Ganglion Cyst
A ganglion cyst is a common, harmless swelling that usually develops around the wrist or hand. It appears as a smooth, round lump filled with clear, jelly-like fluid and can vary in size or fluctuate over time. Although benign, ganglion cysts may cause discomfort, stiffness, or concern about appearance. They can occasionally press on nearby nerves or tendons, leading to pain or weakness. Most ganglions are easily diagnosed and can be treated with reassurance, aspiration (drainage), or minor surgery if persistent or symptomatic.
Common Symptoms
- A smooth, round, or oval lump over the wrist, hand, or finger
- Fluctuating size – sometimes larger after activity, smaller at rest
- Mild aching or discomfort when bending or loading the wrist
- Occasional numbness or tingling if pressing on a nerve
- Cosmetic concern about the lump’s appearance
Typical Causes
Ganglion cysts form when joint or tendon sheath fluid leaks out and collects in a small sac under the skin. They are most often found on the back of the wrist (dorsal ganglion), the palm side (volar ganglion), or at the base of the fingers. The exact cause is not always clear, but they may follow minor trauma, joint laxity, or repetitive strain.
Seek urgent help if
You notice rapid enlargement, redness, warmth, or increasing pain of a lump, or if movement of the wrist or fingers becomes restricted. These symptoms may suggest infection or a different type of mass requiring urgent assessment.
Call 999 for emergencies, or NHS 111 for urgent advice.
On this page:
Symptoms
Ganglion cysts typically appear as smooth, soft, or firm swellings near joints or tendons. The most common site is the back of the wrist, but they can also occur on the palm side near the radial artery, on the end joint of a finger (mucous cyst), or at the base of the finger (flexor tendon sheath ganglion).
The lump may change in size, sometimes disappearing temporarily. Most cysts are painless, but some cause aching, particularly with wrist movement or when leaning on the hand. A small cyst near a nerve can produce tingling or weakness. Although harmless, many patients seek advice to confirm the diagnosis and discuss treatment options.
Causes / Risk Factors
The cyst forms when a small amount of joint or tendon sheath fluid escapes through a tiny defect in the capsule and collects in a sac. This sac becomes sealed off, filled with clear, jelly-like fluid, and may connect to the underlying joint through a narrow stalk.
Risk factors include:
- Repetitive wrist or hand activity
- Previous minor joint or tendon injury
- Underlying arthritis (especially at the finger joints)
- Female gender and age between 20–50
- Connective tissue laxity
In many cases, no single cause is identified, and ganglions may appear spontaneously.
Investigations & Diagnosis
Diagnosis is usually made from the appearance and location of the swelling. Typical findings include a smooth, mobile lump that transilluminates when a light is shone through it.
Investigations may include:
- Ultrasound: confirms the cystic nature of the lump and distinguishes it from solid tumours or vascular lesions.
- MRI: occasionally used if the diagnosis is uncertain or to assess deeper wrist ganglions near nerves or arteries.
X-rays are not usually necessary unless arthritis is suspected in association with a mucous cyst.
Treatment Options
Non-surgical
- Observation: many ganglion cysts disappear on their own without treatment.
- Splinting and activity modification: may relieve discomfort, especially if pain is aggravated by wrist motion.
- Aspiration: the fluid can be drawn off with a needle under local anaesthetic. This often provides relief, though recurrence occurs in around 50% of cases.
Surgical
Surgery is considered if the cyst is painful, recurrent, or cosmetically unacceptable.
- Excision (open or arthroscopic): involves removing the cyst and its stalk at its origin from the joint or tendon sheath.
- Usually performed as a day-case procedure under local or general anaesthetic.
- The recurrence rate is lower than with aspiration, typically around 30%.
Your surgeon will discuss the best approach depending on the cyst’s location, symptoms, and personal preference.
Recovery & Follow-up
After aspiration, you can use the hand normally the same day, though mild soreness may last a day or two.
Following surgical excision, the wrist or hand is lightly dressed and kept elevated for 48 hours. Stitches are removed after 10–14 days, and gentle movement is encouraged to prevent stiffness.
Most people can resume desk-based work within a few days and manual activity within 3–4 weeks, depending on discomfort.
Recurrence can occur even after surgery. The cosmetic result is usually excellent, although the lump has been exchanged for a scar, and symptoms such as aching or weakness typically resolve completely.
When to seek urgent help
Seek urgent medical advice if you notice increasing pain, redness, swelling, or discharge from the aspiration or surgical site, or if your fingers become numb or cold. These may indicate infection or vascular compromise requiring prompt review.
Call 999 immediately or attend A&E if you have a new injury with loss of movement or sensation in the hand, rapidly spreading redness or swelling with fever, or sudden severe weakness.
Use NHS 111 for urgent same-day advice if your symptoms are getting quickly worse.
If you have a ganglion or related symptoms, we can confirm the cause and tailor a plan – often starting with splints/hand therapy and exercises, with medicines, injections or surgery only where appropriate.
This page provides general information and is not a substitute for individual medical advice.
For emergencies (severe/new weakness, spreading infection, uncontrolled pain, significant injury) call 999, or use NHS 111 for urgent guidance.
Appointments:
- Self-pay patients can book without a GP referral
- Insured patients (Bupa, AXA, Aviva, Vitality, WPA, etc…) can book once authorised.
Clinics are available at:
- The Harborne Hospital – HCA, Birmingham
- Nuffield Health Wolverhampton Hospital
- The Priory Hospital, Birmingham
To book or ask a question, contact Vikki (Private Secretary):
☎ 07510 417479
✉ [email protected]