Swollen nodes are a common symptom of a wide variety of medical conditions. The lymph nodes are part of the lymphatic system, which moves lymph fluid through the body and back to the bloodstream. Before this happens, the fluid passes to lymph nodes, where the body’s immune system filters out foreign particles and invading organisms, among other responsibilities. When there’s a problem, like an infection, the lymph nodes fill with lymphocytes, which are a type of white blood cells that spot and remove invading organisms and cancerous cells. Lymph nodes are clustered in a few locations in the body, mainly the side of the neck, jaw, armpits, collarbone, chest, abdomen, or groin area, but smaller clusters are located in other parts of the body. When nodes swell, they usually swell in just one location. In response to infection, the most common location for lymph node swelling is the neck due to the high incidence of upper respiratory infections. When the nodes swell, they become larger than expected and may even be visible under the skin. Swollen nodes often feel tender to the touch or downright painful, especially if they get large enough. In rare cases, they can cause noticeable swelling and look like huge lumps. The entire area, such as the neck, in severe cases, might look grossly swollen.
Although most people experience localized node swelling, nodes in multiple locations can sometimes swell. This usually indicates that a serious condition affects the entire body, so a medical evaluation is needed.
Swollen lymph nodes are a common symptom that may be caused by infection, inflammation, autoimmune disorders, cancer, or exposure to medications or toxins.
Typically, swollen lymph nodes do not require immediate medical attention unless they are large or are accompanied by severe symptoms such as high fever.
Swollen lymph nodes generally do not require treatment unless they are large, don’t improve after several weeks, occur in several places on the body, or there are other symptoms such as unexplained weight loss. Swollen lymph nodes usually resolve within a variable timeline depending on the cause, but most people can expect nodes to return to normal size within four weeks or less.
Treatments of swollen lymph nodes vary by cause.
Swollen lymph nodes can be managed with rest, warm compresses, and over-the-counter pain relievers.
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Because swollen lymph nodes are primarily caused by the body’s immune system, there are many varied causes of swollen lymph nodes. That’s because there are many reasons the body’s immune system starts fighting for the body’s health. These include:
Viral infections such as mononucleosis
Bacterial infections such as strep throat, syphilis, cat scratch disease, and many types of skin infection
Fungal infections
Parasite infections such as toxoplasmosis
Allergies or other hypersensitivity reactions
Metabolic disorders
Types of cancer such as leukemia or lymphoma
Medications
Toxins
Although the list of swollen lymph node causes is long, infections are most commonly the culprit, especially for localized lymph node swelling. The swelling indicates that the body’s immune system is fighting infection. Some may be minor infections, and some may be more concerning.
Are swollen lymph glands something to fret about? It usually depends on the other symptoms. If all the other signs point to a minor infection, like a cold, or an allergic reaction, swollen nodes are no more problematic than a runny nose. Medical care may be needed if there are more serious symptoms, such as high fever. A serious infection may be the cause.
However, if swollen nodes don’t return to normal after four or more weeks or if they are swollen enough to look like a lump, have a healthcare professional look at them. One complication of long-term or severe lymph node swelling is the death of the tissues inside the lymph node. The dead tissue can cause an abscess.
If lymph nodes are swollen in more than one part of the body—say, in the neck and underarms—make an appointment with a clinician. Generalized lymph node swelling is usually a sign of a more serious, body-wide medical condition. It may be the result of an autoimmune disorder or a malignancy. Again, pay attention to other symptoms such as joint swelling, night sweats, or unexplained weight loss.
Lymph node swelling by itself does not require a trip to the emergency room unless the swelling is severe. Again, pay attention to other symptoms. If swollen nodes are accompanied by symptoms such as high fever, severe pain, or changes in mental status, go to an emergency room.
In most cases, clinicians diagnose the cause of swollen lymph nodes from the symptoms, medical history, and a physical examination.
Because there are many causes of swollen lymph nodes, clinicians primarily rely on the symptoms and medical history to narrow down the possible causes. In a physical exam, the physician will feel the nodes to determine which clusters of nodes are swollen. Where nodes are swollen is a vital diagnostic clue. For instance, swollen neck nodes below the jawline might indicate tonsillitis, strep throat, or upper respiratory infection. Swollen nodes behind the ears may be due to an ear infection. Swollen nodes in the groin area might be due to a sexually transmitted infection (STI) or an infection of the leg or foot. Because infections are behind most cases of swollen lymph glands, the physician will also look for other signs of infection to narrow down the possibilities during a physical exam.
Depending on the possible causes, the clinician may order blood tests, X-rays, CT scans, and other tests to narrow further or confirm the diagnosis. You may be referred to a specialist in internal medicine (internist), autoimmune disorders (rheumatologist), or cancer (oncologist).
If there is no clear diagnosis at the end of the process, a clinician may either send you home for a few weeks to see what happens or have a surgeon remove all or part of the lymph node for a biopsy.
Lymph nodes stay swollen for as long as the underlying medical condition provokes the immune response. In minor infections, this may only last a week or two. However, some lymph nodes can remain enlarged for months after an infection has cleared or the underlying condition has passed. This is normal, especially in children whose immune systems are still developing. Sometimes lymph nodes may be permanently larger than normal size, but they won’t be too large (1 cm or less) and shouldn’t hurt.
Swollen lymph node treatments focus on treating the underlying cause:
Infections will be treated with the appropriate medications, though some viral infections are only treated symptomatically
Autoimmune disorders are typically treated with immune-modifying or immune-suppressing medications
Cancer is treated with a variety of medical interventions including chemotherapy, immune-modifying drugs, antibodies, surgery, and radiation—cancerous lymph nodes may need to be surgically removed
Medication-induced lymph node swelling may require switching to a different drugA lymph node that has filled with pus may need to be surgically drained.
Fortunately, swollen lymph nodes are not a chronic or permanent condition. Once the underlying condition is resolved, lymph node swelling will recede. Meanwhile, a few tips can help reduce the discomfort. These include:
Using moist, warm compresses over the swollen areas
Taking over-the-counter pain medications such as acetaminophen, aspirin, ibuprofen, or naproxen
Getting plenty of rest
Instead of worrying about swollen glands, focus your attention on other symptoms. Think of swollen nodes as something more like any other symptom like coughing. There's no worry if you have a cough and a few other minor symptoms like a runny nose and sore throat. However, it's time to see a doctor if there’s also a high fever and cough.
The same applies to swollen lymph nodes. You should only worry about swollen nodes if there are other symptoms. There are exceptions. If the nodes are especially large or painful, the swelling persists for several weeks, or if nodes are swollen in two or more parts of the body, then see a healthcare professional.
The most likely causes of swollen lymph nodes in the breast and shoulder are infections, breast cancer, lymphoma, melanoma, and leakage from silicone breast implants.
Stress does not cause swollen lymph nodes. Scientists aren’t sure how stress affects lymph node swelling. However, stress has been shown to alter the nerve structure of lymph nodes and affect the immune response. Healthcare professionals are confident that chronic stress and anxiety decrease immune system activity, making people vulnerable to infections and subsequent node swelling.
Swollen lymph nodes are not considered a symptom of dehydration. However, many medical conditions that cause swollen nodes may cause people not to drink as much as they should. That’s why healthcare providers commonly advise people to drink plenty of fluids when sick.
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