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Treatments and drugs
By Mayo Clinic staffGanglion cysts are often harmless and painless, requiring no treatment. In fact, in many cases, doctors recommend a wait-and-watch approach before exploring treatment options.
However, if the ganglion cyst is causing pain or it's interfering with joint movement, your doctor may recommend one of several treatment options.
Immobilization
Because activity can cause the ganglion cyst to increase in size, your doctor may recommend wearing a wrist brace or splint to immobilize the area. This helps your hand and wrist to rest, which may help the cyst decrease in size. As the cyst decreases in size, it may release the pressure on your nerves, relieving pain.
Aspiration
In aspiration, your doctor drains the fluid from the cyst. To do so, your doctor applies a local anesthetic to the area above the cyst. Then, he or she punctures the cyst with a needle and removes the fluid from the base of the cyst with a syringe. This can be done right in your doctor's office.
Ganglion cysts may return (recur) after aspiration. In fact, the recurrence rate may be as high as 80 percent. If the cyst recurs, aspiration can be repeated. Having multiple aspirations may eventually result in no recurrence of the cyst.
Your doctor may recommend a steroid injection into the empty cyst after aspiration. Combined with aspiration, steroid injections may reduce the recurrence rate of the cyst. However, the ganglion cyst may still recur and your doctor may recommend surgery to remove the cyst.
Surgery
If you have significant pain or difficulty with joint movement, or if other treatments aren't working, your doctor may recommend surgery to remove the ganglion cyst.
In most cases, doctors perform the surgery on an outpatient basis, which means you'll go home the same day as the operation.
Typically, a local anesthetic is used to numb the affected area. The surgeon then makes an incision in your skin at the location of the ganglion cyst. The size of the incision depends on the size of the cyst. The surgeon will remove the cyst and the stalk that attaches it to the joint or tendon, and likely a small portion of the surrounding tissue, as well. Then the surgeon will stitch and bandage the affected area.
After surgery, you'll be asked to keep the area elevated for up to 48 hours to help reduce swelling. You may experience discomfort, swelling and tenderness for two to six weeks. Your doctor may recommend analgesics, such as acetaminophen (Tylenol, others), or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin, others) or naproxen (Aleve, Naprosyn, others), for pain relief.
At home, you'll need to change your bandages (dressings) as directed, and apply a topical antibiotic ointment with each change. As the incision heals, it's important to watch for signs of infection, including redness, swelling or discharge.
In the weeks after surgery, your doctor may recommend physical therapy to rehabilitate your hand, wrist or foot.
Unfortunately, there's no guarantee that a ganglion cyst won't recur, even after surgery. And as with all surgeries, there are risks to be considered. Though rare, injury to nerves, blood vessels or tendons may occur. These could result in weakness, numbness or restricted motion. Your doctor can help you decide the best treatment for you.
