I had a ganglion cyst in my wrist in 1977. I was a senior in high school and it was painful. Mine was drained by needle extraction and has never returned. I needed no physical therapy, the pain was relieved instantly. I would avoid surgery if yours is drainable. You will have to discuss this with your Dr. but unless it is wrapped around bone or tissue complicating extraction I would not think surgery would be necessary. Yes they can come back, but mine never did. Good luck.