Home / Conditions / Ganglion cysts
A ganglion cyst is a smooth, fluid-filled lump that grows from the lining of a joint or tendon — most often on the back of the wrist, but also in the hand, the fingers and the foot. It is harmless and not a cancer, and many shrink or disappear on their own. Treatment is for one that hurts, presses on a nerve, or simply bothers you.
Most people with a ganglion have three real choices. None is right for everyone: each trades a little convenience against how likely the cyst is to come back.
| Leave it alone | Drain it | Remove it | |
|---|---|---|---|
| Best for | A painless cyst that does not bother you | A painful or unsightly cyst, avoiding surgery | One that keeps coming back, or causes real trouble |
| What it involves | Nothing — keep an eye on it | The fluid drawn off with a needle | An operation to remove the cyst and its stalk |
| Chance it comes back | Many disappear on their own | Often — around half return | Least likely, though not never |
| Downsides | It may stay, or grow | Not suitable beside some blood vessels, such as on the palm side of the wrist | A scar, some stiffness, and weeks of recovery |
Please do not hit it with a heavy book. Ganglions were once called "bible cysts" after the old habit of smashing them with one. It can injure the hand, and the cyst usually comes back. And if a lump is hard, growing quickly, fixed in place, or painful even at rest, it may not be a ganglion — call the clinic and have it checked.
Joints and tendons are lined with a thin layer that makes a slippery, jelly-like fluid. A ganglion forms when some of that fluid escapes into a small sac that bulges out under the skin, still joined to the joint or tendon by a narrow stalk.
What a picture cannot show is why it changes size, and why it comes back. The stalk can act like a one-way valve, so the sac fills more with activity and shrinks with rest. Draining the sac with a needle empties it, but leaves the stalk behind to fill it again.
That is why removing it surgically takes the stalk too, and why it is the least likely treatment to be followed by a return — though a ganglion can occasionally form again from the same joint.
Ganglion cyst symptoms depend largely on where it sits. Many cause nothing but a lump; some ache with use, and one pressing on a nerve can cause tingling or numbness.
Treatment is only needed if the cyst hurts, presses on a nerve, gets in the way, or you would simply rather it were gone. The options run from doing nothing to removing it.
A painless ganglion can be left alone. Many shrink or disappear within a year or two, and watching it costs nothing and risks nothing.
A splint for a short while can ease an aching wrist. It helps the pain, though it has not been shown to make the cyst go away for good.
The fluid can be drawn off with a needle in a quick procedure. The lump goes down straight away, but it often refills, because the stalk remains. It is not done where the cyst sits close to an artery.
An operation removes the cyst together with its stalk. It is the least likely treatment to be followed by a return, but it leaves a scar and the joint can be stiff for some weeks afterwards.
Often, yes. Many shrink or disappear within a year or two without treatment, especially in children. That is why a painless ganglion can simply be watched.
No. It can injure the hand and the bones around the cyst, and the ganglion usually comes back anyway. If you want it gone, draining or removing it is safer.
No. It is a harmless pocket of joint fluid and does not turn into anything worse. A lump that is hard, growing quickly or fixed in place should still be checked, since it may be something other than a ganglion.
Often — around half of drained ganglions return, because the stalk connecting it to the joint is left behind. Removing it surgically is much less likely to be followed by a return.
Yes, if it bothers you. It is worth knowing the trade-off first: an operation leaves a small scar and some stiffness for a few weeks, and a ganglion can occasionally form again.
No. Bring any scan reports, and be ready to say how long the lump has been there and whether it changes size.
Wrist pain · De Quervain's tenosynovitis · Carpal tunnel syndrome · Foot pain
Tell us how long the lump has been there and whether it changes size. Both help confirm it is a ganglion.
