Friday Q&A: Ganglion Cysts

Q: I get a ganglian cyst at the top side of my wrist and sometimes the top of my hand from doing poses that put pressure in those areas. Plank positions, Upward-Facing Dog, etc. Any recommendations?

A: Dear Ganglion Cyst,

Thanks for writing in about this. I, too, have had a cyst in my wrist area many years ago that was of the ganglion cyst variety. These cysts are considered benign, and may grow up out of the tendons of the wrist and hand bones. Scientists still do not know what causes them, so prevention is not an issue.  But dealing with them once they arise is an issue, especially if they interfere with your regular activities.

First off, I'd recommend that you confirm your diagnosis of this common and benign form of a mass that can appear on and around the hands and wrists. A trip to your family MD should do the trick,  with the caveat that they may recommend an ultrasound or drawing a bit of fluid from the mass to confirm that it is indeed fluid filled.

Once you have a confirmed diagnosis, it is important to decide if modifying your practice is needed. The main reason to do so is if the cyst is causing you pain,  especially in the poses you mentioned. If it is,  you may be able to avoid those aggravating poses until the cyst gets smaller. Over half of all ganglion cysts will resolve on their own without specific treatment. So we are talking about any pose that bears weight on the hands and wrist joint and takes the wrist into full extension.  As noted, plus a few more, such as, Plank, Chaturanga, Upward-Facing Dog, Handstand, and most other arm balances done on the hands could all make things worse before they get better.

Avoid the old folk remedy of smashing the cyst with a bible or any other large book for that matter. This has not been shown to beneficial and the cyst can return and be harder to treat if treatment is ultimately necessary. If you want more information on the western medical approach to ganglion cysts, check out this website: emedicinehealth.com. And let us know how things unfold for you and your cyst.

Namaste,
Baxter

A: Since your pain symptoms could be worsened by excessive pressure on the wrists, you should modify the poses that cause pressure. The way to think about pose modification is to look at your wrist and if your wrist "folds" are visible, then there is pressure on the wrist itself.  I might use a chair for Dog pose or do Dog pose with the forearms on the floor (or chair) . The same modification can be used to do Plank pose. Shoulderstand would also have to be modified. Doing the chair version of Shoulderstand, which is less active, would keep the wrists from being vulnerable and keep them in a neutral position. Standing poses, forward bends and twists don't  need modifications. But as long as the cysts are present, I would avoid active Dhanurasana (Upward Facing Bow pose) and other backbends where you use your hands to support yourself and wait till they reabsorb. Passive backbends would still be possible. —Shari