Enlarged Cervical Lymph Nodes

Possible Causes and Accompanying Symptoms

Cervical lymph nodes are small structures in the back and sides of the neck and under the chin. Part of the lymphatic system, lymph nodes work with the immune system to help fight infection.

Cervical lymph nodes typically cannot be seen or felt. However, when you are sick or fighting off an infection, they can become enlarged and tender. Also known as swollen glands or lymphadenopathy, they are common with upper respiratory infections but can be caused by other things as well.

This article discusses cervical lymph nodes. It explains the symptoms and causes of swollen glands and when to see your healthcare provider about enlarged cervical lymph nodes.

Common causes of Swollen Cervical Lymph Nodes

Verywell / Brianna Gilmartin

Symptoms of Swollen Cervical Lymph Nodes

Your cervical lymph nodes are small and found deep under your skin and muscles. Because of this, you typically won’t even realize they are there.

Sometimes, though, an illness may cause cervical lymph nodes to swell. If this happens, you may notice:

  • Neck bumps you can feel and maybe even see
  • Tenderness and pain at the site of the cervical lymph node

To check your cervical lymph nodes, use a gentle circular motion with your fingertips to feel around the jaw, ears, neck, and collarbone for anything that feels like a swollen lump beneath the skin.

Swollen glands are often accompanied by other signs of infection, such as:

  • Congestion
  • Cough
  • Earache
  • Fever with or without chills
  • Headache
  • Sinus pressure
  • Sore throat

Depending on the underlying cause, the lymph nodes may be only slightly enlarged, or they may grow large enough to be visibly obvious. In some cases, swelling may be the only symptom.

If you have swollen lymph nodes in your neck, you may also have swollen lymph nodes in your groin and underarms. These are the three sites in the body where you have the most lymph nodes.

If swelling affects more than one area of lymph nodes, it is usually called generalized swelling of the lymph nodes.

Can Lymph Nodes in the Neck Stay Enlarged Permanently?

It’s common for the swelling to stop once the underlying condition is identified and treated. However, some swollen cervical lymph nodes stay enlarged permanently with certain chronic conditions, like HIV, or after some infections.

Infectious Causes of Enlarged Cervical Lymph Nodes

Bacteria and viruses cause infections that lead to swollen cervical lymph nodes. Staphylococcal infection is a common bacterial cause.

In children, viral infections (especially viral upper respiratory tract infections) are common causes of enlarged cervical lymph nodes.

Viruses, including the Epstein-Barr virus, HIV, and shingles (varicella zoster), are associated with swollen lymph nodes.

Swollen cervical lymph nodes are commonly seen with:

In rare cases, abnormally enlarged cervical lymph nodes have been seen in individuals infected with COVID-19.

When Swollen Cervical Lymph Nodes Could Be Cancer

Swollen cervical lymph nodes are rarely a sign of cancer. However, painless swelling of one or more lymph nodes, especially the cervical lymph nodes, is a key warning sign of lymphoma, including Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL).

In fact, swollen cervical nodes can be one of the few outward signs of lymphoma in the early stages.

  • HL is often marked by the swelling of cervical lymph nodes. The swelling usually moves from one lymph node to the next in a predictable pattern of spread.
  • NHL may cause swollen lymph nodes in the neck, but with a less defined pattern of spread. It appears as a more generalized swelling of lymph nodes.

Metastatic carcinomas and squamous cell carcinoma of the head/neck are other cancerous growths in which swelling of the cervical lymph nodes is common.

Possible Signs of Cancer

Signs of cancer can include:

  • Swollen cervical lymph nodes that last more than six weeks
  • Firm, hard, and painless lymph nodes
  • Nodes that rapidly increase in size
  • Unexplained weight loss
  • Night sweats
  • A lymph node larger than 3/4 inch (2 centimeters)

When to See a Healthcare Provider

Enlarged cervical lymph nodes are a sign your body is fighting an infection. On their own, temporarily swollen glands do not require medical intervention, though the underlying infection may require treatment.

Contact your healthcare provider for swollen lymph nodes that:

  • Are accompanied by fever, night sweats, or unexplained weight loss
  • Are red and tender
  • Continue to get larger
  • Feel hard, irregular, or fixed in place

In children, any lymph node larger than about 1/2 inch (1 centimeter in diameter) should be evaluated by a healthcare provider.

Lymph nodes should return to normal size within two to three weeks following the infection. If the swelling doesn’t go down or lymph nodes are still tender after this period, reach out to your healthcare provider.

Diagnosing Swollen Cervical Lymph Nodes

If you have swollen glands in your neck, your healthcare provider will examine them in context with your other symptoms to identify the cause.

During an exam, you will be asked when your symptoms started, if any of the lymph nodes are tender to the touch, and if the swelling came on suddenly.

Depending on your other symptoms, the following tests may be ordered:

  • Blood tests, including liver function tests, kidney function tests, and CBC with differential
  • Chest x-ray
  • Culture of ear discharge, expelled phlegm, or nasal or throat swab
  • Liver-spleen scan
  • Lymph node biopsy

Treating Enlarged Cervical Lymph Nodes

The treatment for enlarged cervical lymph nodes will depend on the cause.

Infections caused by bacteria, like strep throat, will require antibiotics. Viral infections, on the other hand, have to run their course.

To ease the discomfort of swollen glands at home, try the following:

  • Apply a cold or warm compress to the painful area for about 15 minutes.
  • Drink plenty of fluids to keep hydrated and flush your lymphatic system.
  • Get lots of rest to help your body recover.
  • Take an over-the-counter pain reliever, such as Tylenol (acetaminophen) or Advil (ibuprofen).

Summary

Enlarged cervical lymph nodes, also known as swollen glands in the neck, are commonly caused by an infection in the upper body. They are located under the chin and on the sides and back of the neck and can be tender to the touch or painful.

Swollen glands can last for two to three weeks after an infection, but the swelling should go down once the infection clears. Viral infections, like the common cold or influenza, often clear on their own, while bacterial infections, like bronchitis, require antibiotics.

When enlarged cervical lymph nodes don’t resolve after a few weeks or appear with more troubling symptoms, having your healthcare provider find out why is a good idea. Warm compresses, OTC pain relievers, and other at-home treatments can help ease the discomfort of swollen glands.

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Additional Reading

By Indranil Mallick, MD
 Indranil Mallick, MD, DNB, is a radiation oncologist with a special interest in lymphoma.