Overview
Thecal cyst is cyst-like intumescence around muscle tendons. Clinically it is usually seen on dorsal wrist, dorsal foot and around fingers or toes. The cyst is generally unilocular, sometimes multilocular. It is a "tendon wart" disease in TCM. It is caused by tendon overstrain or traumatic injury which lead to disorder in qi and blood circulation. The main principle of acupuncture therapy is activating qi flow and blood circulation, removing blood stasis and eliminating nodules.

Treatment
Ashi Point
① Three-edged needle therapy is applicable. The three-edged needle is inserted into the centre of the cyst until it reaches the peplos. Then the needle is withdrawed gradually and pressed outside the cyst to extrude the colloidal mucus. If the cyst is very large, another needle could be applied. Apply pressure dressing after the colloidal mucus is totally extruded.

② Puncturing with a heated needle therapy is applicable. Push the content of the cyst to one side. After being burnt on the alcohol lamp till turning red, a 22-24 gauge filiform needle is used to prick deeply into the cyst, avoiding blood vessels. The inside fluid is extruded immediately after needle withdrawing; pressure dressing is applied after sterilization by alcohol-cotton. If the cyst reoccurs, the same process could be done once again.

Note
Acupuncture therapy is effective to this disease, especially the treatment taken with the three-edged needle. Most cases recover fully after one treatment. The rubbing and pressing after puncturing and pressure dressing which are quite critical for getting the curative effect, and it must be done carefully.