Swelling of the neck

Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.

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A swelling in the neck can have different causes - from inflamed lymph nodes as part of a viral or bacterial infection to thyroid diseases (“goiter”) to benign and malignant tumors. Read more about common causes and treatment of neck swelling here.

Swelling on the neck: description

A swelling in the neck can develop for a number of reasons. Such swellings are correspondingly variable in terms of their properties such as position, size, strength and speed of development.

In some cases, a thick neck will go away on its own, for example in the case of a non-specific enlargement of the lymph nodes, once the infection that caused it has healed. In other cases, medical treatment is necessary, for example if the swelling in the neck is due to a thyroid disorder or a tumor.

Swelling on the neck: causes and possible diseases

The main causes of neck swelling are:

Nonspecific lymph node inflammation: A painful, side swelling of the neck is often due to a nonspecific inflammation of the lymph nodes, which is caused by a bacterial or viral infection in the head area (e.g. sore throat).

Specific lymph node inflammation: A thick neck caused by enlarged lymph nodes can also have a specific cause of the disease. Examples are tuberculosis, Boeck's disease (sarcoid), syphilis (syphilis), toxoplasmosis or AIDS.

Neck cyst, neck fistula: cysts are fluid-filled tissue cavities; If there is a small opening in the skin from which secretion is constantly emerging, it is called a throat fistula. Neck cysts and throat fistulas can also be visible as a bump on the neck. They appear as a bulging, elastic swelling above the larynx (median cervical cyst) or on the side of the neck in the angle of the jaw (lateral cervical cyst). In the inflamed state, the neck cysts are painful and the overlying skin is reddened.

Abscess: A swelling on the neck can also be due to an encapsulated collection of pus.

Clot-related occlusion of the great jugular vein (jugular vein thrombosis): If a blood clot blocks one of the two jugular veins, it can become inflamed. This acute thrombophlebitis causes a soft, painful swelling of the neck and a fever. Chronic jugular vein thrombosis, on the other hand, manifests itself in a hard and not always painful swelling of the neck. A clot-related neck vein occlusion is usually caused by medical measures (catheter, pacemaker, radiation, etc.).

Enlargement of the thyroid gland or thyroid nodules (goiter): Behind a swelling in the neck there is often an enlarged thyroid gland or a lump in the thyroid gland. Possible causes are iodine deficiency, increased need for thyroid hormones (puberty, pregnancy), autoimmune diseases of the thyroid gland (Graves disease, Hashimoto's thyroiditis), inflammation of the thyroid gland (thyroiditis), the use of certain medications or thyroid cancer.

Diseases of the salivary glands: A mostly unilateral, painful swelling on the neck under the ear with hot, reddened skin indicates an enlarged, inflamed parotid gland. Other salivary glands can also become inflamed and cause swelling. Acute salivary gland inflammation is usually caused by bacteria or viruses (e.g. mumps).

In the case of chronic inflammation, secretion disorders, for example, can be the trigger. Less often there is a benign and even more rarely a malignant tumor behind swollen salivary glands. Possible signs of a tumor are slower growth, lack of pain and no local signs of inflammation.

Lymph node metastases: In cancer patients, swelling in the neck can indicate metastases of the malignant tumor in the lymph nodes. The affected lymph nodes enlarge slowly, feel coarse, cannot be moved and are seldom painful.

Lymph gland cancer (malignant lymphoma): swelling in the neck, armpits, or groin due to enlarged lymph nodes may be a sign of lymph gland cancer. The neck swelling usually occurs in combination with night sweats, fatigue and itching. However, this type of cancer is rather rare in adults compared to other forms of cancer.

Other tumors in the neck area: Other tumors are also possible causes of swelling in the neck. For example, a cystic lymphangioma can cause a bump on the side of the neck. The tumor consists of many lymph cysts, some of which are communicating.

Neck Swelling: When Should You See a Doctor?

Basically, every neck swelling should be clarified by a doctor if no explanation can be found for it, for example an enlargement of the lymph glands due to an acute sore throat. Above all, a lump or swelling on the neck that is painful or persists for weeks should be clarified.

Symptom: what does the doctor do?

At the beginning, the doctor will ask you in detail about your medical history. For example, it is important to know when the swelling occurred on the neck and whether there are other symptoms (such as fever). This is followed by a physical exam. The doctor examines, for example, whether the swelling is hard or soft, movable or stuck, painful or painless. This gives him important information about what could be the cause.

An ultrasound examination (sonography) usually quickly shows whether the swelling on the neck is due to a cyst, an enlarged lymph node or an abscess, for example. Further imaging procedures (magnetic resonance imaging, computed tomography) or a nuclear medical examination are usually necessary to clarify possible thyroid diseases.

If there is swelling in the neck that is caused by enlarged lymph nodes and lasts for weeks or months, a long-term infection, such as toxoplasmosis, is suspected. A blood test can provide information about this.

This is how the doctor can treat a swelling on the neck

Neck swelling due to nonspecific lymph node inflammation will go away on its own when the underlying infection subsides. In such cases, one therefore usually waits. Sometimes drugs are used to treat the infection. Specific lymph node inflammation is treated according to its cause (e.g. antibiotics for tuberculosis).

Medicines are used to treat inflammation of the salivary glands, which causes throat swelling. A repeatedly inflamed gland may need to be surgically removed.

If the swelling in the neck is caused by a neck cyst, neck fistula, or abscess, an operation is also performed.

Jugular vein thrombosis is generally treated with medication.

If the cause of enlarged lymph nodes cannot be found or there are signs of a serious illness such as lymph gland cancer, the lymph node is surgically removed and examined in the laboratory. If the suspicion of a malignant disease is confirmed, it will be treated accordingly.

Enlargement of the thyroid gland is treated with medication, surgery and / or radioiodine therapy (nuclear medicine treatment) depending on the cause and extent.

Swelling around the neck: you can do this yourself

In harmless cases of neck swelling, there are a few things you can do yourself:

Tea: Chamomile and mint tea help with a sore throat with swelling of the throat. They relieve the symptoms of inflammation and are effective for colds and flu. Inhale the vapors of the hot tea under a towel and then drink it while gargling so that it can act longer in the throat.

Wrap: If the thick neck is due to enlarged lymph nodes as part of an infection such as mumps, cooling quark compresses, vinegar or lemon compresses can relieve the pain. Many mumps patients, however, find warmth (e.g. in the form of a hot water bottle) to be more pleasant.

Envelopes: Envelopes with angelica (Angelica archangelica) are also useful for mumps against the swelling of the neck. Get the ready-made ointment at the pharmacy, spread a thin layer of cotton or linen with it and place it on the affected side of the neck. Apply this ointment dressing one to three times a day. It has a decongestant effect and promotes healing.

Cooling compresses also help with inflammation of the salivary glands with swelling on the neck to reduce swelling and relieve pain. In addition, you should drink sufficient amounts, only eat soft foods and observe very careful oral hygiene. This is how you can support the healing process.

Salivary stimulants: Saliva stimulants (sialogoga) such as candies, chewing gum, lemons and sour juices are also recommended. They boost saliva production, which cleanses the salivary glands.

Homeopathy: Homeopathy also knows various remedies for a swelling on the neck or its cause, which are supposed to help. For example, Phytolacca D12 is recommended for mump patients with rock-hard swollen salivary glands and often painful swallowing. Mercurius solubilis D12 is used for sore throats with swollen lymph nodes and tonsils. Let an experienced homeopath advise you on the selection and dosage of the remedies.

Schüßler salts: Schüßler salts are also said to help against swollen lymph glands in mumps. The most important are No. 4 Kalium chloratum and No. 9 Sodium phosphoricum; if there is heavy salivation, No. 8 sodium chloratum is also given. Inquire with an experienced therapist which remedy and in what dosage is best for your neck swelling.

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