What is a ganglion cyst?

A ganglion cyst is a soft tissue lump which can be connected to joint cavities or to the tendons.

Most commonly, ganglions are located on the top of the wrist and hand but can be found in other areas including the top of the foot. They are often connected to the extensor tendons and respective tendon sheaths.

They are commonest between the ages of 20 and 40.

Workplace factors including using display screen equipment with poor ergonomic setup or manual work involving sustained pressure on the wrist and palm may exacerbate ganglion cysts of the wrist or hand.

Ganglion cyst

Common symptoms

A palpable lump can be felt under the skin which in larger cases may be visible. Usually ganglions are painless. Depending on the site and size of the ganglion you may feel a slight restriction to the wrist or hand joint movements, or a weakness when using your wrist and hand.

How is a ganglion cyst diagnosed?

A ganglion cyst can be provisionally diagnosed by your doctor or physiotherapist by taking a history of your condition and by conducting a physical examination.

Sometimes you doctor or physiotherapist may request an ultrasound scan to confirm the diagnosis.

How is a ganglion cyst treated?

Non-surgical management

Up to 50% of ganglions will disappear over time without any active treatment. Ganglion cysts which remain do not have to be actively treated unless they are increasing in size and causing pain or limiting function of the affected body part.

Display screen equipment (DSE) modifications

Changes to your elbow and wrist position as well as some specialist keyboard and mouse equipment can help to alleviate symptoms of a ganglion affecting the wrist:

Needle aspiration

For individuals with a ganglion cyst who continue to suffer pain or limited wrist or hand function, a needle aspiration of the ganglion can be offered as the next line of treatment. This is effective in only 20-30% so there is a high risk of recurrence . It is however an easily performed and relatively safe procedure that can be repeated,so can be worth a try, particularly if symptomatic. It can be performed under local anaesthetic in the outpatient clinic.

Further information is available here

Surgical management

Availability on the NHS

Surgical treatment is not funded for removal of ganglions unless they cause significant pain or disrupt daily activities.

If you want to have a cyst removed for cosmetic reasons, you’ll probably have to pay for private treatment.

Surgical removal of the ganglion cyst can be considered for those with on-going pain affecting function or where a foot ganglion prevents appropriate footwear being worn.