Observation is usually indicated for asymptomatic cysts, as some cysts may resolve spontaneously. Additionally, many of the smaller cysts do not cause any problems. Cysts diagnosed early may respond to a temporary period of splinting or immobilization.
Aspiration is frequently recommended. Aspiration, or drawing out the fluid contents using a needle, is used to both confirm the diagnosis and to treat the condition. The area is first numbed with a local anesthetic, and a small needle is inserted to withdraw the jelly-like fluid from the sac. Compressive dressings and splinting are usually recommended. Aspiration can be used to minimize the symptoms or to avoid surgery, but is only partially successful with an approximately 50% recurrence rate.
Your physician may recommend surgical excision of the cyst. Surgery is a successful procedure performed as an outpatient, with a recurrence rate of less than 10%. The type of anesthetic used depends on the location of the cyst. Most distal cysts can be removed under local anesthetic. During cyst excision, your surgeon will not only remove the sac, but more importantly, the cyst’s base (or stalk) will also be removed where it originates from the joint capsule, joint bone spur, or tendon sheath.