A cyst is a closed sac or capsule that forms beneath the skin or inside the body, typically filled with fluid, semi-solid material, or pus. While many cysts are harmless, they often require medical intervention if they grow significantly or become infected. The procedure to treat them is called Incision and Drainage (I&D). Drainage is required when a cyst shows signs of infection or causes symptomatic pressure on surrounding tissues.
Pain Caused by the Cyst Prior to Drainage
The discomfort felt before drainage often serves as the primary motivation for seeking treatment. An inflamed or infected cyst transforms into an abscess, a pocket of pus that creates intense internal pressure. This accumulation of material causes the cyst wall to stretch and press against nearby nerves and soft tissues.
This mechanical pressure, combined with the body’s inflammatory response, leads to localized pain, redness, and warmth. The pain level is proportional to the degree of swelling and infection present. Patients report a constant throbbing or sharp pain that worsens with movement or touch. The I&D procedure is designed to puncture the sac and release this pressurized material, providing immediate relief.
Minimizing Discomfort During Incision and Drainage
Incision and Drainage (I&D) is almost always performed using a local anesthetic, such as lidocaine, which numbs the area around the cyst. The most noticeable sensation and the most painful part of the entire process is usually the initial injection of this numbing agent.
The injection of lidocaine causes a brief, sharp sting or a burning sensation as the fluid disperses into the tissue. This temporary discomfort lasts only a few seconds before the medication begins blocking nerve signals. In cases of significant infection, the anesthetic may be slightly less effective due to the acidic environment of the abscess, but the area is still made sufficiently numb for the procedure.
Once the anesthesia has taken full effect, the patient should not feel sharp pain during the actual incision and drainage. The medical professional tests the area to confirm numbness before making a small cut. During the subsequent draining of pus and fluid, the patient typically only feels a pressure sensation or movement as the doctor gently manipulates the area to ensure complete evacuation.
Managing Pain During Recovery and Healing
After the local anesthetic wears off, which generally takes between four and six hours, it is normal to experience a return of pain at the incision site. This post-procedure pain is usually a manageable dull ache or throbbing sensation, not the sharp, intense pain of the pressurized cyst. Over-the-counter pain relievers like acetaminophen or ibuprofen are typically recommended to control this expected discomfort.
Wound care often involves changing a gauze packing placed inside the drained cavity to promote healing from the inside out. Changing this packing can cause temporary, acute discomfort. Applying a warm compress or taking prescribed pain medication about 30 minutes before the dressing change can help reduce this temporary pain.
It is important to monitor the wound for signs that the pain is not progressing normally. Severe, escalating pain that does not respond to medication, along with increasing redness, warmth, or a fever, can indicate a re-infection or complication. Pain that becomes significantly worse over the first 48 hours is an indication to contact the healthcare provider immediately for re-evaluation.