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As professionals that rely on their sense of touch, massage therapists are aware of how different kinds of tissues are supposed to feel. Thus, when a structural anomaly (such as a ganglion cyst) is palpated, massage therapists will notice. Since bodyworkers are likely to see clients more frequently than a physician, it is helpful to have an idea of what might be going on when such a lump is discovered.
Since there is more than one way to approach a ganglion cyst, it is important to have a good understanding of what experts know about this condition. In general:
- Ganglion cysts are more common in women.
- 70 percent of ganglion cysts occur in people between 20-40 years of age.
- Between 60 and 70 percent of all ganglions are dorsal wrist ganglions.
- Ganglion cysts are known to go up and down in size – or even go away completely on their own.
- Ganglion cysts are usually not harmful – although they can cause pain by pressing on neighboring structures.
- Although they don’t spread to other areas, ganglion cysts can get bigger and increasingly lumpy.
- Thick, sticky, clear, colorless, jellylike material is inside ganglion cysts.
- Depending on the cyst size, a ganglion may feel firm or spongy.
- Constant motion of the hand or wrist keeps fluid pumped into the cyst – and that fluid is trapped in a ganglion cyst.
A ganglion cyst typically appears near joints or tendons in the hand or wrist. Common locations include:
- the dorsal surface of the wrist
- the palmar side of the wrist
- the base of the palm adjacent to a finger
- the dorsal surface of the distal joint of the finger
- the top of the foot
Medical professionals are not entirely sure why ganglion cysts form. Two of the most popular theories on ganglion cyst development are:
- Trauma causes joint tissue to break down. This forms small cysts that join into a mass.
- A flaw in or injury to the joint capsule or tendon sheath allows joint tissue to bulge out and fill with fluid.
Ganglion cysts tend to be round and firm, with smooth edges. Often the cyst can be moved around underneath the skin. When positioned at the base of the finger, ganglion cysts are usually firm, pea-sized bumps that hurt when gripping objects. Putting a flashlight on the skin around the mass will make it “light up” in a darkened room, indicating that clear fluid is inside. Cysts at the end of the finger (near the fingernail) may push on the growing nail, causing a groove in the nail.
Traditionally, ganglion cysts were referred to as “Bible cysts,” because whacking them with a Bible – or heavy book – used to be the preferred remedy. This approach would pop the cyst, allowing the fluid to leak out. However, practitioners today usually discourage this treatment because it can cause damage to nearby structures. If the ganglion cyst does not go away with inactivity or on its own, many physicians will aspirate the fluid inside. For ganglions that cause significant pain or impede a person’s range of motion, surgical removal of the cyst is another option.
Using massage therapy to try and reduce the size of a ganglion cyst is controversial. This is because techniques to break the cyst’s wall must be very deep and can be extremely painful. Massage that stimulates the cyst (such as friction) can be very irritating – and could exacerbate fluid production in the sac. As such, local massage therapy is usually cautioned directly over ganglion cysts. However, many bodywork practitioners use other techniques to reduce these common lumps. Three alternative medical remedies include:
- Moxibustion – This Chinese Medical technique of burning moxa over an area may not fall under a massage therapist’s scope of practice, but could be cause for referring out to an acupuncturist.
- Lymphatic Drainage Massage – Improving the removal of lymphatic fluid in the affected extremity can support the body’s natural means of shrinking a ganglion cyst.
- Aromatherapy – According to Valerie Wormwood, ganglion cysts may be gradually dispersed by gently massaging the cyst with a blend of ginger (8 drops), basil (5 drops), patchouli (10 drops) and juniper (7 drops). She advises adding 5 drops of this blend to 1 teaspoon of base oil and gently massaging into the cyst several times a day.
Thankfully, ganglion cysts are usually not dangerous and can go away on their own. For cysts that either cause significant pain or dysfunction – or are cosmetically undesirable – there are several strategies for helping them dissipate. Ranging from alternative medical techniques, to whacking with a Bible, to aspiration to surgery, there is hope for clients wanting to get rid of a ganglion cyst.
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