Ganglion cyst size 1.3mm by 6mm on ankle very painful MRI also shows bone marrow edema around superior calcaneous is surgery my best course of action?

Not yet. Aspiration (using a needle to drain it) would be helpful, but most likely will return, however it's still an option before surgery. Injection steriod into the area is not recommended as it can commonly lead to achilles tendon rupture. If pain continues even after aspiration, then surgery is a viable and safe option as well. Best of luck!
Achilles bursitis . No real good pic of this, but it is in front of the tendon. I would myself aspirate & inject with steroid. Even twice b 4 operating. Also activity modification.