Do you have a firm, smooth lump near your wrist or finger joints? Don’t panic because the lump is most likely not a cancerous tumor, but just a ganglion cyst, also known as a “Bible cyst.” Ganglion cysts are noncancerous fluid-filled lumps that commonly develop along the joints or tendons of hands or wrists, and sometimes near the feet. The exact cause of ganglion cysts is unknown, but they are associated with using the hands or feet too much. They are harmless most of the time, but can sometimes cause pain when they put pressure on nearby nerves. The following tips can help you get rid of your ganglion cyst for medical or cosmetic reasons.

What is a Ganglion Cyst Composed Of?

You must be wondering what’s inside that lump on the back of your hand. Ganglion cysts typically form on top of joints or tendons. Inside the cyst is a thick, sticky, clear or translucent jellylike fluid. The fluid is similar to synovial fluid, a thick, stringy fluid that lubricates and cushions synovial joints. Cysts may feel firm or spongy depending on their size and the amount of liquid they contain.

Diagnosis of Ganglion Cysts

The first step to get rid of your ganglion cyst is to be sure that it is indeed just a ganglion cyst and not something more serious, like a cancerous tumor, so go see your doctor. The following are the questions your doctor will likely ask during your consultation:

• When did you first notice the cyst?
• Do you feel any pain or tenderness?
• Does the lump interfere with your hand movement?
• Are there things that seem to worsen your symptoms?
• Are there things that seem to improve your symptoms?

Prepare yourself by writing down any symptoms that you’re experiencing, even those that seem unrelated to the cyst. List also all the medications, vitamins or supplements that you may be taking. It’s also a great idea to write down all the concerns or questions you have about the cyst. The following are tests your doctor may perform if he suspects a ganglion cyst.

• Physical Exam:Your doctor applies pressure to the cyst to test for tenderness, and to find out if you feel any discomfort or pain.
• Aspiration: The physician may confirm a ganglion cyst diagnosis through aspiration, a process in which a needle and syringe are used to draw out the fluid inside the cyst.
• X-ray: X-rays are used to rule out other conditions such as a cancerous tumor or arthritis.
• Ultrasound and MRI: Other imaging tests like ultrasound and magnetic resonance imaging (MRI) may also be used to learn about the cyst’s shape, size, and depth. Some ganglion cysts are “invisible,” so your doctor may use ultrasound or MRI to see if there’s a hidden ganglion cyst in your hand. Hidden ganglion cysts may cause pain or discomfort if they touch nearby nerves or interrupt joint movement.

Getting Rid of Your Ganglion Cyst

It’s not advisable to get rid of your ganglion cyst if it’s not causing you any pain or discomfort. Some people though want to get rid of their ganglion cysts because of cosmetic reasons. Whatever your reasons are however, the following tips can help you get rid of your cyst as soon as possible.

• Immobilization: Ganglion cysts can increase in size and cause more pain because of hand movement. You may choose to wait for the cyst to decrease in size while wearing a wrist splint or brace to immobilize the area. The splint helps your hand to rest, which may reduce the size of the cyst.
• Aspiration: This procedure involves draining the fluid from the cyst. The doctor applies a local anesthetic above the cyst, then punctures it with a needle. He then uses a syringe to drain the fluid from the base of the cyst. The procedure is quite simple and can be done in the doctor’s office.

Research shows that up to 74 percent of patients are cured after an aspiration procedure. Cysts, however, may recur after some time. In fact, the recurrence rate for aspiration can be as high as 80 percent. You can have the procedure repeated if the cyst recurs. Studies show that having the fluid drawn out three times increases the possibility of being cured to 85 percent with a cyst on the back of the hand.

• Surgery: Your doctor will recommend surgery if the cyst is causing significant pain, difficulty with hand movement, or if other treatments aren’t working. Surgical procedures for ganglion cysts are usually performed on an outpatient basis, which means you can go home the same day as the operation. The following is the typical course of the operation:
  • Step 1: The doctor applies a local anesthetic to numb the area with the cyst.
  • Step 2: He makes an incision in the skin at the location of the cyst. The size of the incision depends on the size of the cyst.
  • Step 3: He removes the cyst and the stalk that binds it to the tendon or joint. Depending on the nature of the cyst, he may also remove a small portion of the surrounding tissue, as well.
  • Step 4: He stitches and bandages the affected area.

Your will be asked to keep the affected area elevated for up to 48 hours to reduce swelling. Expect to feel tenderness, discomfort, and swelling for two to six weeks. Your doctor will probably recommend nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, or analgesics such as acetaminophen to relieve the pain.

Change bandages at home as directed by your doctor, and remember to apply a topical antibiotic ointment with each change. Watch for signs of infection, such as swelling, increased redness, or discharge. Go to your doctor immediately if you suspect infection. Your doctor may recommend physical therapy for a few weeks to rehabilitate your hand or foot.

In general, ganglion cysts recur less often after surgery than after an aspiration procedure. As with all surgeries, however, there are risks to consider. Injury to tendons, blood vessels, or nerves is possible, although this is rare. Injuries like these can result in restricted hand movement, weakness, or numbness. Talk to your doctor about the best treatment for you.

Home Treatment

There are several ways to treat your ganglion cyst at home to reduce its size or remove it. Medical treatment is still better than home treatment, but you may still consider the following:

• Bible therapy: This is an old home remedy for ganglion cysts that is not recommended by today’s experts. It basically involves smashing the cyst with a heavy object, such as a Bible, thus the name “Bible therapy” and “Bible cysts.” This treatment has not been shown to completely get rid of ganglion cysts, and could, in fact, cause more injury and unnecessary pain. Other ineffective and potentially dangerous old home remedies for ganglion cysts include poultices, topical plasters, and heat application. Also, don’t try to burst the cyst by puncturing it yourself with a needle or sharp object since this might only cause infection.
• Splint: You can place a stint on your wrist or foot before or after surgery or aspiration. Doctors typically allow joint movement soon after aspiration. On the other hand, you may be required to put a splint on your wrist for seven to 10 days after surgery. A splint is a firm wrap that keeps your wrist from moving. Recent studies suggest that splinting for a long period of time isn’t really effective in getting rid of ganglion cysts, but using your joint soon after medical treatment may help.



• Avoid repetitive hand motion: Ganglion cysts are especially common in people who perform repetitive strenuous activities with their hands, such as weight lifters, milkers, rowers, tennis and golf players, and musicians like marching cymbals and guitarists. It’s been found that double bass players are especially at risk after extensive use of the German bow. Try to refrain from repetitive hand or foot movement to relieve the pain and reduce the size of the cyst.
• Wait-and-see approach: Cysts on the back of the hand often go away on their own. If the ganglion cyst on your hand doesn’t cause you too much trouble, it may be wise to just go for the wait-and-see approach. See your doctor to confirm if it’s harmless or not; and then give it a couple of months to a year to disappear on its own. If it doesn’t, then start thinking about other ways to get rid of it.

Weigh all the pros and cons of each treatment method before you decide on one. Talk to your doctor about the advantages and disadvantages of each treatment based on your lifestyle or occupation. Ganglion cysts are harmless and easy to get rid of, so don’t worry too much and just set up an appointment with your doctor.