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What's the best treatment for a ganglion cyst in the wrist? I've had one for six months, and it doesn't seem to bother me.

You may not need treatment. Sometimes these types of cysts are absorbed by the body and go away. Most of the time they don't go away and may even grow larger. Some cysts have a one-way valve that allows fluid from the wrist joint to enter the cyst. The valve only allows fluid to move in one direction. So once fluid gets inside the cyst, it's stuck and can't get out.

If the ganglion cyst becomes large enough, it can put pressure on nearby soft tissue structures. This pressure can cause painful symptoms. That's why many patients opt to have the cyst removed.

There are several ways to do this. The doctor can put a needle into the ganglion cyst to suck out the fluid. In some cases, the fluid becomes more like soft jello and doesn't come through a needle very well. This method of cyst removal leaves the cyst lining behind. The ganglion cyst will return about half of the time.

You may have heard about a less optimal approach. That's to smash the wrist ganglion cyst with a hard object such as a book. This pops the cyst, and ruptures the lining of the cyst. With the lining broken, the smashed ganglion cyst may not come back quite as often as those drained by a needle. Most people are unable to do this to themselves (or allow someone else to do it).

The best treatment may be to remove the ganglion cyst with an operation. The wrist ganglion is completely removed including any connection it has to the joint or tendon sheath. There's less chance the cyst will return after complete removal.

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