What is a ganglion?

A ganglion is a non-cancerous fluid-filled lump or cyst which can occur near joints or tendons. It is most commonly found on the wrist (particularly the back of the wrist) or hands. The cyst can range from the size of a pea to the size of a golf ball.

Ganglions are harmless, but can sometimes be painful. If they do not cause any pain or discomfort, they can be left alone and may disappear without treatment, although this can take a number of years. It's not clear why ganglions form. They seem to occur when the synovial fluid that surrounds a joint or tendon leaks out and collects in a sac.

Patient eligibility criteria:

Surgical treatment of ganglion cysts is restricted. The patients local NHS commissioning organisation will only fund this treatment if the patient meets the following criteria:

  • Surgery for ganglion will be funded where painful lump causing disabling pain and restricting activities of daily living and/or work
  • Surgery for a fluid filled swelling (mucous cysts) will be funded when causing distortion of nail growth and discharge which can lead to arthritis in the joint (septic arthritis).

The clinician in charge of the care of the patient’s specific condition, usually a hospital doctor, can assist the application, if there is exceptional clinical need for the treatment to be funded. The patient’s clinician must evidence clinical exceptionality and must be supported by the patient’s local NHS commissioning organisation. See separate leaflet for more information on Individual Funding Requests (IFRs).

Advice and further guidance:

There are two ways surgery can be used to remove a ganglion cyst:

  • Draining the fluid out of cysts with a needle and syringe (the medical term for this is aspiration)
  • Cutting the cyst out using surgery.

Both techniques can be performed under either local anaesthetic, where the patient is awake but won't feel any pain, or general anaesthetic, where the patient is asleep during the operation.

For more information search for ‘ganglion cyst’ at

  • Choosing Wisely UK is part of a global initiative aimed at improving conversations between patients and their doctors and nurses.

Treatment policy for patients covered by NHS Birmingham and Solihull CCG

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