Hand Surgery

Hand Cyst Treatment

at Cadogan Clinic, London’s Leading Cosmetic Surgery Specialists. 

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Medically Reviewed October 2023, by Dr. Susan Mayou (GMC: 2405092) - founder of the Cadogan Clinic and one of the world's leading dermatologists

What is ganglion cyst removal?

Hand cyst removal is treatment to remove a painful or unsightly ganglion cyst which has developed on a joint or tendon on the wrist, hand or finger.

There are two ways that ganglion hand cyst can be removed. Sometimes a needle and syringe are used to drain the fluid out of the cyst in an non-invasive process known as aspiration. Alternatively, hand cyst excision may be recommended. This type of hand cyst removal can be done either through open surgery or arthroscopy, a type of keyhole surgery.

The treatment depends on the location, shape and size of the ganglion hand cyst and whether the growth is causing any pain, discomfort, numbness, weakness or affecting the movement of the joint.

Ganglion cysts at the back of the wrist, a ganglion cyst at the base of the finger and a finger ganglion cyst can be removed via aspiration or surgery. A ganglion cyst on the front of the wrist is often located close to the artery, so aspiration is considered to be a safer method of removal in this case.

One of our expert consultants here at the Cadogan Clinic will examine the lump on your hand or wrist and ask you questions to determine which treatment type is best for you.

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What is a ganglion hand cyst?

Ganglion cysts are benign lumps which form on the joints or tendons on the wrists and hands.

They are most commonly found on the back of the wrist, front of the wrist and the base of the finger in young adults. Hand ganglions on the finger and more common in middle-aged or older people. Ganglions on the front of the wrist are also often seen in older people who suffer from arthritis. Around 80 percent of all ganglions are found in the wrist.

Ganglion hand cysts are round or oval shaped and are filled with a clear, jelly-like substance called synovial fluid, which acts to lubricate and cushion the joints and tendons. Ganglion hand cysts range in size from a pea to a golf ball, but as a rule of thumb they usually measure less than 2.5cm. A ganglion hand cyst may feel soft and spongy or firm if you press them. The size of a cyst can fluctuate, often getting bigger when the joint is used in repetitive motions. They can even go away and come back. It is possible to have more than one ganglion hand cyst connected by deeper tissue.

Ganglion hand cysts are rarely painful unless they are pressing on a nerve, ligament or tendon.

Some ganglion hand cysts are so small, you cannot see them, but they may still cause you pain. These are known as occult ganglions.

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What causes ganglion hand cysts?

No one really knows what causes a ganglion hand cyst. They seem to occur when the synovial fluid that surrounds and cushions a joint or tendon leaks out and, having nowhere else to go, it collects in a sac.

This leakage of fluid may be caused by an injury or trauma to the wrist or hand, irritation to the nearby joints or tendons or by repetitive stress. But these are just theories and the truth is that no one really knows why ganglionic cysts develop.

However, people who suffer with arthritis in the finger joints closest to the fingernails are at higher risk of developing ganglion cysts near those joints. If you have previously sustained a joint or tendon injury, then this also makes you more likely to develop a ganglion hand cyst.

Your age and sex also play a part in whether you are at an increased risk of developing ganglion hand cysts. Ganglion cysts are three times more common in women than in men, and 70 percent of ganglion hand cysts occur in people between the ages of 20 and 40.

It is rare for ganglion cysts to develop in children aged under 10.

What are the signs and symptoms?

The most obvious sign of a ganglion hand cyst is a noticeable lump on the joint or tendon on the wrist or hand. Underneath the skin the ganglion cyst looks like a balloon on a stalk and it may move around beneath the skin if you press it. This lump on the hand or wrist may appear suddenly or develop slowly over a period of time.

Although ganglion hand cysts are generally painless, they can cause pain or an unpleasant sensation if their presence interferes with tendons, ligaments or nerves in the hand or wrist.

A ganglion hand cyst which is pressing on a ligament or tendon may result in a dull ache or pain near the lump. When the cyst is pressing on a tendon, you may feel a weakness in the affected finger. If the cyst is pressing on a nerve, this can result in a tingling or burning sensation, which you may find painful.

In some cases, the presence of a ganglion hand cyst can interfere and limit movement in the affected joint. As a result, you may find it difficult to work or carry out day-to-day tasks effectively.

How does hand cyst excision work?

A ganglion hand cyst can be removed in one of two ways, by draining (aspiration) or cutting (surgery). There are pros and cons to both of these methods.

A needle and syringe are used to remove as much of the fluid from inside the cyst as possible. This causes the cyst to shrink and successfully relieves the pressure on nerves, tendons and ligaments, alleviating any pain and discomfort. It is non-invasive, quick and painless and you will be able to return to your day-to-day activity and work immediately afterwards.

However aspiration only drains the cyst, it does not remove it, so some ganglion hand cysts may return after aspiration, particularly a ganglion cyst at the back of the wrist. In this case, surgery may be necessary to minimise the chance of a cyst returning.

Surgery is a more invasive, but far more effective, method of hand cyst removal.

There are two different surgical options - open surgery or arthroscopy, a type of keyhole surgery.

In open surgery, the surgeon will make an incision measuring around 5cm long over the site of the affected joint or tendon before removing the cyst and the stalk that attaches it to the joint or tendon. In keyhole surgery, a smaller cut is required and a tiny camera called an arthroscope is used to look inside the joint. Using this tiny camera to guide them, the surgeon can then pass instruments through the cut to remove the cyst

Both techniques can be performed under either local or general anaesthetic.

Ganglion hand cyst excision is a highly effective method of removing a cyst. A cyst that is surgically removed is far less likely to return than a cyst that is drained.

However surgery is not considered to be the best option for a ganglion cyst on the front of the wrist as there is a greater risk of complications. Potential problems after surgery include persistent pain, a loss of movement in the wrist and the trapping or nerve branches in the scar. There is also a higher chance of this particular type of ganglion coming back again after surgery (as high as 30 to 40 percent). Draining is the preferred method of removal in this instance.

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The Patient Journey. A breakdown of what you can expect on your journey with us

We are deeply invested in ensuring that every step of your surgical journey with us is as informative and reassuring to you as it can be. This article outlines what you can expect at each stage of the journey

The Patient Journey

Frequently Asked Questions

The good news is that most ganglion hand cysts are not painful. However they can be painful if they are pressing on a nerve, tendon or ligament. If your ganglion hand cyst is pressing on a nerve, you may experience a tingling or burning feeling. If the cyst is pressing against a tendon or joint, then you are more likely to experience pain or a dull ache.

This pain may be coupled with reduced mobility, depending on the location of the ganglion cyst. Hand cyst removal is the only way to permanently relieve a painful ganglion cyst.

Here at the Cadogan Clinic, there is no waiting list for hand cyst removal and you will be able to get your cyst removed as a day case at our award-winning London clinic. Book a consultation with one of our expert surgeons and find out how quickly we can relieve you of painful ganglion hand cysts.

Most ganglion hand cysts are painless and do not cause any problems. They are noncancerous and, if left long enough, over half of ganglion cysts eventually disappear of their own accord.

However, if a cyst is pressing on a tendon, ligament or nerve, this can cause pain or discomfort. A ganglion cyst may limit the movement in the affected joint. This may impact on your quality of life and your work.

If your ganglion hasn't reduced in size after six months, or it is causing you pain or is causing significant functional difficulty, then you should seek treatment.

Book an appointment with one of our expert surgeons here at the Cadogan Clinic to discuss your treatment options.

There is little you can do to self-treat a ganglion hand cyst at home. Avoiding repetitive movements may ease the discomfort and over-the-counter painkillers should be enough to help relieve any pain associated with your hand ganglion.

Some people with ganglion hand cysts swear by warm compresses to help increase blood circulation and promote fluid drainage. However the use of warm compresses will not prevent ganglion cyst growth.

We strongly advise against the old home remedy of cyst treatment which involves hitting the cyst with a heavy book as this may cause damage to the surrounding bones and tissues. Never try to drain a cyst yourself.  The fluid in the cyst is very thick, sticky and difficult to remove. There is also a high risk of infection if you try to aspirate the cyst at home.

Ganglion hand cyst removal surgery is carried out as a day case, meaning you will be allowed to leave the clinic on the same day as your procedure.

In the days following surgery, you should aim to rest the affected wrist or hand and limit movement to help aid the healing process. You should be OK to perform light, non-repetitive, actions such as writing or carrying light objects. You may need two to four weeks off work, depending on the type of work you do.

You can expect a full recovery somewhere between two and six weeks after surgery, although some post-surgical swelling can persist for two to three months. This swelling can be treated with ice packs while over-the-counter medications can help with pain relief.

More than 50 percent of ganglion cysts disappear on their own without treatment. If the cyst is not causing pain, discomfort or affecting joint movement, some people prefer to leave the ganglion hand cyst to go on its own, rather than undergo any treatment.

However, it may take years for a ganglion cyst to go of its own accord and some cysts do not go away on their own. It is impossible to tell whether a cyst will eventually disappear on its own.

Due to their fluctuating size, if left untreated, a ganglion hand cyst may begin to press down on a nerve, tendon or ligament, causing pain and discomfort. This may affect your movement, impacting on your ability to partake in your hobbies or to do your job. This can have a negative impact on your mental and emotional wellbeing, causing you to feel anxious and depressed.

Ganglion cyst surgery is not painful. A local anaesthetic is injected into the hand, so you will not be able to feel any pain during the procedure itself. Aspiration is also a quick and painless method.

Any pain or discomfort you may feel during your post-surgery recovery should be easily controlled by taking over-the-counter painkillers.

As part of your ganglion hand cyst surgery at the Cadogan Clinic, you will receive comprehensive post-operative aftercare courtesy of our specialist team and 24/7 on-call nurse assistance during the recovery period.

If you have any concerns ahead of your ganglion hand cyst surgery, please speak to your surgeon who will be able to put your mind at rest.

The recovery time for hand cyst removal varies depending on the location of the cyst and the type of treatment you have had to remove it. Draining and surgery are carried out as day cases, so you will be able to leave the clinic on the same day as your treatment.

Recovery time for surgical ganglion hand lump removal can range from two to six weeks.

With regards to time off work, this also depends on the type of job you do. The average required time off work is two weeks, although some people find they need to take as many as four weeks off.

It is very important that you follow all the aftercare advice issued by your surgeon. Failure to do so may impact on your recovery and the final result.

What are the risks?

Complications are rare although, as with all surgery, possible. Your surgeon will discuss each of these risks comprehensively at your consultation. 


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Laurel Wreath for Awards
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Laurel Wreath for Awards
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My Face My Body

Highly Commended

Laurel Wreath for Awards
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Aesthetics Awards

Highly Commended

Laurel Wreath for Awards
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Aesthetics Awards


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