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Wrist Ganglion Cysts, What You Need to Know to Avoid Surgery

The wrist is a common location for ganglion cysts. This is a common, benign, fluid-filled tumor that comes from the joint lining on the back or front of the wrist. Once you’ve been diagnosed with a wrist cyst, it can be treated with or without surgery.

image - Wrist Ganglion Cysts, What You Need to Know to Avoid Surgery
What You Need to Know to Avoid Surgery: Wrist Ganglion Cysts

Wrist Ganglion Cyst Treatment — Surgery

Surgery involves making an incision over the mass (also called a tumor) and totally removing the cyst from the wrist. This usually involves pretty deep dissection down to the level of the wrist joint, where the cyst comes from.

One myth about ganglion cyst surgery is that you just open the skin a little and cut the cyst out in the office. A properly performed cyst removal surgery is done in the operating room and involves opening up the joint lining where the cyst arises.


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Nonsurgical Treatment of Wrist Ganglion Cysts

The first thing you can do to treat your cyst is to wait — don’t stick a needle in it or hit it with a book. It may go away on its own!

Most patients with wrist cysts notice that the mass goes up and down in size. Usually, the pain gets worse when the bump gets bigger.

Sometimes the cyst ruptures or pops on its own. I’ve had several patients tell me they were scheduled to come and see me the next day, and they woke up to find the bump on their wrist was gone!

A few doctors still recommend hitting the cyst with a large book, like a bible or a dictionary, trying to pop it. I don’t recommend doing this.

Hitting a body part violently could cause another injury that’s worse than the cyst. It may cause bleeding in the wrist which may be more painful than the cyst was. Besides, it may not even rupture the cyst.

Wearing a wrist splint and avoiding hyperextension of the wrist (like when you’re doing push-ups) may calm down the pain and give the wrist a chance to feel better. There’s no harm in waiting.

Draining Fluid from a Wrist Cyst — How does this Work?

Dorsal ganglions and volar (palm-sided) ganglions of the wrist are filled with a thick, clear jelly-like fluid. The most common treatment between doing nothing and surgery is using a needle and syringe to drain the cyst.

This is done in the office. The doctor will clean the skin with alcohol or iodine solution and then numb your skin up with local anesthetics, like lidocaine, or one of the other “—caine” medicines with a small needle.

image - Draining Fluid from a Wrist Ganglion Cysts
Draining Fluid from a Wrist Ganglion Cysts

Once the skin is numbed up, a larger needle is used to puncture the skin and drain out the fluid. Sometimes the fluid can be sucked out into a syringe, but often it’s just too thick.

Puncturing the cyst several times beneath the skin may cause the fluid to come out through the skin or just underneath it.

Your doctor may recommend massaging the injection site for half an hour to drain out more fluid after the procedure.

Are there Any Disadvantages or Risks to Needle Drainage of a Cyst?

There is a small risk of infection when you have an injection with a needle. The palm-sided cysts are very close to a major artery in your wrist, and this artery could be injured during the injection.

Small nerves can become irritated if they are injected directly with the anesthetic, but this is rare.

The biggest risk is that the treatment won’t work — the cyst may return.

After Treatment for Cysts of the Wrist

How can you keep this cyst from coming back after your doctor drains it? One idea is to wear a wrist brace for a few weeks most of the time. This will prevent too much wrist motion, which may push more fluid out into the cyst, causing it to fill up again.

image - After Treatment for Cysts of the Wrist
After Treatment for Cysts of the Wrist

Does Draining the Ganglion Cyst Work? Will it Come Back?

Draining the fluid out of the cyst generally takes away the pain in the wrist. It might be sore for a few days afterward.

Every cyst and every patient is a little different. Some doctors say that this kind of treatment only works permanently about 20% of the time. Others have better success.

Surgery is more reliable, but also has more risks that go along with it. There is only about a 2-3% chance a ganglion cyst will come back after a well-performed surgery.

References


Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.


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