Ganglion

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What is a ganglion?

A ganglion is a small cyst that contains a thick jelly-like material. It looks and feels like a smooth lump under the skin. It is not fully understood how they occur. It is usually attached to a joint or tendon, and the fluid inside is like a thicker version of the fluid which 'lubricates' the joint and tendon sheaths (synovial fluid).

The two common sites where they are found are on the back of the wrist and on the top of the foot next to the small joints. Other sites of the body are affected less commonly.

Are they serious?

No. They are benign. This means that they do not spread. Sometimes they are mildly painful, particularly if they lie next to a nerve. They can very gradually enlarge to the size of about 1-2 cms. This can make them unsightly which is why most people want them removed. Occasionally, they go away on their own without any treatment.

What is the treatment?

If a ganglion does not cause symptoms it is best just to leave it alone. However, many people prefer to be rid of them.

Many people have heard of the traditional cure. That is, to smash them with a heavy book (tradition holds it to be the family bible). This bursts the cyst under the skin. The fluid is then absorbed into the bloodstream. In some people this works well, but there is a high chance of it recurring as the walls of the cyst can reform. However, it is an instant cure for some.

Sometimes it is possible to suck out the fluid with a needle and syringe. If the jelly-like fluid is very thick this may not work. Also, if it does work, there is a chance that the cyst will recur as the wall of the cyst is not removed, and the fluid may form again to refill the ganglion. However, in some people it cures the problem. As it is quite easy for a doctor to do, it is often attempted first.

Surgical removal of the ganglion is the most successful and permanent cure. This is a relatively minor operation. Rarely, after a ganglion is removed, one recurs again at the same site. However, after having it surgically removed a recurrence is much less likely to occur than after the other treatments mentioned above.

© EMIS and PIP 2006   Updated: October 2006

The authors and editors of this article are employed to create accurate and up to date content reflecting reliable research evidence, guidance and best clinical practice. They are free from any commercial conflicts of interest. Find out more about updating.

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