Internal Medicine

Lymph node pain - how dangerous is it?

introduction

The human body has a total of around 600-800 lymph nodes. 300 of them are in the head and neck area alone. Pain from swollen lymph nodes can be very uncomfortable and bothersome. The causes of these complaints are diverse and can range from harmless infections to more severe illnesses to malignant diseases. In most cases, however, there is a harmless cause and the pain will soon go away on its own.

The main task of the lymph nodes is the immune defense. They serve as a kind of filter station for the circulating lymph fluid, which, in addition to waste materials and nutrients, washes pathogens into the lymph nodes. These are specifically fended off there. If the immune system is busy eliminating large amounts of pathogens, this is often noticed by swollen lymph nodes and fever.

Causes of aching lymph nodes

Lymph node pain is most commonly caused by infection with pathogens (viral or bacterial infections). The immune system is activated and the lymph nodes swell. Usually the lymph nodes are about 0.5-1.0 cm in size. In the activated form, they can also be larger than 2 cm. The swelling of the lymph nodes increases the tension in the tissue and in the lymph node itself. This can be painful, especially if pressure is applied to the lymph nodes.

Other diseases in which the lymph nodes can swell painfully include:

Abscesses (collections of pus)
Sarcoid (lung disease)
tuberculosis
syphilis
HIV
malaria
Leishmanios
rheumatic diseases (Rheumatoid arthritis).

Some autoimmune diseases can also cause the lymph nodes to swell, such as the systemic lupus erythematosus (SLE).

Last but not least, malignant diseases can also be the cause of the symptoms. Lymph nodes can be located in this way (Metastases) of tumors of other origin or even malignant degeneration themselves (malignant lymphoma, Hodgkin's disease).

Painful lymph nodes are almost always harmless. Usually there is a simple infection behind it. Only in rare cases are they the result of a malignant disease.

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Pain in the lymph node with a cold

As part of a cold, which is triggered, among other things, by an infection with adenoviruses or rhinoviruses, swollen and painful lymph nodes occur regularly. The swollen lymph nodes are often accompanied by symptoms that typically occur with colds: runny nose (Rhinitis), Sore throat (Pharyngitis) and general malaise.
The lymph nodes are significantly enlarged (sometimes up to several centimeters), can be moved and clearly delimited. Usually the lymph nodes are swollen on both sides. If the lymph node swelling persists for more than 2-3 weeks or is accompanied by a fever or weight loss, a doctor should be consulted. This palpates the superficial lymph nodes and asks questions about the occurrence of the symptoms in order to find a possible cause.

Read more on this topic at: Symptoms of a cold and Therapy for a cold

Lymph node pain when swallowing

Often, painful lymph nodes are also expressed as difficulty swallowing. The swallowing process also tensions the lymph nodes in the front of the neck, which leads to a feeling of pain. This pain can easily be confused with a sore throat associated with a cold, which is triggered by an attack by the pathogen on the oral mucosa.

In some cases, the swollen lymph nodes are the first symptom of an infection or a cold. The pain in this case indicates an inflammatory rather than a malignant process. Fever, headache and earache are often associated with this. Often reports of the pain radiating to the ear area.

If the pain in the neck area does not improve within a few days, if the swelling of the lymph nodes lasts for more than two to three weeks, or is accompanied by fever and weight loss, a doctor should always be consulted.

Read more on this topic at: Pain when swallowing

Lymph node pain after wisdom tooth surgery

During the wisdom tooth operation, the wisdom teeth are removed from the jawbone. Depending on the position and size of the essential teeth, a relatively large amount of the jawbone has to be removed, so that a large area is involved in wound healing with the participation of various tissues (bones, connective tissue, oral mucosa).

As a result, it is not uncommon for swollen and painful lymph nodes to appear as a result. The cervical lymph nodes, the lymph nodes below the jaw and those on the chin are particularly affected. Occasionally the collarbone lymph nodes can also cause pain. Sufficient cooling of the operated area is particularly helpful in relieving pain.

However, it should be noted that the lymph node swelling should subside within a few days after a wisdom tooth operation. Otherwise it could be an indication of a wound healing disorder. In this case, and especially if the wound does not close or pus appears, the attending dentist should be consulted.

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Lymph node pain after alcohol

Often there is pain in the lymph node area associated with alcohol consumption. The exact mechanism of how alcohol-related pain occurs has not yet been clarified. This so-called alcohol pain is a typical symptom of Hodgkin lymphoma. It usually occurs relatively quickly after drinking alcohol and then quickly subsides again. Sometimes it is accompanied by pain in the neck and shoulder area.
Hodgkin's lymphomas are malignant tumors of the lymphatic cells that spread along the lymphatic system in the body. As a result, several lymph nodes often merge. Some of the swollen lymph nodes are not painful and can be moved. In addition, other symptoms occur with Hodgkin's lymphoma: fever, night sweats and an inexplicable weight loss of more than 10% of body weight within six months. In addition, a general reduction in performance, swelling of the spleen and liver, and manifestations in the skin area are possible.
Read more about this under: Symptoms of lymphoma

In the event of any pain in the lymph node area of the neck / shoulder area associated with the consumption of alcohol, a doctor should be consulted for further examinations.

Other symptoms of pain in the lymph nodes

Painful lymph nodes are usually not only painful, but also enlarged. The pain usually occurs when pressure is applied to the lymph nodes. However, if the lymph nodes become very large in a short period of time, the pain can also arise from the abrupt compression of the adjacent tissue.

Most often, the painful and enlarged lymph nodes in the head and neck area can be felt, for example in the neck, behind / in front of the ears, under the earlobe, under the lower jaw or above the collarbone. In the armpit and in the groin, enlarged and painful lymph nodes can also be felt more frequently.

Read more on the topic: Swelling on the side of the neck

To distinguish between a benign and a malignant disease, some attributes of the affected lymph nodes can provide clues. A bilateral occurrence of the swollen lymph nodes, tenderness to pressure, good mobility and delimitation of the individual lymph nodes in the tissue, as well as a rather soft consistency speak for a benign cause of the symptoms ("resilient“).

In contrast to this, signs of a malignant disease can be lymph nodes that are only enlarged on one side, are firmly attached to their surroundings and cannot be moved, are of a coarse consistency and are very large. Rapid growth of the lymph node can also lead to reddening of the skin around the lymph node.

Occasionally, the lymph nodes can become calcified. Read also: Calcified lymph nodes - what's behind it?

Diagnosis of painful lymph nodes

A doctor can usually make the diagnosis of a swollen, painful lymph node very quickly. To do this, the body's lymph node stations are scanned. Swollen lymph nodes are easy to find.
If in doubt and for further clarification, an ultrasound of the lymph nodes can also help. With ultrasound, the exact size of the lymph node can be better determined and its shape and texture can be assessed.

If there are signs of a possible malignant disease of the lymph node, it can be taken as a tissue sample and pathologically examined.The pathologist can examine the lymph node tissue under a microscope and determine whether there are any malignant cells in the lymph node or whether it is just a benign lymph node swelling.

Therapy against painful lymph nodes

Lymph nodes that are swollen and painful due to a bacterial or viral disease do not require any explicit therapy. As a rule, the swelling disappears on its own as soon as the body has fought the infection and the symptoms subside. Sometimes the lymph nodes remain tender and enlarged over a long period of time, but the symptoms usually subside within a few weeks.

Frequent colds can lead to a permanent connective tissue remodeling of the lymph nodes, so that they can be felt somewhat enlarged over a long period of time. However, this is without disease value.

In principle, the treatment of painful lymph nodes depends on the underlying disease. The only situation in which the lymph nodes must be treated directly is when there is a malignant disease. Are the lymph nodes the site of tumor colonization (metastasis), they must be removed. The same also applies if the lymph node itself is the site of origin of the primary tumor. Usually chemotherapy and / or radiation are added to the surgical removal of the degenerated tissue.

If the lymph nodes are very painful during an infection or a malignant disease, painkillers can help make the symptoms more bearable.

Home remedies for painful lymph nodes

Lymph node pain, in most cases, is due to inflammation in the body. Different home remedies can be used depending on where this inflammation is.

Pain in the lymph nodes is particularly common in the context of colds and infections of the upper respiratory tract. The result is swollen and painful lymph nodes on the neck, under the chin and under the jaw. On the lymph nodes themselves, cooling applications are usually perceived as pleasant, so that ice packs or quark compresses are good home remedies.

However, critical voices claim that the cooling reduces the blood flow to the lymph nodes so that they cannot carry out their tasks. Therefore, it should not be chilled for too long at a time.

If you suffer from a sore throat due to the common cold, you will probably feel more comfortable with warm wraps on your neck. Adequate fluid intake is also essential for recovery, which is why cold teas (ginger, peppermint, herbal, chamomile, sage tea, etc.) are very important. A warm broth can also help relieve pain in the lymph nodes by treating the underlying disease symptomatically.

Homeopathy for lymph node pain

Many nutrients and medicinal plants can be used in homeopathy for pain in the lymph nodes (often associated with lymph node swelling). In the diet, attention should be paid to an adequate intake of spruce, sage, rosemary, garlic and clove.

Medicinal plants such as red clover, licorice root, olive leaves and cypress oil can be taken for pain in the lymph nodes.

Warm or cool painful lymph nodes?

The effects of cold and warmth on swollen and painful lymph nodes are controversial. The supply of cold weakens the immune system and the susceptibility to viruses and other pathogens is higher. At the same time, the blood flow to the cooled skin areas is reduced, which has a slightly numbing effect.
The supply of heat and the resulting increased blood flow can lead to faster and more effective removal of harmful germs. For this reason it is recommended to be swollen and keep painful lymph nodes warm if possible.

How long does lymph node pain last?

A distinction is made between acute (less than 4 weeks) and chronic (more than 4 weeks) pain in the lymph nodes.
The duration of the swollen, painful lymph nodes varies greatly depending on the cause or disease. With a classic cold there is usually a complete swelling of the lymph nodes within 5 to 10 days. In the case of other infections, the lymph nodes can be swollen for longer, which is why an appointment with a doctor can be arranged within the next few weeks.

In the case of chronically swollen and painful lymph nodes, a doctor should always be consulted.
Other risk factors that may require medical attention include:

particularly large lymph nodes (larger than 2 centimeters),
particularly rapid development of the swollen lymph nodes,
hard consistency,
lymph nodes that have grown together,
reddened and tight skin,
Fever,
Night sweats,
Weight loss.

A blood sample or a biopsy may be required to further clarify the cause of the painful lymph nodes.

Prophylaxis - Can you prevent painful lymph nodes?

There is no direct prophylaxis to prevent lymph node pain. One can rather speak of an indirect prophylaxis, since the diseases responsible for the lymph node swelling must be avoided. In order to prevent general infections, a healthy diet and lifestyle with sufficient fresh food (fruit, vegetables) and sufficient physical activity is recommended.

Lymph node pain by localization

Pain in the lymph node on the ear

In the area of the ear, a distinction is made between two lymph node stations, which are examined separately by the attending physician. Lymph nodes are found here (pre-auricular) and behind the ear (retroauricular). Swelling with pain in the lymph nodes is often accompanied by reddening and overheating in the area of the ears. Fever, tiredness and fatigue can also occur depending on the clinical picture.

Common causes of pain in the lymph nodes in front of the ear are infection with rubella virus, inflammation of the parotid gland and toxoplasmosis. Syphilis can also lead to swelling of the lymph nodes in front of the ear.

Common causes of pain in the lymph nodes behind the ear are corneal inflammation or conjunctivitis and an infection with chlamydia. In addition, the reactivation of herpes zoster viruses in the face can lead to swelling with pain in the lymph nodes behind the ear to lead.

Read more about this under: Lymph node swelling behind the ear - dangerous?

Pain in the lymph node on the neck

During a palpation examination of the lymph nodes, the doctor palpates the individual lymph node stations on the neck. It usually begins at the front in the chin area, continues along the lower jaw to the angle of the jaw and along the neck to the collarbones. He then examines the lymph nodes in the back and sides of the neck (including the neck) as well as the lymph nodes in front of and behind the ears.

Normally, the lymph nodes in the neck area, which are up to one centimeter in size, cannot be felt. In the course of various diseases, the lymph nodes may swell (up to two centimeters), which means that the doctor can feel them.

In the course of various diseases, the lymph nodes swell (Lymphadenopathy), which in some cases is accompanied by pain. Common causes of lymph node swelling are infections (bacterial and viral), tumor diseases (benign and malignant), and some autoimmune diseases.

In benign diseases (infections, benign tumors), the lymph nodes present themselves as swollen, painful, soft and easily movable and delimited. Usually the lymph nodes are swollen on both sides. Frequent causes of this type of lymph node swelling are inflammation in the area of the tonsils or teeth, Pfeiffer's glandular fever, borreliosis, tuberculosis, HIV and toxoplasmosis.

In malignant diseases (malignant tumors in the area of the lymphatic drainage area or the lymph node itself), the lymph nodes are usually swollen, not painful, coarse, irregular and difficult to move. Common head and neck tumors that cause lymph node swelling are squamous cell carcinoma and lymphoma. The swelling is due both to the presentation of the tumor particles in the lymph nodes and to the spread of individual tumors via the lymph.

Read more about this under: Lymph node swelling on the neck - dangerous?

Pain in the lymph node in the neck

The lymph nodes located there can also swell in the area of the neck. Often the swelling is discovered by accident while washing your hair or combing it. These lymph nodes filter the lymph from the back of the head.

In addition to colds and infections, minor lesions in this area can also lead to swelling with painful lymph nodes. The swelling of the lymph nodes stands for the fight against the pathogens in the affected lymph nodes and thus represents a sign of the body's own defense.

In rare cases, intolerance to hair products or jewelry can lead to swelling of the lymph nodes. Often the symptoms are accompanied by neck pain, neck stiffness and pain in the back of the head. In this case, too, we recommend that the patient see a doctor if the symptoms do not improve within 1-2 weeks.

Read on below: Lymph node swelling in the neck - dangerous?

Pain in the lymph node on the chest

Like all other lymph nodes in the body, the lymph nodes in the breast are usually not palpable. They filter the lymph that accumulates in the chest area and forward it to the collecting lymph nodes in the sternum, collarbone and armpits area.

A swelling of the lymph nodes supplying the breast is often a symptom of a tumor disease of the breast (at least in women). The lymph nodes are usually not painful, coarse, irregular and difficult to move.
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Another common cause of swelling of the lymph nodes in the breast area can be inflammation in the breast tissue area (e.g. mastitis). The lymph nodes are usually painful, easy to move and can be separated from one another.

In women, or men who shave their armpits, swollen lymph nodes are also more common. When shaving, there are always minor injuries to the skin. These injuries can cause bacteria to get under the skin. There is minor and harmless inflammation that can cause the lymph nodes to swell.

In the case of swelling of the lymph nodes in the breast area, a (gynecologist) should always be consulted to clarify the possible cause of this lymph node swelling.

Find out more about this topic at: Lymph node swelling in the armpit - dangerous?

Pain in the lymph node in the groin

Pain in the lymph nodes in the groin often occurs with discomfort in the abdomen or pelvis, but also with injuries to the legs and feet. In addition, small inflammations during intimate shaving can lead to painful swelling of the inguinal lymph nodes.

The body reacts to injury and inflammation by activating its immune system. This leads to an immune response, which is often associated with swollen lymph nodes. The swelling, in turn, can cause pain in the lymph node.

If the swelling in the groin area is unclear, an inguinal hernia should also be considered.

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