Wrist worries

Wrist worries

After riding on a rough cycle path, a bump developed on my wrist. It feels solid but does not hurt when prodded. However, any twisting makes a loud click, and pressure to the heel of my hand can be excruciating. The doctor sent me to a physio who gave me a short blast of ultrasound and a brace. It hasn’t gone yet. What can I do?

Jane Devlin

A ganglion is a benign cyst filled with thick jelly, commonly found on the wrist. They vary considerably in size. If a ganglion is not causing any problems, it is often best left alone.

The traditional cure was to hit a ganglion with a heavy book (a bible). This bursts the cyst under the skin and the fluid is reabsorbed into the body. This technique is rarely recommended nowadays. In some cases, where the jelly-like fluid is not too thick, it may be possible to aspirate (suck up) the fluid with a needle and syringe. There is a chance that the cyst will recur as the cyst wall is not removed.

Surgical removal is the most successful permanent cure, with a smaller chance of recurrence. But given the current financial restrictions within the NHS, it is an operation which is not routinely funded in most areas unless the ganglion is causing a lot of pain or disruption of daily activities.

Soft tissue damage to the wrist triangular cartilage can be treated in the usual way (Rest, Ice, Compression and Elevation). Consider a short course of anti-inflammatories like Ibuprofen if you can take them. Padded cycling gloves should help. Look also at your position on the bike. Some cyclists find a lower saddle, raised handlebars and a shorter stem reduces pressure on the wrist, but you may need to experiment as each case will differ. Change the position of your hands on the bars frequently and ensure your grip is not too tight. Bumpy tracks and rough terrain would seem best avoided. If all else fails, you may need to rest while it improves. Different wrist supports may be worth a try.

Dr Matt Brooks

 

This was first published in the December 2013 / January 2014 edition of Cycle magazine.

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