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Can acupuncture help with a wrist ganglion?

A:  We were asked about a ganglion on the thumb some time ago, and the response we gave then is equally as valid for the treatment of a wrist ganglion. We wrote:

Long gone are the days when the treatment for a ganglion was to lay the hand flat on the table and drop the family bible onto it. Current conventional medical treatment is to aspirate the rather thick, clear jelly-like content from the cyst at a GP surgery or occasionally to have a minor operation in the hospital day surgery unit. These latter are less frequent because they are regarded as relatively low priority, and also can be quite complicated if the cyst is entwined with nerves and blood vessels, as is often the case in the wrist area.  We are assuming that you have seen your GP and had the options explained to you. If you haven't this is always a worthwhile thing to do. GPs are very adept at making judgements about what may appear to be simpler conditions which in reality aren't, and having your GP take a look is a wise move.

From a Chinese medicine perspective any accumulation and thickening of fluids in the body points either to a local obstruction in the flow of energy, called 'qi' in Chinese medicine, or to a systemic problem which manifests in a number of problems across the body and mind as a whole. A skilled practitioner can quickly make this determination, and treat accordingly. The greater majority of cases we come across are local problems, often caused by muscular tensions which constrict the flow of fluids and blood. Treatment can help to reduce the tension and encourage flow, but can also help to disperse the thickened fluids. From a Chinese medicine point of view these are 'stuck' qi, and needling moves the qi and reduces the lump.
You won't, of course, find any clinical evidence for this; it is one of the least likely problems to be researched at great expense. Our experience, however, is that acupuncture may be helpful, but we always taken into account the other factors which may have contributed to the cysts' occurrence. There may be postural reasons - work stations, frequent use of the joint in a skilled operation - which mean that the cyst will return. There may also be wider tensions and stresses in the system which again may result from lifestyle. Addressing a small problem like a cyst may not work if it is part of a wider pattern of disharmony.
The best advice we can give you is to seek the face to face opinion of a BAcC member local to you. Our own feeling is that if you did decide to have treatment, the results would manifest relatively quickly or not at all, and you should not get tied into a long sequence of treatment. If it does work, the question then remains about how sustainable the improvement is. If treatment is only successful for a short time, then it may be worth discussing with your practitioner whether some forms of massage may be a more effective way of addressing the problem, either Chinese massage such as tui na or orthodox massage.  

We think that this probably remains the best advice we can offer. What we can say is that if a ganglion is going to respond to treatment it tends to do so quite quickly; this is not a cause for taking on an extended course of treatment. The one caveat is that 'easy go, easy come' occasionally applies; the ganglion can sometimes become visibly smaller during the course of a session and carry on shrinking, only to regain its original size again later. If this happens twice in a row, we would be cautious about treating over and over again, unless of course the problem was causing such an impact on someone's life that the cost of maintenance treatment over an extended period was more than offset by the gains, however temporary.

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