Ganglion cyst: treatment, symptoms and whether it will go away

The NHS says most ganglion cysts do not usually need to be treated or removed. The BSSH describes three possibilities for treatment: explanation, reassurance and waiting to see whether the cyst disappears on its own; removing the liquid contents with a needle (aspiration) under local anaesthetic; and surgical removal. For any individual cyst, the recommendation depends on where it is and what symptoms it is causing.

If a ganglion cyst is causing problems, the NHS lists draining the cyst using a needle, a steroid injection to reduce swelling, or cutting the cyst out with a small surgical operation. The NHS says that once a cyst is removed it usually does not return, but sometimes it can come back.

The NHS says ganglion cysts are smooth, soft lumps under the skin that are usually on the hands or wrists near a joint, vary in size from smaller than a pea to a few centimetres across, and are usually painless but can be painful during or after moving the affected joint. The lump may be your only symptom, but you may also have numbness or aching after moving the joint.

The BSSH says a swelling becomes noticeable and it may or may not be painful. It adds that the diagnosis is usually straightforward because ganglion cysts tend to be smooth and round, fluctuate in size and occur at characteristic locations in the hand and wrist. If the diagnosis is uncertain, scans may be helpful.

A ganglion cyst is a type of swelling in the hand and wrist. The BSSH says it contains a thick clear fluid and can arise from a variety of structures.

The BSSH names four common locations: the middle of the back of the wrist (from the scapholunate ligament), the front of the wrist at the base of the thumb (from the wrist joint), the base of a finger on the palm side (from the tendon sheath), and the back of an end joint of a finger (from the end joint).

The NHS says the cause is not always known, but ganglion cysts sometimes happen after an injury causes fluid to leak from a joint. They are much more common in women than in men.

The BSSH says most arise spontaneously, but occasionally there is a history of injury or the joint is starting to develop arthritis.

Often, yes. The NHS says ganglion cysts usually get better without treatment, and this can take from several months up to a year. The BSSH says many disappear spontaneously and many others cause little trouble, with no long-term consequences from leaving a ganglion untreated.

Because of this, a cyst that is not painful and does not limit movement is commonly just watched. Aspiration can empty it, but the BSSH notes that for a cyst on the back of the wrist the swelling often returns.

The BSSH gives different advice for each of the four common sites, because the chance of coming back and the risks of surgery vary.

If a ganglion cyst hurts when you use your hand, the NHS says you can take ibuprofen or other NSAIDs to help reduce swelling and pain, and try wrist supports or compression wraps, which you can buy from supermarkets or pharmacies. A pharmacist can recommend medicines for pain and advise on supports.

The NHS is clear that you should not try to burst or pop a ganglion cyst, because this could cause an infection or skin damage.

The NHS says to see a GP if you are worried about a lump, if a lump gets bigger, or if a lump is hard and does not move. It says to ask for an urgent GP appointment or get help from NHS 111 if you have a lump that is very painful, hot or red, noting that redness may be harder to see on brown and black skin.

On the NHS a GP can examine the lump, and most people need no more than reassurance. If a cyst is painful or limits use of the hand, the GP can discuss aspiration, injection or referral for surgery. The BSSH notes the best option depends on location and symptoms, so it is reasonable to ask the person offering a procedure how often cysts in that site return.

Hand surgeons also see ganglion cysts privately. As the risk of recurrence and the possible problems after surgery listed by the BSSH apply wherever the operation is done, ask about them before agreeing to an operation for a cyst that is not causing symptoms.