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What Are Your Lymph Nodes Trying to Tell You?

Your lymph nodes can provide valuable clues about your overall health

By Lisa Mulcahy

You touch your neck and feel a little lump. You have a swollen lymph node, but should you worry? Many times, no, but it's essential to understand what different presentations of this condition can mean.

The location of your swollen node can be a significant clue, for starters. Is there a bump under your chin? You might have a dental abscess about to erupt painfully. Is your lymph node a little bigger than a pea or close to a grape? Different conditions can cause different proportions of swelling.

A doctor examining a patient's lymph nodes. Next Avenue
Your lymph nodes, also called lymph glands, act as filters to trap viruses and bacteria before they can spread throughout your body  |  Credit: Getty

Does your swollen node feel rubbery or hard and fixed? Rarely severe health conditions, like cancer, can present this way. According to Cancer Centers of America data, the good news is that only about 1.1% of patients who see their physicians about a swollen lymph node have a malignancy.

First, What Are Lymph Nodes?

Lymph nodes are part of your body's lymphatic system, a crucial part of your immune system. According to the Mayo Clinic, your lymph nodes, also called lymph glands, act as filters to trap viruses and bacteria before they can spread throughout your body. They do this by draining fluid, which can prevent infection.

Lymph nodes are located in clusters in different parts of your body. Nodes under your neck, chin, armpits and groin are most likely to swell noticeably.

"A lymph node is like a traffic checkpoint, where the immune system 'police' are routinely checking for bad actors," says Arif Kamal MD, chief patient officer of the American Cancer Society. 

Lymph nodes are part of your body's lymphatic system, a crucial part of your immune system.

"If something abnormal is detected, the immune system calls in 'back up', and the checkpoint enlarges with more immune cells. In the case of an infection, lymph nodes swell because a bacteria or virus is caught at the checkpoint," Kamal explains.

Lymph nodes are pretty small, and you often can't even feel them at their normal size. "Lymph nodes vary in size between a few millimeters to 2 centimeters," says Wais Rahmati, MD, an otolaryngologist-head and neck surgeon, ENT at Massachusetts Eye and Ear in Boston, and a faculty member at Harvard Medical School. 

"Technically, a lymph node that measures more than 1 centimeter along its shortest dimension is considered abnormally enlarged," Rahmati explains.

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When Is A Swollen Lymph Node Cause For Concern?

According to Cleveland Clinic, an upper respiratory infection is the most common reason for lymph node enlargement. However, when there's sudden swelling, chances are the cause is not overly worrisome. 

"Lymph nodes can become swollen suddenly in the setting of infection," says Rahmati. "A single lymph node may be involved, or multiple lymph nodes may be involved." You may notice discomfort with a lymph node that swells out of the blue. 

"We generally think about lymph nodes being of more concern if they are non-painful, greater than the size of a pea, and persist for longer than two weeks."

Again, this may seem scary, but it points more toward an infection than a severe disease. "Lymph node swelling that occurs suddenly also tends to be associated with pain or tenderness in addition to warmth, skin redness, and a fever," Rahmati adds. "These nodes tend to have a soft, fluid-like consistency."

It's also not unusual for lymph nodes to stay briefly swollen after you've been sick. "For example, we might expect lymph nodes in the neck to be enlarged after a recent sore throat," says Kamal. "It's more concerning if a patient doesn't have or hasn't had a local infection."

According to Kamal, "We generally think about lymph nodes being of more concern if they are non-painful, greater than the size of a pea, and persist for longer than two weeks."

The texture of a swollen lymph node is also important to note. "Lymph nodes which are large in size, not tender, firm, or fixed (not movable) would raise concern for potential involvement with cancer," explains Rahmati. On the other hand, if you touch a lymph node and it does feel hard, and you can't push it around, you don't want to ignore it.

If cancer is the cause of a swollen lymph node, it can happen in one of two ways. "Cancer can develop primarily within a lymph node or can spread to lymph nodes from a distant site," explains Rahmati. 

"For instance, cancer involving the left side of the throat is likely to spread to one or more lymph nodes on the left side of the neck." Lymphoma, a type of cancer that starts in the lymph system such as Hodgkin's or non-Hodgkin's, often causes lymph nodes to swell over time.

When Should To See Your Doctor About A Swollen Lymph Node?

First, evaluate how you're feeling and how long the swollen node has been present. 

Changes in the node and your health that appear to be worsening are essential to check out.

"Generally speaking, if you feel well overall, and you don't have significant symptoms like unintended weight loss, night sweats, or drenching fevers, then observing the lymph node for two weeks before talking to your doctor is acceptable," says Kamal. 

Additional symptoms can be ongoing fatigue, cough, shortness of breath, loss of appetite, itchy skin after showering or taking a bath or drinking alcohol, swelling or a feeling of fullness in your stomach, or pain in your lymph nodes after drinking alcohol.

If specific characteristics of swollen lymph are present and persistent, you want to see your doctor immediately. In addition, symptoms or changes in the node and your health that appear to be worsening are essential to check out. 

"Progressive swelling (of the node), worsening pain, redness, fever, difficulty breathing or swallowing require evaluation," says Rahmati. "An enlarged lymph node that has been present more than four weeks, with or without other symptoms, should also be evaluated."

The bottom line: swollen lymph nodes most often will go back to normal once an infection resolves. However, it's key to listen to your body. Pay close attention if things don't feel right, and be proactive – it's always the best way to handle your health.

Lisa Mulcahy is an internationally established health writer whose credits include Oprah Daily, Good Housekeeping, Prevention, Elle, Cosmopolitan, WebMD, Glamour, Men's Health, Marie Claire, The Los Angeles Times, Harper's Bazaar, Woman's Day, Health, Family Circle, Self, Redbook, Parade and Seventeen.  She is the author of eight best-selling books, including the Amazon #1 new release, The Essentials of Theater. Read More
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