The lymphatic system is a complex network of thin vessels, valves, ducts, nodes, and organs. It helps to protect and maintain the fluid environment of the body by producing, filtering, and conveying lymph and by producing various immune blood cells.
The lymph system is present throughout the body. Common areas where enlarged lymph nodes can be felt (palpable nodes) include the groin area (inguinal region), armpit (axilla), the neck (there is a chain of lymph nodes on either side of the front of the neck, both sides of the neck, and down each side of the back of the neck), under the jaw and chin, behind the ears, and over the occiput (prominence on the back of the head).
Lymph nodes play an important part in the body’s defense against infection. Swelling might occur even if the infection is trivial or not apparent. Swelling of lymph nodes generally results from localized or systemic infection, abscess formation, or malignancy. Other causes of enlarged lymph nodes are extremely rare. By far, the most common cause of lymph node enlargement is infection. As a rule, when swelling appears suddenly and is painful, it is usually caused by injury or an infection. Enlargement that comes on gradually and painlessly may result from malignancy or tumor.
Lymphadenitis is an infection and inflammation of one or more of the lymph nodes. Lymphadenitis usually results from an infection that begins near a lymph node. Often caused by Staphylococcus aureus bacteria, this condition affects the nodes in the neck, groin, and armpit. It sometimes strikes individuals who have had coronary artery bypasses using a saphenous vein from the leg: The removal of this vein is accompanied by removal of related structures of the lymphatic system, lowering immunity to infection.
Acute lymphangitis is a bacterial infection in the lymphatic vessels which is characterized by painful, red streaks below the skin surface. This is a potentially serious infection which can rapidly spread to the bloodstream and be fatal.
Common causes of enlarged lymph nodes include:
Infectious mononucleosis (behind the ears or neck), rubella also known as German measles (behind the ears), tuberculosis (above the collar bone), mumps (salivary glands), ear infections or sore throat (neck glands, sometimes), infection in the scalp (behind the ears or in back of the head), impacted tooth (swollen gums), HIV disease or AIDS, cat-scratch fever, juvenile rheumatoid arthritis, serum sickness, leukemia, Hodgkin’s disease, non-Hodgkin’s lymphoma, canker sores, drugs (such as phenytoin), typhoid vaccination, and salivary duct stones. Any persistently swollen lymph gland requires careful diagnostic study.
Soreness in lymph glands usually disappears in a couple of days without treatment. Glands become painful due to the rapid swelling of the gland in the early stages of fighting the infection. It takes much longer for the gland to return to normal size than it did to enlarge.
Call your health care provider if:
- after several weeks of observation the glands don’t get smaller
- swollen glands are red and tender
- glands are hard, fixed to the skin, or are growing rapidly
- swollen glands are located behind the ear and there is also a scalp infection
- symptoms such as weight loss, night sweats, fatigue, or prolonged fever are also present
- one or more glands get larger over a period of 2-3 weeks
Generally, if you have symptoms of a cold or other minor infection, give the glands about 2 weeks to go back to normal. No specific treatment for them is needed. If the glands are small (less than 2 cm (3/4 inch), are in your groin or under the chin, and you are a young adult, this is considered normal. Children tend to have a more active lymphatic system, so their glands may feel enlarged.