Medically reviewed by: Mark A. Yaffe(opens in a new tab), MD — Board-Certified Orthopedic Surgeon, Subspecialty Certified in Hand Surgery
Key Takeaways
- A ganglion cyst is a noncancerous, fluid-filled sac that forms next to a joint or tendon, most often on the back of the wrist, and it is one of the most common lumps in the hand and wrist.
- Many ganglion cysts are painless and harmless, and some shrink or disappear on their own, so a cyst that isn't causing problems can often simply be watched.
- Draining a cyst with a needle can be done, but the cyst often returns, while removing the cyst along with its connection to the joint or tendon is generally more definitive.
- Removal is typically considered when a cyst is painful, limits hand use, keeps growing, presses on a nerve, or needs to be identified, and it can often be done with local anesthesia.
- A lump that grows quickly, feels hard, or hurts at rest should be checked promptly, because not every lump in the hand is a ganglion cyst.
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What Is a Ganglion Cyst?
A ganglion cyst is a noncancerous sac filled with a thick, jelly-like fluid. It grows from a joint capsule or a tendon sheath and forms a round or oval lump under the skin. Ganglion cysts are among the most common masses in the hand and wrist, and they can appear on the back of the wrist, on the palm side of the wrist, at the base of a finger, or near the joint closest to the fingertip.
Cysts in the fingers are covered on the page about finger ganglion cysts(opens in a new tab). Evaluating a lump is part of broader hand and wrist(opens in a new tab) care, and the main goals are to confirm that the lump is a ganglion and to decide whether it needs treatment at all.
What Causes a Ganglion Cyst, and Who Is at Risk?
The exact cause isn't fully understood. A ganglion seems to form when joint or tendon fluid leaks into a pocket that is lined by thickened tissue, a bit like a balloon connected to the joint by a stalk. Factors linked with ganglion cysts include:
- Women and people between about 20 and 50, who are affected more often
- Irritation or strain of a wrist or finger joint, including repetitive use
- An earlier injury to the wrist, such as wrist ligament injuries(opens in a new tab)
- Arthritis, particularly finger arthritis(opens in a new tab) near the fingertip joint, which can produce small cysts
- Gymnasts and others who put repeated stress on the wrist
Many cysts appear without any clear trigger, and having one doesn't mean you did anything wrong.
Symptoms of a Ganglion Cyst
Many ganglion cysts cause no symptoms apart from the lump itself. When symptoms occur, they often include:
- A smooth, round lump that may feel firm or slightly spongy
- A lump that changes in size, often larger after activity and smaller with rest
- An ache or tenderness at the lump, especially with pressing, gripping, or repeated use
- A small tender bump at the base of a finger on the palm side that hurts when gripping
- A groove or ridge in the nail when a cyst near the fingertip presses on the nail growth area
- Tingling, numbness, or weakness if the cyst presses on a nearby nerve
A cyst near the palm side of the wrist can press on nearby nerves, and the symptoms can overlap with carpal tunnel syndrome(opens in a new tab). When that condition needs surgery, this article on carpal tunnel surgery(opens in a new tab) explains the options.
How Is a Ganglion Cyst Diagnosed?
Diagnosis usually starts with your history and a hands-on exam. A hand surgeon checks the size, location, and feel of the lump and how it relates to the nearby joints and tendons. A ganglion often lets light shine through it when a small penlight is held to the skin, which helps tell it from a solid mass. X-rays, ultrasound, or MRI may be used when the diagnosis is unclear, when the cyst can't be felt but the pain is real, or to see what is under the lump.
Other causes of wrist swelling are worth ruling out, including wrist tendonitis(opens in a new tab), which is covered in this article on tendonitis treatment(opens in a new tab), as well as arthritis and, rarely, a solid tumor. That is one reason it's worth having a new lump checked rather than assuming it is a ganglion.
Non-Surgical Treatment for a Ganglion Cyst
Not every ganglion cyst needs to be treated. Common approaches include:
- Observation: A cyst that isn't painful or limiting your hand is often just monitored, because many shrink or disappear over time.
- Activity changes and splinting: Resting the joint and reducing repetitive strain can ease soreness, and a splint may help when the cyst is irritated.
- Aspiration: A needle can be used to drain the fluid from the cyst, which may relieve pressure. The thick fluid and the stalk that connects the cyst to the joint remain, so cysts often return after aspiration.
Please don't try to burst a cyst yourself, for example by striking it with a heavy object. This can injure the wrist, and the cyst can come back.
Surgery for a Ganglion Cyst
Removal is considered when a lump is painful, limits hand use, keeps growing, presses on a nerve, bothers you cosmetically, or needs to be identified. In an excision, the surgeon removes the cyst through a small incision, including its connection to the joint or tendon, which is designed to lower the chance of it returning. Dr. Yaffe typically uses local anesthesia for finger and hand cases, which avoids the need for sedation by an anesthesiologist and can speed recovery. Removed tissue can be examined to confirm what the lump was, and the practice uses minimally invasive surgery(opens in a new tab) techniques with the goal of limiting discomfort and speeding recovery. If you decide on removal, this guide on preparing for surgery(opens in a new tab) explains how to get ready.
What to Expect During Recovery
After removal, the area is covered with a dressing and sometimes a splint for a short time. Your surgeon will give specific instructions for wound care, when to begin using the hand, and when to return to your usual activities. Many people return to light daily activities fairly quickly, while heavy gripping, lifting, and sports may take several weeks. Stitches are usually removed after about 10 to 14 days if they are not absorbable. The practice's post-op instructions(opens in a new tab) outline general care after a procedure, and this overview of hand surgery recovery(opens in a new tab) gives a broader picture.
Risks and Recurrence
Complications are uncommon but can include infection, scar tenderness, stiffness, and injury to nearby nerves, blood vessels, or tendons. Recurrence is the most common concern. Cysts can come back after any treatment, and they return more often after aspiration than after surgical removal. If a cyst does return, it can often be treated again. Your surgeon will review the benefits and risks before you decide.
When to See a Hand Surgeon
It's worth seeing a hand surgeon if a lump is painful, growing, limiting your grip or motion, causing numbness or tingling, or if you simply want to know what it is. Seek an exam promptly for a lump that grows quickly, feels hard, or hurts even at rest. If you are unsure whether it's time, this article on persistent hand pain(opens in a new tab) can help you decide, and this one on hand specialist treatment(opens in a new tab) covers the conditions a hand specialist treats.
If you are looking for care, see this guide on how to find a hand specialist in Chicago(opens in a new tab), and this article on hand pain help(opens in a new tab) shows what a hand surgeon can do. Dr. Yaffe sees patients in Schaumburg(opens in a new tab), Elk Grove Village(opens in a new tab), and Buffalo Grove(opens in a new tab). To get started, schedule an appointment(opens in a new tab) online, and it helps to note when you first noticed the lump and whether it has changed in size.
Frequently Asked Questions
Do ganglion cysts go away on their own?
Sometimes. Some ganglion cysts shrink or disappear without treatment, but others stay the same or come back. Because the course is hard to predict, a cyst that isn't causing problems is often simply monitored.
Is a ganglion cyst dangerous or cancerous?
No. A ganglion cyst is noncancerous and isn't dangerous. It can be uncomfortable or press on a nerve, though, and other lumps in the hand can look similar, so a hand surgeon should examine any lump that grows quickly, feels hard, or hurts at rest.
Should I pop or drain a ganglion cyst at home?
No. Hitting a cyst or trying to puncture it at home can injure the wrist and cause infection, and the cyst usually returns. If a cyst needs to be drained or removed, it is safer and more effective to have it done by a hand surgeon.
When does a ganglion cyst need to be removed?
Removal is generally considered when a cyst is painful, limits hand use, keeps growing, presses on a nerve, or needs to be identified, or when you simply want it gone. If it isn't causing problems, it can usually be watched.
Will a ganglion cyst come back after surgery?
It can. Recurrence is the most common issue after any treatment for a ganglion cyst, but it is less likely after surgical removal that includes the cyst's connection to the joint or tendon than after draining it. A recurrent cyst can often be treated again.
