Ganglion cysts

About ganglion cysts

Ganglion cysts are fluid-filled sacs and appear as a smooth, soft lump under your skin. They form when the natural lubricating fluid found in your joints and tendons (called synovial fluid) leaks out and makes a small sac (or cyst).

Women are three times more likely to get ganglion cysts than men, and you’re most likely to get them between your 20s and 40s.

You can get ganglion cysts in any joint of your body. They are most common around your wrist. Ganglion cysts may also appear on the back of your knee, ankle, foot, palm and fingers.

Symptoms of ganglion cysts

The main symptom of a ganglion cyst is a swelling in the area that is affected. Ganglion cysts are often smooth and round. They can vary in size – some may be large and prominent, while others are so small that you can't feel or see them. Sometimes they shrink or grow, and may even disappear altogether, only to reappear at a later date.

The ganglion cyst may be painful but not all cysts cause pain. If a ganglion cyst puts pressure on a nerve, you may experience discomfort or it can affect how well you can move the area or joint that is affected.

Causes of ganglion cysts

The exact reasons why you may develop a ganglion cyst aren't fully understood at present.

Sometimes, ganglion cysts form after an injury or after placing too much stress on a joint or tendon (for example, following repeated stress on the wrist in gymnasts). However, most people who get ganglion cysts haven’t had an injury and it isn’t known what has caused it.

Diagnosis of ganglion cysts

Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history.

Your GP will probably make a diagnosis by feeling and looking at the lump, and from asking you questions about your symptoms. He or she might shine a small, bright light through the lump, as this can help to confirm that the fluid inside is clear.

Treatment of ganglion cysts

Ganglion cysts are harmless and aren't cancerous. Many disappear on their own without any treatment, and often they don't cause any problems. Your GP may suggest that you keep an eye on your cyst and wait to see if it disappears on its own over time.

Non-surgical treatments

If your ganglion cyst is painful or affects how you move the area where you have the cyst, you can have it drained to reduce the swelling. This is called aspiration. A needle is used to puncture the cyst, and will draw the fluid away into a syringe. This is usually done under local anaesthesia. This completely blocks pain from the area and you will stay awake during the procedure.

Aspiration will reduce the swelling but it's likely that your ganglion cyst may come back. You can have a steroid injection to help prevent the ganglion from coming back but it may still return.

Aspiration isn’t suitable for everyone – it will depend on where your cyst is. Ask your GP if it’s an option for you.


Surgery to remove your ganglion cyst is often a last resort if other treatments haven’t worked for you. There is still no guarantee that it won’t return after surgery.

If you have open surgery to remove a ganglion cyst, your surgeon will cut your skin over the cyst and remove it from your joint or tendon lining. He or she will then close the cut with stitches and cover it with a dressing. The operation can also be done as keyhole surgery and smaller cuts will be made in your skin.

Most ganglion cysts are removed under local or regional anaesthesia as a day-case procedure. Local anaesthesia numbs the area that is being operated on, while regional anaesthesia numbs the whole limb. Your surgeon will advise you which type of anaesthesia is most suitable for you.

If you're in any doubt about driving after surgery, contact your motor insurer so that you're aware of their recommendations, and always follow your surgeon’s advice. Before you go home your nurse will give you some advice about caring for your healing wounds and a date for a follow-up appointment.

It usually takes about two to eight weeks to make a full recovery from surgery to remove a ganglion cyst, but this varies between individuals and depends on where the cyst is, so it's important to follow your surgeon's advice.

The area will feel sore, stiff and swollen for a few days after surgery. Generally it’s best to get your joint moving again as soon as possible. Your surgeon will give you advice and some specific exercises for you to perform.

It‘s possible that your ganglion cyst may return after having treatment. This is less likely if your cyst was removed by surgery than aspirated with a needle – a cyst returns in up to six to eight in 10 people who have aspiration treatment for the first time. This lowers to about one in 10 people who have the treatment several times. After surgery the number of people who have a cyst return varies from less than one in 10 to four in 10 people. The cyst is less likely to return after keyhole surgery than open surgery.

If you suspect your ganglion cyst is returning, see your GP.

Is a ganglion cyst the same as a bible bump?


Yes - ganglion cysts used to be commonly known as 'bible bumps' or 'Gideon cysts'.


Ganglion cysts used to be known as 'bible bumps' because the age-old cure for a ganglion was to thump it with a bible in an effort to burst the cyst. This method isn't recommended, however. It will probably hurt, you might damage your wrist, and it's unlikely to get rid of your ganglion cyst.

If you're concerned about a ganglion cyst, visit your GP.

Why do I need a steroid injection after having my ganglion cyst drained?


A steroid injection can reduce inflammation, swelling and provide pain relief very quickly.


If your ganglion cyst is painful or it affects how you move the area that is affected, you can have it drained using a needle and syringe. You can also have an injection to the area with a steroid medicine to reduce the inflammation and help to relieve your pain. However, there is no evidence that steroid injections work and the cyst may return.

Will weightlifting give me ganglion cysts on my wrist?


It's possible the pressure put on your wrists during weightlifting may increase your chance of developing ganglion cysts on your wrists.


Ganglion cysts form when the natural lubricating fluid inside your joints and tendons, called synovial fluid, leaks out and makes a small sac (or cyst). This can happen spontaneously or after an injury. Putting pressure on your wrists can increase the risk of ganglions. Repeatedly lifting heavy weights is one way of doing this.

It's best to wear wrist supports when you’re doing sports activities in which you’re putting pressure on your wrists. Wrist supports protect your tendons and joints from injury. These are available to buy from most chemists and sports shops.