Swollen lymph nodes are a painful symptom that can come from multiple causes. Generally, if you have swollen lymph nodes (known as lymphadenitis) they are a result of bacterial or viral infection. In many cases, they will return to normal when you get over the infection. However, in some cases they may become more of a problem. You should see a doctor if you have swollen lymph nodes that appear to have no cause, keep growing, have been swollen for two or more weeks, feel hard or rubbery, or are accompanied by persistent fever or unexplained weight loss. Lymph nodes in the neck can cause a problem as they can interfere with swallowing or breathing. Because of this, you may need to seek treatment immediately, which may involve draining the affected node or, more rarely, surgery. More rarely, certain cancers, such as thyroid cancer and throat cancer can cause lymph nodes to become swollen.
An ENT specialist can treat swollen lymph nodes in the neck in various ways.
Before treating, the doctor will attempt to ascertain what is causing the lymph node swelling. Swollen lymph nodes in the neck or under the jaw are particularly common, and generally associated with an infection in that area (in fact, they can be caused by a tooth abscess).
- Antibiotics or antivirals to treat the underlying infection.
- Home remedies including pain relievers, fever reducing medicine and warm compresses.
- Draining a localized point of infection.
- Treatment of underlying autoimmune conditions that often cause lymph node swelling.
- In some cases, surgical removal of the affected node may be the only way to resolve a problem affecting breathing or swallowing. Surgery may also be needed if the lymph node swelling is the result of cancer.
In most cases, invasive treatment is not needed, however, with the exception of swelling associated with cancer. Most lymph node swellings resolve when the underlying condition is treated, with surgical remedies needed only in rare cases. However, this does not mean you should not seek medical attention, especially if you are unsure what is causing the swelling.
Antibiotics or Antivirals
Antibiotic or antiviral medication is likely to be prescribed when the swelling is the result of an infection. Strep throat, for example, is one of the most common causes of lymph node swelling in the neck, but other respiratory and throat infections can also cause swelling. In most cases, the swelling will go away with the other symptoms. If you are prescribed antibiotics, always take the full course even if you are feeling better. Bear in mind that swollen lymph nodes can be the last symptom to go away and can linger after the infection is treated, but if in doubt you can always go back to the doctor and get it checked again. In some cases you may need more than one course of medication to fully resolve the infection. Make sure to tell your doctor anything which might help them identify the infection, such as hiking in areas known to have ticks or having sex with a new partner. This is particularly important if, as sometimes happens, swollen lymph nodes are your only symptom.
For lymph node swellings caused by an infection, your doctor or ENT specialist may also recommend home remedies. These might include taking NSAIDs (e.g. tylenol) to relieve pain and reduce inflammation. A warm compress can be helpful, and should be your first line of offense against a swollen lymph node that is causing discomfort, although if you have difficulty breathing or swallowing, again, you should seek immediate medical attention. You should also take steps to help your recovery from any underlying infection, particularly making sure you get adequate rest. Although home remedies will not resolve the situation, they will help keep you comfortable while you recover or while you wait for your appointment.
In some cases, swollen lymph nodes are caused by a local infection which needs to be surgically drained. If the problem is caused by a tooth abscess, you will need to see your dentist for treatment. Otherwise, local abscesses are generally drained and then packed. However, in most cases, swollen lymph nodes in the neck specifically are caused by dental problems, and your ENT specialist will talk to your dentist about coordinating treatment. In some cases, the lymph node itself may need to be drained, particularly if it is interfering with breathing or swallowing.
One of the most common causes of "random" swelling of lymph nodes is autoimmune conditions. These should be suspected if the swellings are systematic (over your entire body). If an autoimmune condition is suspected, you will be referred to a specialist and receive medication to treat that condition. Lymph nodes in the neck specifically may indicate an autoimmune condition affecting your thyroid gland, which is generally treated with medication.
Removal of Affected Nodes
If swollen lymph nodes are making breathing or swallowing particularly difficult or if they are a result of cancer, a neck dissection may be performed to remove the affected lymph nodes. The surgery may remove only selected nodes or all or most of them, depending on the risk of malignancy. This is generally a hospital procedure that requires an overnight stay. The level of procedure needed will be determined by your surgeon. Fortunately, surgery is rarely needed to treat swollen lymph nodes. Neck dissection may also include the removal of some muscles and veins, in which case the hospital stay may be longer. The most common cancer to affect lymph nodes in the neck is thyroid cancer, which fortunately has very high survival rates.
Swollen lymph nodes in the neck are seldom anything to worry about. They are most often the result of an infection, and will go away once the infection is treated. However, if you have lymph nodes that stay swollen for more than two weeks or feel hard they can be a sign of something worse and you should visit an ENT specialist. Our board certified head and neck surgeons can help if you do end up needing surgery, and if not then they can give you the peace of mind of knowing it is not a big deal and is something which will go away on its own. If in doubt, never be afraid to seek the help of a qualified ENT specialist for your swollen lymph nodes.