Ganglion cyst

A ganglion cyst is a fluid-filled swelling that can occur near a joint or tendon. They are usually harmless but can be rather unsightly. The cyst can range from the size of a pea to the size of a golf ball. They most commonly form on the back of the wrists but can appear near any joint including on your feet, ankles and other parts of your hand too.

Ganglion cysts look and feel like a smooth but hard lump under the skin. They contain a thick, jelly-like fluid called synovial fluid, which surrounds joints and tendons to lubricate and cushion them during movement.

It is not clear why ganglion cysts form. They seem to occur when the synovial fluid that surrounds a joint or tendon leaks out and collects in a sac.

Local commissioning policies are in place for this condition.

Please be aware that there are local commissioning policies in place for this condition. This means that certain treatments may not be available to you on the NHS. This is because these treatments have been assessed by experts as less effective, with more side effects or only work well in certain scenarios. Overall, it is better to use other treatments at least initially.

Please click here for more information.

Selfcare and more information

Managing my condition

Ganglion cysts are harmless and do not spread to anywhere else in your body or lead to any serious problems. If they don’t cause any pain or discomfort, they can be left alone and may eventually disappear without treatment, although this can take several years. Around half of all ganglion cysts will resolve on their own within ten years.

Further treatment is usually only recommended if the cyst causes pain or affects the range of movement in a joint. The two main treatment options for a ganglion cyst are:

  • draining fluid out of the cyst with a needle and syringe – the medical term for this is aspiration.
  • cutting the cyst out using surgery.

In view of the recurrence rate (which is over 50% after aspiration and around 25% after surgery) and the risks of joint stiffness or unsightly scars after surgery, these procedures are only recommended for patients with significant symptoms.

Availability on the NHS

Treatment for ganglion cysts will not be funded unless they are causing you significant pain, or if they are disrupting your daily activities.

If you want to have a cyst removed because you do not like its appearance, you will have to pay for private treatment. You can read more about your local policy on ganglion removal here.

If you do decide to have treatment privately, you can find a guide on your next steps by visiting the NHS website.

Aspiration

Aspiration is usually carried out in the outpatient department of your local hospital or GP surgery. Aspiration is not offered on the NHS unless the ganglion is causing significant pain or significant disruption to your daily activities. Your doctor will remove as much of the contents of the ganglion as possible using needle and syringe.

More information about aspiration

After aspiration the ganglion may be injected with a dose of steroid medication to try and help prevent the ganglion returning, although there is no clear evidence this reduces the risk of recurrence.

Aspiration is a relatively painless, straightforward procedure, and you can usually leave the hospital or GP surgery straight afterwards. It is usually the first treatment option offered for ganglion cysts.

Around half of all ganglion cysts treated using aspiration return at some point. If a cyst does return and is causing significant pain or discomfort, surgery may be necessary.

Surgery

Surgery for ganglion cysts is not routinely funded on the NHS unless it is causing significant pain or significant functional impairment (when you suffer a loss of absence of your individual capacity to meet personal, social or occupational demands). You can read the ganglion removal policy by clicking here for further information.

Useful information about ganglion

Waiting for a specialist opinion

If you have been referred for a specialist opinion your details will be reviewed and it may be recommended that you are seen by a hospital clinician. Information to support you in choosing your preferred hospital, including waiting times can be found using the links below.

How long will I wait?

If a hospital assessment and/or treatment is clinically recommended your information will be sent to a specialist. Click below to find out more about waiting times for routine hospital assessment and/or treatment.