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Ganglion Cyst: Treatment and Removal in London

A ganglion is a harmless, fluid-filled lump that grows from a joint or tendon sheath, most often on the back of the wrist. It is not cancer and does not spread. Many go away on their own, and leaving one alone does no long-term harm. If it is painful or gets in the way, it can be drained with a needle, but it often comes back. Surgical removal has a much lower chance of coming back, especially by keyhole surgery.

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Written and reviewed by Mr Dafydd (Taff) Edwards FRCS(Tr&Ortho), Consultant Hand, Wrist and Elbow Surgeon, Cleveland Clinic London. Last reviewed: 31 October 2026.

 

Private consultations at Cleveland Clinic London, 55 Moorgate, EC2R 6BH. Call 020 3423 7183 or book online.

Ganglion cyst to the wrist joint

What is a ganglion cyst?

A ganglion is a smooth, round swelling filled with thick, clear, jelly-like fluid. It grows out from the lining of a joint or a tendon sheath, a bit like a small balloon on a stalk. It is one of the commonest lumps in the hand and wrist. Most appear for no clear reason, though some follow an injury or develop where a joint is becoming arthritic.

Where do ganglions appear?

  • Back of the wrist. The commonest site, usually in young adults. It grows from a ligament between two wrist bones (the scapholunate ligament) and often disappears on its own.

  • Front of the wrist, at the base of the thumb. Grows from the wrist joint and lies close to the radial artery. It can occur in young adults, or with wrist arthritis in older people.

  • Base of a finger, on the palm side (a seed ganglion). A small, hard lump that feels like a dried pea and hurts when you grip.

  • Back of the fingertip joint (a mucous cyst). Usually in middle-aged or older people with early arthritis in that joint. It can cause a groove in the nail and sometimes leaks fluid.

What are the symptoms?

  • A lump that may change size, and may get bigger with use

  • It may be painless, or ache, especially with wrist movement or gripping

  • Rarely, tingling if it presses on a nerve

Is a ganglion serious?

  • No. It is harmless and does not turn into cancer. Leaving it alone has no long-term consequences. A new lump should still be checked, to confirm what it is. An ultrasound scan helps if there is doubt. See a specialist promptly if a lump grows fast, is very hard, changes colour, or causes numbness or weakness.

Do ganglion cysts go away on their own?

  • Many do, especially on the back of the wrist, and many others cause little trouble. Because a ganglion is harmless, waiting is a sensible first choice, and treatment is for one that is painful or gets in the way.

How do I get rid of a ganglion cyst?

I follow the British Society for Surgery of the Hand (BSSH) guidance on ganglion cysts. If a ganglion is causing symptoms, I usually start with aspiration, and offer surgical removal, open or keyhole, if it comes back.

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  • Reassurance and waiting. For a painless ganglion, this is often best. Studies have found that draining a ganglion is no better than reassurance alone over time.

  • Aspiration (draining with a needle). Under local anaesthetic and ultra-sound guidance, the fluid is drawn off with a needle. It is quick and the lump goes down, but it often fills again: in a review of studies, it came back in about 59% of cases. For a seed ganglion at the base of a finger, fewer than half come back. Ganglions at the front of the wrist need care, because the radial artery lies close by.

  • Surgical removal (excision). The ganglion is removed together with its stalk where it joins the joint or tendon sheath. This makes it much less likely to come back. It can be done in two ways:

  • Open excision, through a small cut over the lump. In the same review it came back in about 21% of cases.

  • Arthroscopic (keyhole) excision, for some wrist ganglions, through small cuts with a camera. It came back in about 6% of cases, with fewer complications than open surgery.

  • Recurrence also depends on the site. BSSH figures after surgery: about 1 in 10 for the back of the wrist and fingertip joint, and about 3 in 10 for the front of the wrist, so I advise surgery only when a ganglion is causing symptoms.

  • Squeezing or hitting a ganglion to burst it is not recommended.

How long is recovery after ganglion removal?

  • Bandage: 2 weeks, with no heavy lifting

  • After 2 weeks: back to normal activities

  • Scar care: massage and moisturise the scar once it has healed

  • Anaesthetic: usually local

What are the risks of surgery?

  • The ganglion coming back (see the figures above)

  • A tender scar, and some loss of wrist movement

  • Persistent aching at the wrist

  • Irritation of small skin nerves caught in the scar

  • For fingertip mucous cysts: infection, stiffness, and pain from the underlying arthritis

  • In a review of studies, complications occurred in about 14% after open excision and 4% after keyhole excision

Frequently asked questions

  • Do ganglion cysts go away on their own? Many do, especially on the back of the wrist. A ganglion is harmless, so waiting is a sensible first choice.

  • Is a ganglion cyst cancer? No. It is a harmless, fluid-filled swelling that does not spread. A new lump should still be checked to confirm what it is.

  • Should I have it drained or removed? Draining with a needle is quick, but the ganglion comes back in about 6 in 10 cases. Removal is more likely to be permanent, and keyhole removal has the lowest recurrence.

  • Why does my ganglion hurt? It can press on the tissues around a joint or tendon, so it may ache with wrist movement or gripping. A seed ganglion at the base of a finger hurts when you grip.

  • Can a ganglion come back after surgery? Yes, in about 1 in 10 at the back of the wrist and about 3 in 10 at the front, according to BSSH.

  • Book a consultation: 020 3423 7183 or contact the clinic.

Sources

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