatment may involve:

• Surgery
• Bone grafting
• Bone reconstruction
• Physical therapy

In rare cases, amputation is needed. But radiation treatment is also an option if your tumor can't be removed or comes back.

Inclusion Cysts

A small, painless, and moveable bump on the hand, wrist, or finger may be an epidermal inclusion cyst. Also known as an epidermoid cyst, these firm, noncancerous tumors just below the skin can develop on any part of the body.

Inclusion cysts develop during healing after an injury, though it may take years to become apparent. They occur when a penetrating wound or deep cut pushes cells from the skin's surface into the deep layers of skin.

The immune system views these cells as foreign invaders and surrounds them with a soft waxy material known as keratin to create a protective barrier. They gradually expand over time to form cysts.

Treatment

Epidermal inclusion cysts are not dangerous and do not need to be treated unless they become infected. If the cyst becomes swollen, inflamed, tender, or enlarged it may require treatment.

Treatment will depend on the symptom:

• An inflamed or swollen cyst may be treated with a steroid injection.
• A swollen, large, or tender cyst may be drained or surgically removed by your healthcare provider.
• An infected cyst may require prescription oral antibiotics.
  

Carpal Boss

A hard lump on your wrist that feels like bone may be a carpal boss. This is an overgrowth of the bone on the back of the hand. It's similar in appearance to a bone spur.

A carpal boss is essentially a small area of osteoarthritis occurring at the point where the long hand bones and small wrist bones connect.

While frequently misdiagnosed as a ganglion cyst, a carpal boss is firmer. Unlike a cyst, you cannot move it or feel any "give" when you press on it. 

Treatment

You may not need treatment for a carpal boss if it doesn't cause you any pain. If it becomes painful the following options are available:

• Avoiding movement that triggers pain
• Icing the area
• Over-the-counter pain relievers
• Steroid injections
• Surgery

Dupuytren’s Contracture

A hard lump on the palm of your hand is a symptom of Dupuytren's contracture. Also known as Dupuytren's disease, it causes an abnormal thickening of connective tissue (fascia) under the skin of the palm of your hand.

Dupuytren's disease usually begins with tender nodes under the base of the ring or pinky fingers. These may develop into a hard lump or thick band and become less tender. Over time, this can cause one or more fingers to curl or pull sideways or toward your palm.

The condition is not painful but can inhibit your ability to use your hands for certain tasks, grasping large objects, or straightening your fingers.

Treatment

Treatment for Dupuytren's disease varies based on several factors, such as your age, your health history, and the degree to which the condition bothers you. There is no cure for this condition.

Treatments can include:

• Steroid injections to relieve pain
• Enzyme injections to release tight bands of tissue and allow for stretching and straightening of joints.
• Needle aponeurotomy, a procedure where a needle is used to divide affected tissue and straighten bent fingers
• Surgery for advanced cases

Enchondroma

Enchondroma is a noncancerous tumor that develops when cartilage grows inside a bone.

An enchondroma can become a problem if and when the tumor weakens the bone. This increases the risk of a pathologic fracture, a break in a bone that was weakened by another disease.

Enchondromas are mostly benign (not harmful) and only rarely develop into cancer.

Treatment

If your tumor does not cause pain, you may not need treatment. Your provider may recommend that you observe the tumor to ensure that it doesn't change.

If treatment is required, surgical and non-surgical options are available. Treatments include:

• Curettage, a treatment that involves scraping the bone to remove the tumor
• Bone graft for bone stabilization
• Chemotherapy or radiation in rare instances
  

Rheumatoid Arthritis

Rheumatoid arthritis (RA) can cause firm lumps just below the skin on the hands, known as rheumatoid nodules.

An autoimmune form of arthritis, RA causes swelling and pain in the lining of your joints. It can affect joints in the wrists, hands, fingers, elbows, feet, spine, jaw, and knees.

RA often occurs symmetrically, meaning the same joints are affected on both sides of the body. Other common RA symptoms include:

• Difficulty moving your joints
• Fever
• Fatigue
• Joint stiffness and pain, especially after resting
• Loss of appetite
  
• Red, puffy hands
  

Treatment

The goal of RA treatment is to manage inflammation and reduce pain. Lifestyle changes, medication, and physical activity can also help to slow the progression of the disease, prevent joint damage, relieve fatigue, and improve overall physical function.

Medications for RA include:

• Nonsteroidal anti-inflammatory drugs (NSAIDS) (such as ibuprofen or naproxen) or analgesics (such as Tylenol)
• Disease-modifying antirheumatic drugs (DMARDs) such as methotrexate
• Biologics (genetically engineered proteins) given by injection or infusion
• Janus kinase (JAK) inhibitors taken orally
• Corticosteroid medications given by prescription

Lifestyle and activity treatments include:

• Regular physical activity, including strength and mobility exercises
• Working with a physical therapist
• Participating in lower-impact physical activities that you enjoy, such as swimming, water aerobics, low-impact aerobics, or stationary cycling
• Quitting smoking
• Using self-help devices such as adaptive zippers or can openers, rails in the shower or bath, or wide key holders
• A healthy diet including fruits, vegetables, and whole grains
• Stress management activities such as journaling, massage, or meditation

Surgery may sometimes be required to repair joints and improve function. The most common procedures are hip and knee replacements.

Cancer of the Hands or Wrists

It is rare that a lump or bump on the wrist or hand is cancerous. When this occurs, it is usually due to cancerous cells that have spread (metastasized) from elsewhere in the body.

Cancerous lumps are usually hard, but not all hard lumps are cancer.

Types of cancer that can affect the hands or wrists include the following:

• Chondrosarcoma is a type of bone cancer where a large mass develops in the cartilage. You may feel pressure around the mass and pain that gradually increases over time and is worse at night. 
  
• Soft tissue sarcoma can grow in cartilage, fibrous tissue, muscles, tendons, blood vessels, and synovial tissue that lines the joints. Sarcomas are typically painless until they grow to compress a nerve. 
• Non-Hodgkin lymphoma can present as a painless, slowly growing soft tissue mass with joint swelling. However, this is extremely uncommon.
• Squamous cell carcinoma, a type of skin cancer, can appear as a firm red bump on the back of the hand. It may also look like a scaly red patch, an open sore, or a wart that bleeds or crusts easily.

Though rare, cancers of the hands and wrist are serious problems that require invasive treatment and prolonged care.

Treatment

Treatment for cancer of the hand will depend on the type of cancer that you have. There are many different types of cancer treatment. Your healthcare provider will discuss your options with you at the time of diagnosis.

In general, cancer treatments can include:

• Chemotherapy
• Radiation
• Hormone therapy
• Immunotherapy
• Stem cell transplant
• Surgery

When to See a Healthcare Provider

While most bumps on the hand or wrist are nothing to worry about, they should still be evaluated by a medical professional.

Specific symptoms of concern vary for each condition, but there are some signs that consistently call for interaction with your health team:

• You develop new growths that have not been addressed previously.
• You develop a visible bump along with fluid build-up, limited movement, or pain.
• You develop a firm, immovable bump (especially if accompanied by pain).

Diagnosis

Your healthcare provider will first perform a physical exam and ask for your symptom history. They will palpate the mass, shine a light on it, move the affected joint in different directions, and examine the skin.

Imaging tests, including X-ray, ultrasound, CT scan, or MRI, are sometimes helpful for identifying the cause. In some cases, a tissue sample may be removed for a biopsy and examined under a microscope.

Summary

Most of the time, masses in the hand and wrist are noncancerous. One common type of benign growth in the hand or wrist is called a ganglion cyst.

While rare, it is possible for a lump or bump in the hand or wrist to be cancerous, however. When this occurs, it's typically because of cancer found elsewhere in the body.

It's important to visit your doctor if you notice a mass or growth beneath your skin. After careful evaluation, they can determine if the growth is cancerous or nothing to worry about.