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Glomus tumour excision
Glomus tumours are small, benign growths that usually develop under the fingernail and can cause sharp pain, sensitivity to cold, and tenderness at the site. Surgical excision removes the tumour to relieve symptoms and is typically curative, with most patients experiencing significant pain relief afterward.
At a glance
Anaesthetic
Typically sedation or general anaesthetic, but can be performed under local anaesthetic
Where
The Avenue Hospital
Day case or overnight
Day case - home the same day
First post operative review
Approximately one week after surgery
Driving
Plan not to drive for one week
Post Operative Hand Therapy
Routine, so that you can be fitted with a thermoplastic splint for protection one week after surgery
Splinting
Routinely recommended for post operative protection to facilitate return to activities
Pain relief
Usually paracetamol and/or ibuprofen
Return to repetitive & heavy loading
As tolerated, but generally several weeks
Surgical removal of a glomus tumour of the finger
A glomus tumour is a small, benign tumour arising from the glomus body, a structure involved in temperature regulation of the skin. In the hand these are most common under or near the fingernail and are typically excised because of pain.
Who is this procedure for?
- People with a painful lump under or near the fingernail, often with cold sensitivity
- People with a diagnosis (or strong clinical suspicion) of glomus tumour, sometimes confirmed on MRI
- People whose pain is affecting daily activities or sleep
- Not generally needed for asymptomatic, incidentally found lesions
What does the surgery involve?
Surgery involves careful exposure of the tumour, which is usually located beneath the nail bed or in the pulp of the fingertip, and its excision under magnification to preserve surrounding nerve and nail bed structures. The nail bed is repaired if it was opened to access the tumour.
Alternatives to surgery
Glomus tumour excision is one option for a painful glomus tumour. Depending on your situation, the alternatives may include:
- Doing nothing for now (watchful waiting): reasonable if pain is mild and not affecting function, though glomus tumours rarely resolve on their own
- Further imaging first: an MRI may be used to confirm the diagnosis and localise the tumour before proceeding to surgery
What happens if left untreated: the pain typically persists or worsens, and the tumour does not resolve without treatment.
Dr Tomlinson will discuss which options suit you at your consultation.
Frequently Asked Questions
Where will my surgery be done?
At The Avenue Hospital.
Why might I choose local anaesthetic rather than sedation or a general anaesthetic?
A procedure under local anaesthetic avoids the risks and recovery of sedation or a general anaesthetic. You don’t need to fast beforehand, you can eat and drink normally, you recover quickly, and you usually go home soon afterwards. For many people it’s also less expensive and more convenient.
How much time will I need to have away from work?
This depends on what your job involves. If your work is desk-based or administrative, you may be able to return relatively soon, often with some temporary modifications. If your work is physical – heavy lifting, manual labour or “on tools” – you’ll usually need longer. As a guide for this procedure: plan 1-2 weeks away from administrative duties.
When will I be able to drive again?
Multiple things affect this: which hand was treated, whether you’re wearing a bandage, whether you can grip the wheel and respond safely in an emergency, whether you are driving for personal or commercial purposes, the nature of the vehicle you are driving, and your pain levels and medications. You also need to be safely in control of the vehicle for insurance purposes – you should be able to grip the steering wheel strongly with both hands and be able to take evasive action in an emergency before you get behind the wheel. As a guide: plan not to drive for one week after the procedure.
When can I do a full day of administrative or desk work?
Often from 2 weeks after surgery, particularly with some temporary adjustments (see below). Keeping your hand elevated and taking reg1-ular breaks helps reduce swelling and discomfort in the early days. If you need to drive to work or carry or lift objects as part of your administrative work then alternate or half days may be a prudent measure when first returning to work.
What workplace modifications might help?
Depending on your job, helpful temporary modifications can include:
– Half days or alternate days to begin with
– No heavy lifting
– Lighter duties or being off tools
– More frequent breaks
– Using a headset instead of holding a phone
– Voice-to-text or dictation instead of typing
– Keeping the hand elevated at your workstation
– Avoiding repetitive gripping
– Help with carrying or moving items
– Moving temporarily to reception or phone duties if your role is normally manual
– Protecting the wound if your work exposes your hands to water or contamination (e.g. food handling, healthcare, wet trades)
We’re happy to provide a letter for your employer outlining recommended modifications.
I take a GLP-1 medication (such as Ozempic, Wegovy, Mounjaro or Trulicity) — how does this affect my procedure?
GLP-1 medications, used for diabetes or weight management, slow the emptying of the stomach. This can increase the risk of stomach contents being present during sedation or a general anaesthetic. In line with current ANZCA guidance, if you’re having sedation or a general anaesthetic you’ll be asked to follow a clear-fluid-only diet for 24 hours before your procedure, followed by the standard 6-hour fast. Please tell us and your anaesthetist that you take this medication — your anaesthetist will give you specific instructions. (If your procedure is under local anaesthetic only, fasting is generally not required, but please still let us know.)
How long will I need to wear a splint?
In the first week you will have a bulky bandage on your finger, protecting the operation site. After that bandage is removed we routinely suggest seeing a hand therapist for a cap splint that provides slimline protection of the operation site, facilitating early return to activities.
Will I need to see a hand therapist afterwards? May I see one if I'd like?
Not mandatory, but recommended so that you can be fitted with a thermoplastic splint one week after the procedure to facilitate your early return to activities.
What pain medication will I need afterwards?
Usually simple pain relief – paracetamol and ibuprofen – is all that’s needed. Some procedures are more uncomfortable and you may need stronger pain relief. We can always prescribe stronger painkillers if you need them.
Risks & complications
General risks of hand surgery
- Bleeding and bruising; rarely, a collection of blood (haematoma) that may need draining
- Infection, which may require antibiotics or, rarely, further surgery
- Pain — usually temporary, occasionally persistent
- Swelling – common, and usually settles over weeks to months
- Scarring – scars are permanent and occasionally become thickened, raised or sensitive
- Allergic reaction to the local anaesthetic, antiseptic, dressings, tape or suture material
- Delayed or problematic wound healing
- Stiffness or reduced movement in the fingers, hand or wrist
- Injury to nerves, causing numbness, altered sensation or, rarely, a painful neuroma
- Injury to blood vessels (arteries)
- Injury to tendons
- Injury to bone (fracture)
- Failure to fully relieve your symptoms, or symptoms returning over time (recurrence)
- Complex regional pain syndrome (CRPS) – an uncommon but significant condition causing ongoing pain, stiffness and swelling
- Cold intolerance – the hand becoming more sensitive to cold, usually improving with time
- The need for further surgery
- Blood clots in the leg or lung (DVT/PE) – uncommon in hand surgery, with a slightly higher risk after a general anaesthetic or prolonged immobilisation
Specific risks of this surgery
- Recurrence of the tumour, either from incomplete removal or a new lesion nearby
- Nail ridging or deformity, since these tumours often sit close to the nail-forming (germinal matrix) tissue
- Persistent cold sensitivity or tenderness at the site
- Numbness if a small nerve branch is affected during removal
Anaesthetic
If you are having sedation or a general anaesthetic for this procedure, your anaesthetist will discuss the specific risks of anaesthesia with you separately.
Recovery & rehabilitation
First 48 hours
Keep your hand elevated for 48 hours to reduce bleeding and post-operative swelling. Local anaesthetic lasts 6–24 hours (occasionally 1–3 days); your hand will have numb areas during this time.
First week
Keep the dressing dry and intact until your post-operative review. You may use your hand for light activities, but listen to your hand and avoid anything that causes pain, such as lifting or gripping. Sensitivity and discomfort with lifting and gripping are expected in the first few weeks. Listen to your hand and do not perform activities that cause discomfort. You should find that your hand function is better each day.
Second week
Wound and nail bed continue to settle. A custom fitted thermoplastic splint can protect your finger as you resume usual activities.
6 weeks
Full grip strength may take several months to return, and deep-pressure tenderness at the operation site can persist for some months. The scar will feel tight and firm. Massage assists with improving scar mobility and minimising scar firmness.
3 months
Nail growth (if the nail plate was affected and the nail bed was opened) takes months to fully settle.
Long term
Most patients report resolution of the characteristic pain and cold sensitivity. Nail changes, if present, may take up to a year to grow out and achieve a new normal.
Want to know more about Glomus Tumour Excision?
Contact us to schedule an appointment with Dr Tomlinson.
Fees and costs
You will receive a written financial quotation after your consultation, once your operation and any third-party requirements are confirmed. See our Fees and informed financial consent page for how our fees work, what your quotation includes, and the resources available to you.