Swollen lymph nodes or swollen lymph nodes are an annoying complaint. You can suffer from swollen lymph nodes, especially in the neck, armpits and groin. The largest concentration of lymph nodes are located in the neck, armpits and groin. Every palpable or palpable lymph node is already referred to as an enlarged or swollen gland. In most cases, the cause of a swollen lymph node is relatively harmless. In children, for example, a lymph node swelling in the neck is in the vast majority of cases a response to (recurring) upper respiratory infections, such as a cold or flu. Sometimes the glands will also become infected. Lymph node swelling is a normal response to infection and the swelling subsides once the infection has been suppressed by the body’s immune system. A swollen lymph node in the neck usually does not cause any harm. The treatment for swollen lymph nodes depends on the underlying cause.
- Swollen lymph nodes
- Lymph nodes or lymph nodes
- Local lymph node swelling
- Generalized lymph node swelling
- Glands in neck, neck, groin and armpit
- Causes of enlarged lymph nodes
- Swollen lymph nodes due to infections
- Upper respiratory tract infection
- Pfeiffer’s disease
- Cold sores
- Breast infection
- Testicular inflammation and epididymitis
- Skin infection
- Tropical infectious diseases
- Other infections
- Chronically swollen lymph nodes
- Swollen glands due to systemic diseases
- Systemic lupus erythematosus (SLE)
- Lyme disease
- Rheumatoid arthritis
- Acne fulminans
- Swollen lymph nodes due to stress and anxiety
- Possible mild infection
- Muscle tension
- Other causes
- Swollen lymph nodes due to cancer
- Lymph node swelling due to medications
- Swollen glands due to wounds and ulcers
- Often innocent cause
- When to seek medical attention?
- Examination and diagnosis
- Treatment of swollen lymph nodes
- Causal treatment
- Can you exercise with swollen lymph nodes?
- Exercise is good for your lymphatic system
- Are swollen lymph nodes dangerous?
Lymph nodes / Source: National Cancer Institute, Wikimedia Commons (Public domain)
Swollen lymph nodes
Lymph nodes or lymph nodes
Lymph nodes or lymph nodes are found throughout the body; a human has a total of about 400 to 600 lymph nodes. Lymph nodes are an important part of the immune system and are located in very strategic locations in the body, including in the armpits, in the neck, under the jaw and in the groin area. The lymph nodes contain accumulations of lymphocytes, which are responsible for the production of antibodies (antibodies). Lymph nodes also have the task of filtering foreign substances, bacteria, viruses or toxins from the body and destroying them. Most lymph nodes lie under the skin and cannot normally be felt. Every palpable or palpable lymph node is said to be enlarged. A number of lymph nodes are located in places that are inaccessible for physical examination.
Local lymph node swelling
If there is an infection somewhere in the body, the nearest lymph node will often become swollen. When people notice an (unexplained) enlarged lymph node, they often suspect lymphatic cancer or metastases from other cancer. This can lead to (great) anxiety. Yet it is rare that an enlarged lymph node is the result of cancer. Swollen lymph nodes are almost always a response to an infection. Enlarged cervical lymph nodes often occur in children and are in most cases a response to (recurrent) upper respiratory infections.
Generalized lymph node swelling
One in four people with lymph node swelling have multiple places in the body affected by swollen lymph nodes (generalized lymphadenopathy).
Lymphatic system woman / Source: The Emirr, Wikimedia Commons (CC BY-3.0)
Glands in neck, neck, groin and armpit
The largest concentration of lymph nodes are located in the neck, armpits and groin. Lymph nodes are also found in the area of the sternum, the abdomen, between the ribs, the back of the knees, the crease of the elbow, around the ankles and under the edge of the occipital bone.
When the immune system is needed to fight a bacterial or viral pathogen, the lymph nodes swell. This swelling is often noticed on the side of the neck, for example with a cold. The lymph nodes may then be larger than two centimeters. In healthy people they are normally not palpable. It is common for lymph nodes to remain swollen even after an illness such as a cold or inflammation of the tonsils has resolved. This can last for several days. If the symptoms persist and do not disappear, it is wise to contact your doctor.
Causes of enlarged lymph nodes
Several mechanisms can cause the lymph nodes to enlarge:
- Systemic diseases;
- Malignancy (cancer);
- Medicines; and
- Wounds and sores.
Swollen lymph nodes due to infections
Infections (viral, parasitic and bacterial): swelling of the lymph node is a normal response to an infection. Lymph nodes enlarge in response to an infection in their drainage area. The white blood cells or lymphocytes in the lymph nodes then multiply very quickly, causing the lymph nodes to swell. Swollen lymph nodes often occur in the neck, especially in children. In that case you will feel the enlarged lymph node in the front of the neck and/or in the neck or behind an ear. You feel them on one side or on both sides of the neck. You can feel one gland, but sometimes several. Neck glands can quickly increase in size, but they often shrink quickly once the inflammation is over. However, sometimes it takes a little longer for the lymph nodes to shrink.
Upper respiratory tract infection
In upper respiratory infections, the nose and sinuses (sinusitis), throat (strep throat), tonsils (tonsillitis) or larynx (larynxitis) are infected. The most common cause of lymph node swelling in the neck is upper respiratory infections, such as a cold or flu.
Mononucleosis can cause painful and swollen lymph nodes, especially in the neck, but sometimes also in the armpits and groin. Other possible complaints include sore throat, fever and fatigue. Glandular fever goes away on its own, usually within a few weeks. Sometimes complaints such as fatigue last longer.
In the case of a bladder infection or urinary tract infection, the lymph nodes in the groin can swell. If you develop a bladder infection during pregnancy, it is wise to consult your doctor immediately.
Swollen lymph nodes in the neck due to a cold sore / Source: Public domain, Wikimedia Commons (PD)
With a cold sore you sometimes also suffer from swollen lymph nodes in the neck. The neck glands can also hurt.
A breast infection is an inflammation of a mammary gland in the breast and mainly occurs in women who are breastfeeding. It can cause swollen lymph nodes in the neck or armpits.
Testicular inflammation and epididymitis
Typical of testicular inflammation is the fairly acute onset of scrotal pain and swelling of the scrotum or scrotum, whereby the pain can radiate to the groin. This is accompanied by complaints consistent with a lower urinary tract infection and possibly fever. Swollen lymph nodes on one or both sides also occur. This also applies to epididymitis.
or a (skin) infection in the feet, legs or genitals, the lymph nodes in the groin can swell. In the case of a skin infection on the hands or arms, the lymph nodes in the armpit can become swollen. The swelling of the lymph nodes disappears once the pathogens are eliminated by the body. When viruses, bacteria or other pathogens are involved, the nearby lymph nodes do everything they can to destroy them. The following skin infections can cause lymph node swelling:
- erysipelas (a bacterial infection of the dermis and underlying tissue)
- cellulitis (a bacterial infection of the subcutaneous connective tissue)
- inflamed finger
Impetigo on elbow / Source: Evanherk, Wikimedia Commons (CC BY-SA-3.0)
- hidradenitis suppurativa
- impetigo or impetigo
- staphylococcal infections
- eczema herpeticum (a complication of atopic eczema, in which the skin becomes infected by the herpes simplex virus)
- Gianotti-Crosti syndrome (a skin condition characterized by the development of red bumps on the face, arms and legs, and buttocks)
- aquarium granuloma (a skin disorder caused by the bacterium Mycobacterium marinum)
Tropical infectious diseases
Swollen lymph nodes can also be caused by tropical infectious diseases:
- West Nile virus
- sleeping sickness
- Chagas disease
- tuberculosis (TB)
Other infectious diseases that can cause swollen lymph nodes include:
- adenovirus infection (common, especially in children)
- aphthous stomatitis (a condition characterized by sores on the tongue and lining of the mouth)
- cytomegalovirus (CMV)
- hepatitis B and hepatitis C
- meningitis (meningitis, with headache, fever and stiff neck)
- measles (viral infectious disease that mainly affects children)
- ear infections
Mastoiditis with subperiosteal abscess / Source: B. Welleschik, Wikimedia Commons (CC BY-SA-3.0)
- ear canal inflammation or swimmer’s ear
- mastoiditis (a bacterial infection in the mastoid process, the protruding bone behind the ear)
- sexually transmitted infections (STDs), such as:
- aggressive chlamydia, or lymphogranuloma venereum (LGV)
- genital herpes
- bacterial dental infections (such as periodontal disease)
- jaw abscess
- lacrimal gland inflammation
- Q fever fatigue syndrome (QVS)
- scalp fungus or tinea capitis
- stomach flu
Chronically swollen lymph nodes
In the case of a chronically swollen gland in a non-sick child, the cause may be an infection with an atypical mycobacterium.
Lymphadenopathy or swollen lymph nodes (in the neck) / Source: James Heilman, MD, Wikimedia Commons (CC BY-SA-3.0)
Swollen glands due to systemic diseases
Systemic diseases such as systemic lupus erythematosus, Lyme disease, sarcoidosis, rheumatoid arthritis and fibromyalgia, can also be the cause of swollen lymph nodes.
Systemic lupus erythematosus (SLE)
Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect the skin, joints and internal organs. The symptoms and severity vary from person to person. Common complaints include fatigue, weight loss and moderate fever. You often also develop muscle and joint complaints. A red rash on the hands and nose is also common. Kidney inflammation is relatively common and mental health problems such as depression and anxiety are also common complaints. Some lymph nodes may also swell.
Lyme disease is caused by the Borrelia bacteria that is transmitted by ticks. Lyme has many manifestations. You may experience flu-like symptoms such as fever and swollen lymph nodes, pain in the muscles and joints, and often a severe headache.
Sarcoidosis is a rare autoimmune disease in which spontaneous inflammation occurs in various organs and tissues of the body. The condition preferentially affects the lungs and lymph nodes in the chest area (pulmonary sarcoidosis).
Rheumatoid arthritis is an autoimmune disease in which the immune system turns against the body. It is characterized by inflammation in the joints, which causes pain and stiffness of the joints.
Fibromyalgia is common and is a form of soft tissue rheumatism that causes pain, stiffness and fatigue. It is also possible that you will experience tender or swollen lymph nodes, especially in the neck and armpits.
Acne fulminans is a very severe form of acne, an acute worsening of existing acne that is accompanied by a general feeling of illness (fever, malaise, swollen lymph nodes).
Swollen lymph nodes due to stress / Source: Istock.com/BartekSzewczyk
Swollen lymph nodes due to stress and anxiety
Anxiety can cause many extremely unusual symptoms. In rare cases, anxiety and stress can even cause a feeling of swollen lymph nodes, and for people with anxiety disorders, this feeling can be incredibly frightening. Interestingly, it is unclear whether anxiety and stress actually cause swollen lymph nodes. What is clear is that anxiety makes people feel like they have swollen lymph nodes, and this can lead to increased anxiety about your overall health. There are several possible causes of swollen lymph nodes due to anxiety or stress:
Your lymph nodes often vary in size and shape. When you feel anxious, it is not uncommon for your lymph nodes to feel larger than they actually are. That’s because some forms of anxiety can cause a feeling of hypersensitivity and when you touch your lymph nodes, you have the subjective feeling that they are larger than normal.
Possible mild infection
Stress weakens your immune system. Your body is constantly fighting against germs and bacteria. It’s possible that stress makes you more susceptible to very mild infections that your body then has to fight. These infections may not be dangerous or have other symptoms.
Anxiety and stress also cause a significant amount of muscle tension in your neck and shoulder. Many people feel that they have a lump in their throat, while others feel the pressure more on the sides of their neck towards the lymph nodes. A common anxiety symptom is neck tension that you feel when swallowing, so it’s possible that your glands may only feel swollen while the neck is tense and swollen.
Your lymph nodes may be swelling for reasons that are still unclear. Anxiety causes many strange sensations in the body and many people experience anxiety in a different way. While the neck is the most common place to find swollen lymph nodes, they can also occur in other areas, such as the armpits, abdominal cavity and groin.
Swollen lymph nodes due to cancer
Malignancy (cancer): Hodgkin’s lymphoma, non-Hodgkin’s lymphoma, lymphocytic leukemia or metastases (spreads) from a primary tumor. For example, breast cancer usually spreads first to the lymph nodes in the armpit and melanoma on a leg first spreads to the lymph nodes in the groin.
Swollen lymph nodes due to medications / Source: Stevepb, Pixabay
Lymph node swelling due to medications
- Phenytoin: regulates the heart rate and has various disturbances in the heart rhythm. Prescribed for epilepsy and cardiac arrhythmias).
- Carbamazepine can: used to prevent manic episodes.
- Allopurinol: a xanthine oxidase inhibitor and by inhibiting xanthine oxidase, the formation of uric acid is inhibited. It is used for conditions caused by too much uric acid, including gout and kidney stones.
- Pandemrix: pandemic influenza vaccine Mexican flu.
- Medication for the treatment of malaria.
Swollen glands due to wounds and ulcers
Cuts, bruises, fractures, but also mouth ulcers can lead to swollen lymph nodes around the site of the injury. In this way, the body repels germs, causing the wound to heal faster.
Consult your doctor if you have swollen lymph nodes / Source: Michaeljung/Shutterstock.com
Often innocent cause
It is important to know that in the majority of cases there is a relatively harmless explanation for swollen lymph nodes. It may involve one enlarged gland or multiple enlarged glands. If multiple glands are enlarged, there is a greater risk of a systemic condition. This may be accompanied by general symptoms, such as fever, general malaise and night sweats.
When to seek medical attention?
In the vast majority of cases, there is an innocent explanation for a swollen lymph node. Always contact your doctor in the following cases:
- If the swelling lasts longer than two weeks or if the swelling is accompanied by symptoms such as weight loss, night sweats, fatigue or persistent fever.
- If the enlarged lymph node is very firm (this may indicate metastasis, sometimes in Hodgkin’s, and TB) or rubbery (can be seen in lymphoma and chronic leukemia). If the gland is soft or loose in consistency, the cause is usually harmless.
- When not one, but several lymph nodes in the body are swollen.
- In case of an abscessed lymph node swelling (i.e. a lymph node swelling with abscess formation).
GP examines child / Source: Istock.com/michaeljung
Examination and diagnosis
In case of swollen lymph nodes, the GP will take a history and perform a physical examination to arrive at a proper diagnosis. Sometimes the examination shows that it is not an enlarged lymph node, but a different type of swelling. Additional research may be performed, such as imaging research (for example an X-ray) or a cytological puncture. An injection is made into the swelling and cells are sucked into a needle. These cells are then examined by the pathologist to determine the nature of the swelling.
Treatment of swollen lymph nodes
The treatment for swollen lymph nodes depends on the cause:
- Antibiotics may be prescribed for an infection caused by bacteria.
- Medications that help with inflammation (for lupus and rheumatoid arthritis).
- Surgery, radiation or chemotherapy (in case of cancer).
- Paracetamol or ibuprofen can be taken against the pain.
In the case of an abscess, wait until it has matured. The surgeon will then make an incision in the abscess under local or general anesthesia so that the pus can come out.
Can you exercise with swollen lymph nodes?
Sports activities and other physical exertions should be avoided with swollen lymph nodes. Apparently your immune system is currently defending against pathogens. Additional (sports) challenges and efforts would unnecessarily weaken the body in such a situation.
Exercise is good for blood circulation, breathing, muscles, joints, bones, intestines and lymphatic system / Source: Goodluz/Shutterstock.com
Exercise is good for your lymphatic system
Exercise is good for blood circulation, breathing, muscles, joints, bones, intestines and lymphatic system. The lymphatic system is stimulated when you move your muscles and increase your heart rate. This stimulates lymph flow in the large lymphatic vessels, which facilitates drainage from the smaller vessels. The contraction of your muscles becomes the pump that helps move fluid through your body. Exercise and sporting activities can help the lymphatic system flow more effectively and possibly help prevent infections and other diseases, such as cancer.
Are swollen lymph nodes dangerous?
Usually, swelling of the lymph nodes indicates an increased defense against infection during a cold or flu. The enlargement of the nodes is then harmless. The symptoms may also indicate a serious illness. For example, it happens that lymph nodes swell even if more lymphocytes (white blood cells) are produced than necessary or if they are no longer sufficiently broken down in the lymphatic system. Then so-called lymphomas (malignant) can develop. If there is no apparent reason for the swelling of the lymph nodes or if the symptoms persist for a long time, you should consult your doctor.
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