As I'm sure you already know, a ganglion cyst is a bump or mass that forms under the skin. Most commonly, ganglions are seen on the wrist (usually the back side) and fingers, but they can also develop on the shoulder, elbow, and knee. These form when tissues surrounding certain joints become inflamed and swell up with lubricating fluid. They can increase in size when the tissue is irritated and often can "disappear" spontaneously. These masses or cysts appear to grow sometimes but they are not tumours or cancerous. A ganglion cyst is also referred to as a "bible cyst" as the practice of smashing the cyst with a bible has been an old wives tale for many years. If the cyst is in an area of the hand which will directly affect a nerve ( Tunnel of Guyon - ulnar nerve or Carpal tunnel - median nerve ) it may cause neuropathy in the hand. Therefore, it is ill advised to smash the cyst with a book or any other heavy object as this may cause permanent nerve and/or other soft tissue damage, which, as a chiropractor, I'm sure you can appreciate. From the medics point of view the causes are unclear but may be occupationally associated, be due to trauma, or arise as a part of certain pathologies such as rheumatoid arthritis. The medical treatment of ganglion cysts includes rest, splinting and nonsteroidal anti- inflammatory medication. Aspiration and cortisone injection may be used, depending on the location. If these treatments fail, surgical excision is usually performed. At surgery, the cyst is identified and removed with its stalk. There are many people who report, however, post surgery that they are plagued by recurrence of the cyst as well as scar tissue and persistent pain. Other risks associated with surgery are infection, a painfull scar, stiffness of the wrist, and numbness of the skin in the area of the incision. To the e-mail posted question: DC needs info concerning a ganglion cyst: DC is a chiropractor and has developed a ganglion cyst that just flares up every adjustment he makes. He has it adjusted regularly, ice, acupuncture, homeopathy, brace... .most every treatment... it's much better, but still there.... oh, and yes he smashed it with a book too...... if you have any other effective treatment, please let him know. He has many more adjustments to give and starting to have some concern that this will be an issue for the rest of his career and doesnžt want to have surgery .. any input is greatly appreciated. Answer shared by Dr. Klein: gklein@intop.net The medical literature even states that post surgical patients report between a 5% and 25% recurrence. I cannot advise you on what you should or should not do but as a straight chiropractor, I would reserve pharmaceutical and/or surgical intervention for myself as an absolutely last resort. Now for some alternative ideas: Many patients report the use of aloe vera and pure vitamin E extract (taken from liquid gel capsules) when rubbed into the area will shrink and sometimes remove the cyst altogether. Some patients report the use of (believe it or not) preparation H with the same effect. I was reading a message board and some people reported using an "immune balancer" product for complete removal of the cyst. Another message stated that the patient used lavender oil on the cyst and the cyst broke open and drained within twenty-four hours and has never reappeared. I do not have any first hand experience with these remedies but I personally would try just about anything and everything before I would go the route of cortisone injections or surgery.