Some tendon sheath cysts can be rubbed down, but they are prone to recurrence and most need to be recovered with regular treatment. The main causes of tendon sheath cysts are trauma and chronic strain, which may be caused by prolonged strenuous activity. In the presence of predisposing factors, localized sterile inflammatory exudation occurs, leading to tendon sheath cysts. Some tendon sheath cysts can be ruptured by manipulation and the fluid dispersed evenly into the adjacent superficial tissues and absorbed by the body. However, most cysts, even if rubbed, will revert to their original size within a short period of time due to the retention of the cyst wall and will not recover completely. If you wish to remove the tendon sheath cyst completely, you will eventually need surgery to remove the cyst wall completely. Even so, a small percentage of tendon sheath cysts will recur. Patients with tendon sheath cysts should usually rest, avoid excessive activity and avoid trauma. If there is localized pain or gradual increase in size, surgical removal may be performed.