Ganglion

A ganglion is a fluid-filled lump that usually forms near a joint or tendon sheath. It is most common on the wrist and hand, but can also occur on the foot and ankle. Ganglions are benign (non-cancerous) and may fluctuate in size.

Ganglion removal surgery is a procedure to remove the cyst and its connection to the joint or tendon sheath. Surgery may be recommended when a ganglion is painful, keeps returning, limits movement, affects nerve function, or is causing ongoing concern.

At the Royal Buckinghamshire Hospital, we offer consultant-led assessment and treatment planning, including surgical management where appropriate.

---

Types of Ganglion

Ganglions are often described by location:

• Dorsal wrist ganglion – on the back of the wrist (most common)
• Volar wrist ganglion – on the palm side of the wrist
• Finger ganglion (mucous cyst) – near the end joint of a finger
• Ganglion in the palm – near tendon sheaths
• Foot and ankle ganglion – around joints or tendon sheaths in the foot/ankle

The best treatment option can depend on location and nearby structures (such as nerves and blood vessels).

---

When ganglion removal surgery may be recommended

Surgery may be considered if:

• The ganglion is painful or tender
• It restricts movement, grip strength, or activity
• It is pressing on a nerve causing tingling, numbness, or weakness
• It is recurrent after aspiration (drainage) or has repeatedly flared
• The diagnosis is uncertain and your consultant recommends removal for clarity
• It is causing significant discomfort or impact on day-to-day life

Some ganglions settle without treatment, so your consultant may recommend observation first if symptoms are mild.

---

Symptoms of a Ganglion

Symptoms vary by size and location. Common symptoms include:

• A visible or palpable lump near a joint or tendon
• Aching or discomfort, often worse with use
• Reduced range of movement or stiffness
• Weakness in grip (wrist/hand ganglions)
• Tingling or numbness if a nearby nerve is irritated
• Symptoms that fluctuate with activity

---

Diagnosis

Your consultant will usually diagnose a ganglion with a clinical assessment, which may include:

• History and examination of the lump (size, tenderness, mobility)
• Assessment of movement, strength and function
• Checking for nerve symptoms (sensation and power)
• Imaging if required, such as:
  • Ultrasound (to confirm a fluid-filled cyst)
  • MRI in selected cases (complex location, uncertain diagnosis, or surgical planning)

---

Treatment options

Treatment depends on symptoms, location and your preferences. Options may include:

• Observation (if mild and not troublesome)
• Splinting/activity modification for symptom control
• Aspiration (drainage) in selected cases (more common for certain wrist ganglions, but recurrence can be higher)
• Surgical excision (removal) to reduce recurrence risk and address persistent symptoms

Your consultant will explain which option is most suitable for you.

---

What happens during ganglion removal surgery?

The procedure typically involves:

• Anaesthetic: often local anaesthetic (numbing injections), sometimes regional or general anaesthetic depending on location, complexity, and preference
• A small incision over the ganglion
• Removal of the cyst and its “stalk”/connection to the joint or tendon sheath
• Closing the wound with stitches and applying a dressing (sometimes a splint)

Your consultant will explain the approach, expected scar position and aftercare.

---

Recovery and aftercare

Recovery varies depending on the site (wrist/hand vs foot/ankle), size, and the type of work or sport you do.

You may be advised to:

• Keep the wound clean and dry until reviewed
• Elevate the limb for the first few days to reduce swelling
• Move fingers/toes gently (as instructed) to reduce stiffness
• Limit heavy lifting or strain until cleared
• Attend a follow-up for wound check and stitch removal (if non-dissolvable)

Some stiffness, swelling or aching is common early on. Full comfort and strength can take several weeks. Physiotherapy or hand therapy may be recommended if movement is slow to return, particularly after wrist or finger surgery.

---

Risks and complications

Ganglion removal surgery is commonly performed, but all procedures carry risk. Potential risks include:

• Recurrence (the ganglion can return even after surgery)
• Infection or delayed wound healing
• Scarring or tenderness around the scar
• Stiffness or reduced range of movement (usually temporary)
• Nerve irritation or injury (may cause numbness/tingling)
• Blood vessel injury (particularly with volar wrist ganglions)
• Pain that persists or takes time to settle

Your consultant will discuss individual risks based on location and your medical history.

---

When to seek urgent help after surgery

Seek urgent advice if you develop:

• Increasing redness, heat, swelling, or pus from the wound
• Fever or feeling unwell
• Severe or worsening pain not controlled with advised medication
• New numbness, weakness, or colour change in the fingers/toes
• Bleeding that soaks through the dressing and does not stop with pressure

---

If you have a ganglion that is painful, recurring, affecting movement, or causing nerve symptoms, contact Royal Buckinghamshire Hospital for assessment and treatment. There is no need to be registered with the hospital, or live locally.

If you have insurance which covers consultations, we can in most cases invoice the insurer directly. Where you are paying directly, any costs will always be discussed.