A ganglion cyst is a benign lump filled with thick fluid that grows from a joint or tendon sheath, and it is the most common lump in the hand [1][3]. Watching a painless cyst is safe, and many shrink or disappear within months [1][2]. If it causes pain, numbness or trouble with daily tasks, needle drainage or surgery can be discussed; surgery brings the cyst back less often than needle drainage [4].
What is a ganglion cyst?
It is a small sac on a stalk, like a balloon, holding jelly-like fluid similar to joint fluid. It is the most common cause of a lump in the hand and wrist and it is not cancer [1][3].
The usual sites are the back of the wrist, the palm side of the wrist near the base of the thumb, the palm side of the base of a finger, and the back of the end joint of a finger [1][3].
What symptoms does it cause?
Size ranges from smaller than a pea to a few centimetres, and it may grow and shrink over time [1][2].
- A smooth, soft or firm lump under the skin
- Often painless; an ache after using the joint is possible
- Tingling, numbness or weakness if it presses on a nerve
- Pain even from very small cysts that cannot be seen
- Concern about appearance
What causes it, and who gets it?
The exact cause is unknown. Sometimes it appears after an injury lets fluid leak from a joint [1][2].
It is more common between the ages of 15 and 40 and in women. It is also more frequent in athletes who repeatedly stress the wrist, such as gymnasts, and in people with joint arthritis; cysts at the end joint of a finger usually appear in middle or older age with arthritis of that joint [1][2].
How is it diagnosed?
Examination is enough for most patients: we check the position, firmness and tenderness of the lump and, when useful, shine a light through it to see whether it contains fluid [1].
An X-ray may be taken to rule out bone or joint problems. Ultrasound or MRI can show small hidden cysts and confirm that a lump really is a cyst [1]. A lump that is hard, fixed or growing quickly should never be assumed to be a cyst without being examined [2].
Non-surgical options: watching and aspiration
For a painless cyst, watching is a reasonable path. Many shrink or disappear over several months to a year [1][2][3]. A wrist support and short-term painkillers can ease symptoms [1][2].
Please do not try to burst the cyst at home or hit it with a heavy object; it can cause infection and tissue damage [2].
Draining with a needle makes the cyst smaller, but the root stays in place so it often returns [1][3]. A meta-analysis found that aspiration did not clearly reduce recurrence compared with simply watching [4].
When is surgery considered?
Surgery is discussed if the cyst is painful, presses on a nerve and causes numbness or weakness, interferes with daily tasks, or keeps returning despite other treatment [1][3].
The cyst is removed together with the stalk that connects it to the joint or tendon sheath; it is usually a day-case operation [1]. A meta-analysis showed that surgical removal clearly lowers the risk of recurrence compared with needle drainage, although complications are more frequent with surgery [4].
The cyst can come back after surgery too. Recurrence is more common on the palm side of the wrist, which lies close to an important artery, so the decision depends on where the cyst is [3].
Recovery after surgery
Tenderness, swelling and discomfort can last for a while. Most patients are back to usual activities within two to six weeks [1].
Possible problems include ongoing pain and irritation of small nearby nerve branches, and, for finger cysts, infection and joint stiffness [3].
When should you not wait?
Seek assessment promptly if [1][2]:
- The lump becomes very painful, hot or red
- The lump is hard, does not move, or grows quickly
- You have numbness, tingling or weakness in the hand or fingers
Frequently asked questions
- What causes a lump on the wrist?
- The most common cause of a soft, smooth lump on the back of the wrist is a ganglion cyst. A lump that is hard, fixed or growing quickly needs to be examined [1][2].
- Does a ganglion cyst go away on its own?
- Many shrink or disappear over several months to a year. For a painless cyst, watching is a safe option [1][2][3].
- Should I pop a ganglion cyst?
- No. Squeezing or hitting it at home can cause infection and tissue damage. If it needs draining, a doctor does it with a needle [2].
At our clinic we first ask about your pain, how much the appearance bothers you and what you expect; the treatment decision follows from your answers.
Sources
- Ganglion Cyst of the Wrist and Hand. American Academy of Orthopaedic Surgeons (OrthoInfo), n.d.. orthoinfo.org
- Ganglion cyst. NHS (nhs.uk), 2025. nhs.uk
- Ganglion Cysts. British Society for Surgery of the Hand (BSSH), n.d.. bssh.ac.uk
- Wrist ganglion treatment: systematic review and meta-analysis. The Journal of Hand Surgery (Head L, et al.), 2015. pubmed.ncbi.nlm.nih.gov
This article is general information and does not replace an examination or imaging. If you have symptoms, see a doctor.
More in this area
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- Thumb-side wrist pain: De Quervain's tenosynovitis
- Broken wrist: cast or surgery?
- Numbness and tingling in the hand and fingers: causes, what helps, who to see
- Cut tendons and nerves in the hand: when is it urgent?
- Trigger finger: injection or surgery?