Evidence checked 26 October 2026. General information, not a personal diagnosis.
What is this lump on my wrist or hand?
A ganglion cyst is a swelling containing thick, clear fluid. It is the commonest type of swelling in the hand and wrist. Common sites include the back or palm side of the wrist, the base of a finger on the palm side, and the end joint of a finger. A lump may be painless or uncomfortable, and it can change in size [1]. A new lump should not be labelled a ganglion from an online description alone.
Concerned about a wrist or hand lump? Send a consultation enquiry, email team@thewellnesslondon.com or call 020 3951 3429. The first decision is what the lump is, not which injection to book.
At a glance
- A confirmed ganglion is harmless and can often safely be left alone. Many disappear spontaneously; others cause little trouble [1].
- Observation, aspiration and surgical removal are the main options described by the British Society for Surgery of the Hand (BSSH). The choice depends on location and symptoms [1].
- Aspiration can reduce a wrist swelling, but recurrence is common [1][2].
- Surgery can reduce recurrence compared with aspiration, but it carries risks. Arthroscopic surgery has not been shown superior to open surgery by adequate comparative trials in the review discussed below [2].
- PRP is not among the ganglion treatments recommended in the BSSH patient guidance [1].
Why do ganglion cysts develop?
Most arise spontaneously. Sometimes there is a history of injury or arthritis in a nearby joint [1]. They are not all in the same place, and that matters: a cyst on the palm side of the wrist can lie close to the artery where you feel your pulse. A lump at the end finger joint may be associated with arthritis and can produce a groove in the nail [1].
That is why advice about a dorsal wrist ganglion should not automatically be applied to a palm-side cyst or a finger cyst. Tell the clinician exactly where the swelling is and what happens when you grip, move the wrist or use the hand.
How is a ganglion diagnosed?
BSSH describes the diagnosis as usually straightforward because ganglions tend to be smooth and round, change in size and occur in characteristic locations. If the diagnosis is uncertain, scans may help [1]. A scan is a tool for uncertainty, not proof that every lump needs a procedure.
A lump that is growing, hard, fixed or worrying you should be assessed. Seek urgent help if it becomes very painful, hot or red [3]. Do not assume those symptoms are simply a harmless cyst.
Can I leave it alone?
For a confirmed ganglion, often yes. BSSH states that many disappear on their own and there are no long-term consequences from leaving a ganglion untreated [1]. That statement applies after the lump has been identified, not to every unexplained swelling.
Observation is an active choice rather than a failure to treat. It avoids procedural risks when the lump causes little trouble. If it hurts or interferes with function, the balance can change. The question is whether the symptoms justify treatment, not whether a scan can find fluid.
Do not try to burst or pop a cyst yourself. This can damage the skin or cause infection [3]. A wrist support may help if movement is uncomfortable [3].
What does the evidence say about draining it or surgery?
Aspiration removes the fluid with a needle, usually under local anaesthetic. Surgical removal is another option [1]. Neither is a guarantee that the swelling will never return.
A 2015 systematic review identified 35 studies covering 2,239 wrist ganglions. Six studies, including two randomised trials, could be included in its comparison meta-analysis. In the randomised trials, surgical excision was associated with a 76% relative reduction in recurrence compared with aspiration. The authors rated the randomised evidence moderate quality and the cohort evidence very low quality [2]. This is a relative comparison, not a 76 percentage-point reduction or a personal prediction.
Across separate studies, average recurrence was 59% after aspiration, 21% after open excision and 6% after arthroscopic excision. Those figures came from different groups of studies, not a single head-to-head trial. They do not prove arthroscopy is best. The authors specifically said comparative data were limited and had not demonstrated arthroscopic superiority [2].
Complications and recovery also matter. BSSH lists persistent pain, reduced movement and painful trapping of nerve branches in a scar after wrist ganglion surgery. For palm-side cysts, proximity to the artery and the risk of symptoms after surgery mean many surgeons advise against operating [1]. Ask for an explanation specific to the location of your cyst rather than relying on one pooled recurrence figure.
Does PRP work for a ganglion cyst?
PRP is not included among the ganglion treatment options in the cited BSSH guidance [1]. The evidence discussed here does not establish it as a routine treatment. An injection offered for a different tendon or joint problem is not automatically appropriate for a fluid-filled lump.
If wrist pain rather than the lump is your main concern, read our wrist pain and RSI guide. Our hand and wrist injection overview explains why the diagnosis must come first. These related pages do not establish an indication for a ganglion injection.
What should I ask before treatment?
- How certain is the diagnosis, and would imaging change it?
- Is observation reasonable for the symptoms I have?
- How does the position of this cyst affect aspiration or surgery?
- What recurrence and complication evidence applies to this particular location?
- What will recovery involve for work, sport and using my hand?
- What is the full cost, and what happens if the cyst returns?
Bring a note of when the lump appeared, changes in its size, pain, numbness and any effect on grip. A photograph from a time when it was larger can help describe a fluctuating swelling. Discuss the options before agreeing to a procedure.
Next step
For a clear discussion of the next step, send a consultation enquiry, email team@thewellnesslondon.com or call 020 3951 3429. An assessment should explain whether observation is sensible and whether a hand specialist is the appropriate route. Treatment is not assumed.
Frequently asked questions
Will a ganglion go away on its own? Many disappear spontaneously, although not all do [1].
Does draining it stop it returning? No. Recurrence is common after aspiration [1][2].
Does surgery guarantee it will not return? No. Recurrence and complications remain possible, and the location changes the balance of benefit and risk [1][2].
Should I book PRP for a wrist lump? Not on the basis of a lump alone. Confirm the diagnosis first. PRP is not a ganglion treatment listed in the cited BSSH guidance [1].
General information does not replace a personal medical assessment. Individual outcomes vary.
References
- British Society for Surgery of the Hand. Ganglion cysts. https://www.bssh.ac.uk/patients/conditions/20/ganglion_cysts
- Head L, Gencarelli JR, Allen M, Boyd KU. Wrist ganglion treatment: systematic review and meta-analysis. Journal of Hand Surgery. 2015;40(3). doi:10.1016/j.jhsa.2014.12.014. https://www.jhandsurg.org/article/S0363-5023(14)01719-5/abstract
- NHS. Ganglion cyst. https://www.nhs.uk/conditions/ganglion-cyst/