A ganglion cyst is a common, non-cancerous lump that typically forms near joints or tendons, most frequently in the wrist or hand. This benign growth can cause concern, especially when it becomes noticeable or painful. Understanding the nature of the cyst, recognizing symptoms that require professional attention, and knowing which specialists are best equipped to treat the condition are important steps for diagnosis and treatment.
Understanding What a Ganglion Cyst Is
A ganglion cyst is a fluid-filled sac that originates from a joint capsule or a tendon sheath. The cyst contains synovial fluid, a thick, clear, jelly-like substance that lubricates joints and tendons. While the exact cause is often unknown, they are thought to form when small tears or irritations allow the joint fluid to leak out and collect in a localized sac.
These growths are the most common soft tissue masses found in the hand, though they can also appear in other locations like the ankle or foot. The cysts are benign and will not spread to other parts of the body. They can fluctuate in size, sometimes enlarging with increased joint activity and occasionally disappearing completely without intervention.
Initial Assessment: When to Seek Medical Care
While many ganglion cysts are asymptomatic and require only observation, certain symptoms indicate a need for medical evaluation. Consult a healthcare provider if the lump is causing persistent pain or begins to interfere with the normal movement of the adjacent joint or tendon.
A sudden or significant increase in the size of the cyst should be checked by a doctor to confirm the diagnosis and rule out other conditions. Any signs of nerve compression, such as numbness, tingling sensations, or muscle weakness in the affected limb, necessitate an urgent consultation. If the cyst is not causing any discomfort or functional issues, many providers recommend monitoring the lump’s size and symptoms over time.
Specialized Care: Which Doctors Treat Ganglion Cysts
The type of doctor you see depends on the cyst’s location, size, and symptoms. A Primary Care Physician (PCP) is often the first point of contact, as they can perform an initial physical examination and confirm the lump is likely a cyst. They can offer reassurance about its benign nature and discuss conservative initial management options, such as observation or bracing.
If the cyst is causing significant pain, functional limitation, or requires intervention, a specialist referral is necessary. Orthopedic Surgeons specialize in conditions of the bones, joints, ligaments, and tendons, making them the primary specialists for definitive diagnosis and treatment, including surgical excision.
For cysts located in the hand or wrist—the most common sites—a Hand Surgeon is often the preferred expert. Hand Surgeons are typically orthopedic or plastic surgeons with specialized fellowship training in the complex anatomy of the hand and wrist. For cysts in the foot or ankle, a Podiatrist may also be involved. A Rheumatologist might be consulted if there is suspicion that the cyst is connected to an underlying inflammatory joint condition.
Common Treatment Pathways
For cysts that are small, painless, and do not restrict movement, the most common approach is observation and monitoring. Since many ganglion cysts may resolve spontaneously, the doctor may recommend waiting to see if the lump disappears on its own. If the cyst is symptomatic or aesthetically bothersome, more active intervention may be considered.
One common non-surgical procedure is aspiration, where the doctor uses a sterile needle to drain the fluid contents from the cyst. While aspiration is a minimally invasive procedure, it has a high recurrence rate, with up to half of cysts returning because the “stalk” connecting the cyst to the joint is not removed. For cysts that are painful, recur after aspiration, or cause nerve compression, surgical excision is recommended.
Surgical excision involves removing the entire cyst, including the stalk or root that connects it to the joint capsule or tendon sheath. This is performed to reduce the chance of recurrence, which occurs less frequently than with aspiration. Recovery involves a period of immobilization followed by rehabilitation to restore full range of motion and strength in the affected joint.