Updated on 6/20/2005
Ganglion cysts are very common fluid-filled lumps that form on the hand and wrist, usually on the upper side of the wrist. Their cause is unknown. While harmless, even tiny ganglion cysts that aren't visible as lumps can sometimes be quite painful. These growths tend to get bigger (and can cause increasing discomfort) with repetitive activity, such as typing. They contain a fluid that is similar to that found in joints - in fact, the ganglion cysts grow out of a joint, like a balloon on a stalk that rises out of the connective tissues between bones and muscles.
Unless they're painful or unsightly, you really don't have to do anything about ganglion cysts. In the past, the treatment was to smash them with a heavy book, usually a family bible. My family doctor actually did this to me with an anatomy text when I was a teenager, and it worked. My marble-sized ganglion, which had been quite painful at times, disappeared, never to return.
Sometimes, the cysts go away on their own. So unless yours is troublesome, you could just wait to see what happens. If it becomes inflamed, you can have it injected with cortisone. Another option is to have a painful cyst drained. This is done with a thin needle after the area is numbed. However, the cyst will refill with fluid about half of the time, so this treatment won't always eliminate the problem. Another way to relieve pain and reduce swelling is to immobilize your wrist in a splint.
If all else fails, you can have the cyst surgically removed, but this is a complicated procedure and still not fool-proof since there is a chance that the cyst will recur. The surgery is an outpatient procedure, but you'll need two to six weeks of recuperation before you can resume your normal activities. My recovery from the book-smashing routine was about five minutes, and I would do that again if I ever needed to get rid of a troublesome ganglion cyst.
Andrew Weil, M.D.