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Ganglion cysts


Disease: Ganglion cysts Ganglion cysts
Category: Surgical diseases

Disease Definition:

Ganglion cysts are noncancerous fluid-filled lumps or cysts that mostly develop along the tendons or joints of the wrists, hands or feet.
These cysts could develop either suddenly or gradually over time. Unfortunately, the exact cause of a ganglion cyst is still not known.


Mostly, ganglion cysts require no treatment, cause no pain and go away on their own. In case someone needs treatment because of pain, interference with joint movement or for cosmetic concerns, then it will involve either the surgical removal of the ganglion cyst, or removal of the fluid from the cyst. 


Work Group:

Symptoms, Causes


Usually, ganglion cysts appear as:


  • Round, firm and smooth
  • Raised lumps near the wrist or finger joints
  • A little more than 3 centimeters (1 inch) in diameter
  • Even though fixed in one place, however, it could "give" a little when it is pushed.
  • Painless, but sometimes the cysts could put pressure on the nerves near the joint causing pain, weakness or numbness in the hand.
  • Depending on the person's activity level, its size could vary. In case the person uses their affected joint, the cyst could become larger and if the person's at rest, it could grow smaller.


Sometimes, the telltale lump that indicates a ganglion cyst isn't available, and pain is the only indication of these smaller, "hidden" ganglion cysts. This form is known as occult ganglions.


A person should visit the doctor in case they notice a lump or pain in their hand, wrist or foot. Whether they need treatment or not will be determined according to the diagnosis.


The exact cause of the development of ganglion cyst is not known yet. Just like a balloon on a stalk, it grows out of a joint and it appears to occur when the tissue surrounding a joint or tendon has bulged out of place. Inside of the cyst, there's a thick and sticky fluid which is quite similar to what is found around tendons or in joints.





Usually, ganglion cysts require no treatment because they're painless and harmless. Before exploring any treatment options, the person will be recommended the wait-and-watch approach.


Someone may be recommended one of several treatment options in case the ganglion cyst is causing pain, or if it's interfering with joint movement.



A person will be recommended wearing a wrist brace or splint in order to immobilize the area because activity could cause the ganglion cyst to increase in size. This will help the hand and wrist to rest, helping the cyst to decrease in size. As it decreases in size, the pressure on the nerves will be released and the pain relieved.



The fluid from the cyst is drained in aspiration. In this procedure, a local anesthetic is applied to the area above the cyst, then the cyst is punctured with a needle and the fluid is removed from the base of the cyst with a syringe. This procedure could be done in the doctor's office.


After aspiration, ganglion cysts could return (recur). Almost 80% of the cases of ganglion cysts recur, and as they do, aspiration could be performed again. In case someone has multiple aspirations, their cysts could eventually stop recurring.


After aspiration, a person may be recommended a steroid injection in the empty cyst. Steroid injections could reduce the recurrence of the cyst when combined with aspiration. However, if the ganglion cyst still recurs, surgery to remove the cyst may be recommended. 



Surgery may be recommended to remove the ganglion cyst in case a person experiences significant pain or difficulty with joint movement or in case other treatments haven't worked.
Usually, the surgery is performed on an outpatient basis and the patient gets to go home the same day as the operation.


In most cases, to numb the affected area, a local anesthetic is used. Then, at the location of the ganglion cyst, an incision is made. The size of this incision will be determined by the size of the cyst. The cyst is removed along with the stalk that attaches it to the joint or tendon, and possibly a small portion of the surrounding tissue too. The affected area is then stitched and bandaged.


After the surgery, in order to reduce swelling, the affected area should be elevated for 48 hours. For two to six weeks tenderness, swelling and discomfort may be experienced. In order to relieve the pain analgesics, such as acetaminophen or NSAIDs, such as naproxen or ibuprofen may be recommended.


The bandages should be changed at home as directed, in addition to applying a topical antibiotic ointment with each change. It is quite important to watch out for signs of infection such as swelling, redness or discharge, as the incision heals.
In order to rehabilitate the hand, wrist or foot, physical therapy may be recommended in the weeks after the surgery.


Even after surgery, there's no guarantee that a ganglion cyst won't recur and just like in any surgery, there are risks to be considered. Some of the rare complications of this surgery include injury to nerves, blood vessels or tendons. In case this happens, symptoms will include numbness, weakness or restricted motion.


In order to decide the best treatment, the doctor should be consulted.



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Dr. Faisal Dibsi

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