1. Ganglion Cysts Are Very Common Around the Wrist
Ganglion cysts may arise from the back of your wrist (which is called a dorsal ganglion cyst) or from the palm side of your wrist (a palmar ganglion cyst). Ganglion cysts arise from either joints or tendon sheaths. They also are common in the back of the knee, where they are called Baker's cysts (popliteal cysts). No one knows exactly what causes them to form, and there is often no preceding trauma. Other times, there is an injury to the joint, such as when you sprain your wrist. That causes a small rent or tear in the joint capsule. Joint fluid then escapes through the small hole, which acts like a one-way valve. The fluid accumulates and forms a balloon-like structure, with a stalk coming off the joint.
2. They Can Be Very Painful
Because ganglion cysts take up space and can put pressure on surrounding nerves, they can cause pain. Oddly enough, the smaller ones seem to cause more discomfort. Larger ones are more unsightly, but sometimes don't cause much pain at all.
3. If They Don't Bother You, You Don't Have to Do Anything About Them
Sometimes, the ganglion cyst doesn't cause much pain or cause any limitations in motion. If that is the case, you can continue to observe the cyst. Because a growth around the wrist is not necessarily a ganglion cyst, a visit to a doctor can help confirm the diagnosis. The doctor may illuminate it with a penlight to see that it is fluid-filled. Sometimes, especially in the case of smaller cysts that are not readily apparent, an MRI can help pin down the diagnosis. Initially, a brace and anti-inflammatory medications can help. Because the ganglion cyst arises from a joint, activities that involve more joint motion can cause the cyst to grow. A brace can help restrict motion and rest the joint, which will hopefully cause the cyst to shrink.
Sometimes, ganglion cysts will burst or go away by themselves. Another term for them is "Bible bump," from the non-medical and non-encouraged treatment of pounding on them with a Bible.
4. Sometimes, an Injection Can Help
If rest alone does not help, you may want to consider an aspiration and possibly a steroid injection. The chances are about even that a cyst will grow back after an aspiration. (So your decision depends on whether you're a glass half-empty or -half-full kind of person.) After the aspiration, some doctors will inject a bit of steroid to calm down the swelling in the area.
5. If All Else Fails, Consider Surgery
If non-surgical measures fail to relieve your pain, you may want to consider surgical excision of the mass. This is an outpatient procedure that is done under either general or local anesthesia. The mass is traced down to the joint or tendon and removed. Sometimes, part of the joint capsule or tendon sheath is removed, to avoid creating another one-way valve. Usually, you will recover within 4 to 6 weeks.
