15219 Swollen Lymph Nodes

Overview

Lymph nodes are small, bean-shaped glands that are part of your body's defence system (the immune system). They help filter germs and fight infection. You have them all over your body, but you can usually only feel them in places like the neck, jaw, armpit and groin. When one or more of these glands gets bigger than usual, doctors call it 'swollen lymph nodes' or 'lymphadenopathy'. Most of the time it simply means your body is doing its job and fighting an infection.

Very common. Swollen lymph nodes are one of the most frequent reasons people visit their doctor or pharmacist, and in children they are a normal part of growing up and catching infections.

Anyone can get swollen lymph nodes, at any age. They are especially common in children and young adults, who pick up more infections. In older adults, a new lump is more likely to need checking, because the list of possible causes is wider.

Symptoms

Common symptoms

• A lump or swelling you can see or feel under the skin, most often in the neck, jaw, behind the ear, in the armpit or in the groin
• The lump may feel tender or sore when you press it
• The glands often feel soft and move slightly under the skin
• Symptoms of the infection causing it, such as a sore throat, cough, runny nose, earache, fever or feeling tired
• Sometimes the skin over the gland looks slightly pink or feels warm

Symptoms in children

• Small pea-sized lumps in the neck are very common and often completely normal in children, even when they are well
• They often follow colds, tonsillitis, ear infections, chickenpox or skin infections like impetigo
• Children may also have a sore throat, poor appetite or feel more tired than usual
• Lumps can take several weeks to shrink, even after your child feels better

Symptoms in older adults

• A new lump in an older adult should always be checked, even if it is not painful
• Swelling may be linked to infections, skin problems, some medicines, or other medical conditions
• Unexplained tiredness, fever, night sweats or weight loss alongside a lump should be mentioned to your doctor
• Older adults may need a few more tests to find the cause

Causes

Main causes

• Viral infections such as colds, flu, glandular fever (a viral infection that causes a sore throat and tiredness) and COVID-19
• Bacterial infections such as tonsillitis, strep throat, an ear infection or a tooth abscess
• Skin infections such as impetigo, cellulitis (a spreading skin infection) or infected cuts and insect bites
• Childhood illnesses such as chickenpox, measles or rubella
• Some long-term conditions where the immune system is overactive, such as arthritis or lupus
• Rarely, some medicines, or more serious conditions including certain cancers of the blood or lymph system — this is why a lump that does not go away should be checked

Risk factors

• Being a child or young adult, when infections are more common
• Being in close contact with others who are unwell, such as at school, nursery or in shared housing
• Not being up to date with routine vaccinations
• Problems with your teeth or gums, or long-standing skin conditions that can get infected
• A weakened immune system, or taking medicines that suppress the immune system
• Recent travel to areas where certain infections, such as tuberculosis, are more common

When to see a doctor

See a doctor urgently if:

• The lump is red, hot, very painful, or feels soft and squishy
• You feel generally unwell with a fever and shivering
• Swelling is making it hard to swallow or breathe, or your voice has changed
• Your baby is under 3 months and has a fever
• You have a new lump above your collarbone

Book a routine appointment if:

• A swollen gland that has not shrunk after about 4 to 6 weeks
• A gland that feels hard, rubbery, or stuck in place and does not move when gently pushed
• Swollen glands in several parts of the body with no obvious infection
• A lump that is slowly getting bigger
• Ongoing tiredness, itching, or repeated infections alongside a lump
• Any lump that is worrying you — even if you think it is probably nothing

Diagnosis

A doctor will usually start by asking about your symptoms, how long the lump has been there, and whether you have had a recent infection. They will feel the glands gently, check both sides of your neck, armpits and groin, and look for a source of infection such as a sore throat, ear problem, skin rash or sore tooth. Often that is all that is needed, and your doctor may simply suggest watching and waiting for a couple of weeks.

Tests that may be done

• Blood tests to check for infection, inflammation and blood cell counts
• A throat swab, or a urine sample if a urine infection is suspected
• An ultrasound scan, which uses sound waves and is painless, to look at the gland more closely
• A chest X-ray in some cases, particularly if the swelling is in the neck and lung problems are suspected
• A referral to a specialist for a biopsy, where a small sample of the gland is taken and examined under a microscope — this is only done when there is a reason to be more certain

What to expect at your appointment

Most appointments are quick and simple. If your doctor thinks the swelling is linked to an infection you already have, they may suggest a short period of watchful waiting while you recover. If a test is needed, ask how long the results will take and who will contact you.

Treatment

Treatment depends on the cause. In most cases, the lymph nodes settle down on their own once the underlying infection clears, and the aim is simply to keep you comfortable while you recover.

Self-care at home

• Rest and drink plenty of fluids, especially if you have a fever or sore throat
• A warm, gentle compress over the sore area may help ease discomfort
• Ask your pharmacist about suitable pain and fever relief, and follow the instructions on the packet
• Avoid squeezing or repeatedly pressing the lump, as this can make it more sore
• Gently clean and cover any cuts or skin infections to stop germs spreading
• Keep an eye on the lump and note if it changes in size — this is useful information for your doctor

Medical treatments

Your doctor will treat the cause rather than the gland itself. If a bacterial infection such as tonsillitis or a skin infection is found, they may prescribe an antibiotic, which you take exactly as directed and complete fully. Viral infections do not respond to antibiotics, so the focus is on rest, fluids and symptom relief while your body clears the infection. If a long-term condition or another illness is found to be behind the swelling, your doctor will discuss the right treatment plan for that condition and may involve a specialist team. Medicines are only ever started after a proper assessment, so always talk to your own doctor before taking anything new.

When is surgery considered?

Surgery is rarely needed for swollen lymph nodes. It may occasionally be suggested if a gland needs to be removed and examined (called a biopsy) when tests have not given a clear answer, or if an abscess has formed and needs to be drained. Your doctor would explain the benefits and risks before any procedure.

Living with this condition

For most people, a swollen gland is a short-lived inconvenience rather than something to live with long term. You may notice it for a few weeks while the infection clears. If you are waiting for test results, it can help to keep a simple diary of the lump's size, any pain, and other symptoms, so you can share clear information with your doctor.

Lifestyle tips

• Wash your hands regularly and teach children to do the same
• Avoid sharing cups, water bottles, toothbrushes and utensils when someone is unwell
• Try to get enough sleep and manage stress, both of which help your immune system
• Look after your teeth and gums and see a dentist regularly, as dental infections often cause neck lumps
• Clean and cover cuts and grazes, and check pets' scratches and bites don't become infected

Diet and exercise

There is no special diet that makes swollen glands go away. Eating a balanced diet with plenty of fruit, vegetables and fluids supports your general health and recovery. While you are unwell, gentle activity such as walking is fine, but it is sensible to rest if you have a fever or feel exhausted. Once you feel better, you can return to your usual exercise.

Mental health and emotional wellbeing

Finding a lump can feel frightening, and many people worry it means cancer. In reality, the great majority turn out to be due to a simple infection. If worry is affecting your sleep, appetite, or mood, please tell your doctor — support is available and asking for it is a sign of strength. If you ever feel overwhelmed or unsafe in your thoughts, contact your local emergency number or a crisis service in your area straight away.

Prevention

You cannot prevent every swollen gland, because infections are part of normal life. But you can lower your chances of the infections that most often cause them: keep hands clean, avoid sharing drinks and utensils, treat teeth and gum problems early, keep vaccinations up to date, and get cuts and skin problems looked after.

Vaccines

Staying up to date with routine vaccines, including childhood immunisations, helps prevent some of the infections that cause swollen glands. Ask your doctor or pharmacist which vaccinations are recommended for you, for example seasonal flu or travel-related vaccines.

Screening programmes

There is no screening test for swollen lymph nodes. The most useful thing you can do is get to know your own body and notice any new lumps, then mention anything that does not settle to your doctor.

Complications

If left untreated

• An infection can spread and form an abscess (a painful pocket of pus) that may need draining
• Rarely, an infection in the neck can become serious and need urgent hospital treatment
• An underlying condition causing the swelling might be found later than it could have been
• Very rarely, longstanding lymph node damage can cause puffiness in an arm or leg (lymphoedema)

Long-term outlook

The outlook is very good. Most swollen lymph nodes shrink back to normal within a few weeks once the infection has cleared, and need no treatment at all. Even when a lump lingers, it usually turns out to be harmless. If a rarer cause is found, getting checked early means it can be managed sooner — so there is every reason to feel hopeful and to ask for help if something does not feel right.

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