I am a born and bred cowgirl in South Florida. My two horses keep me busy in the rodeo circuit roping calves and running barrels. My problem is I have a wrist ganglion that hurts. I can't help but wonder if it isn't slowing me down in my events. Should I have it removed? Everybody tells me to leave it alone and it will eventually go away. What do you think?
A ganglion is a small, harmless cyst, or sac of fluid, that sometimes develops in the wrist. Doctors don't know exactly what causes ganglions. But we know they can be very painful and disabling. Many patients report pain increases whenever moving the wrist into extremes of wrist motion (flexion and especially extension). Wrist motion is very important with the kinds of activities you are engaged in. Aspirating or surgically removing it are two treatment options. Aspiration involves placing a needle into the cyst and removing any fluid inside. Surgery can be done two ways: open incision or the less invasive arthroscopic approach. Most experts recommend leaving it alonge unless it is creating serious problems. There are several reasons for the leave-it-alone advice. First, they don't get much worse than what you are experiencing now. The medical term for that idea is limited morbidity of the lesion. Second, left alone, they often go away on their own. And third, if you have them surgically removed, they often come back. Patients should keep in mind that surgery comes with its own set of risks. Infection, poor wound healing, and decreased wrist motion are possible complications. Other problems that can develop include damage to the blood vessels or nerves, injury to important wrist ligaments or bones, and poor cosmetic appearance. Where does all that leave you? Each person must make his or her own decision about treatment. If the cyst doesn't hurt and doesn't limit activity or function, then the evidence supports leaving it alone. Given your concern about your rodeo performance, you have the option of trying aspiration to see if reducing the cyst and altering the symptoms (even if only temporarily) affects your time. If there's no change in your activities and it comes back, then further treatment may not be needed. There's always the possibility that aspiration will take care of the problem. There are many clinical factors to consider. Your surgeon is the best one to advise you on this.