Swollen Lymph Nodes: When to Worry and When to Wait

Swollen lymph nodes are usually a sign that your body is fighting an infection, most often a cold, a sore throat or a skin infection nearby. They are tender, movable and go down within two to three weeks. Worry, and get examined in person, when a node is hard, fixed, painless, larger than about 2 cm, lasts more than four weeks, or comes with night sweats or weight loss.

What are lymph nodes and why do they swell?

Lymph nodes are small bean-shaped filters spread along the lymph vessels. They are full of white blood cells. When germs from a nearby infection reach a node, the cells multiply to fight them and the node grows and becomes tender. That is a healthy response. Most people notice them in the neck, under the jaw, in the armpit and in the groin, because those nodes are close to the skin. Once the infection clears, the node shrinks back over a few weeks.

Swollen glands in the neck

The neck is where most people feel them. Common causes are a cold, flu, tonsillitis or pharyngitis, an ear infection, a dental abscess, or glandular fever (mononucleosis) in teenagers and young adults. Nodes on both sides, tender, with a sore throat or runny nose, point to a simple infection. Our sore throat and tonsillitis page explains when a throat infection needs treatment. A single hard, painless node, or a node above the collarbone, is a different matter and needs an in-person exam.

Swollen lymph nodes in the armpit

Armpit nodes drain the arm, the chest wall and the breast. They swell with cuts, insect bites or infected skin on the arm or hand, after a vaccination in that arm (this is expected and settles in a few weeks), and with shingles on the chest. A painless armpit lump in a woman, or any armpit node with a change in the breast, should be examined without delay.

Swollen lymph nodes in the groin

Groin nodes drain the legs, feet, lower belly and genitals. Athlete's foot, an infected toenail, a leg wound or a sexually transmitted infection are the usual causes. Many people have small, soft groin nodes they can always feel; that is normal. A new, painful groin node with a sore or a discharge needs a sexual health check.

Other causes besides infection

• Whole-body viral infections such as glandular fever, HIV, cytomegalovirus or rubella, which swell nodes in several areas.
• Immune conditions such as lupus or rheumatoid arthritis.
• Some medicines, including certain epilepsy drugs and allopurinol.
• Cancers of the lymph system (lymphoma, leukaemia) or a cancer that has spread to a node. These are a minority of cases, but they are why persistent or unusual nodes are always examined.

How long should swollen lymph nodes last?

With a simple infection the node is at its biggest while you are ill and shrinks over the next two to three weeks. It may stay slightly enlarged and painless for a while afterwards, especially in children. A node that is still growing after two weeks, or has not gone down after four weeks, should be checked, even if you feel well.

Swollen lymph nodes: when to worry

• Hard or rubbery, rather than soft.
• Fixed: it does not move under your finger.
• Painless and still growing.
• Larger than about 2 cm, or any size above the collarbone.
• Lasting more than four weeks, or more than two weeks without an obvious infection.
• Nodes in several areas at the same time.
• With fever that lasts, drenching night sweats, unexplained weight loss, lasting tiredness or itching.
• With easy bruising or bleeding, or you look pale.

None of these mean cancer on their own. They mean a doctor should feel the node and decide whether a blood test, an ultrasound or a biopsy is needed.

Swollen glands in children

Children get swollen neck glands with almost every cold, and small nodes are often felt for months afterwards. See a doctor if a node is larger than about 2 cm, red and very painful (a possible abscess), still growing after two weeks, or if the child has fever that does not settle, is losing weight or seems unwell.

What will the doctor do?

The doctor asks how long the node has been there, what else you have noticed, and about travel, pets, sexual contacts and medicines. Then they feel the node: size, texture, tenderness and whether it moves. They check your throat, ears, skin and the other node areas. Depending on what they find, next steps may be a blood test (full blood count, inflammatory markers, a glandular fever test), an ultrasound, or a referral for a biopsy. Our guide to high lymphocytes explains one of the results that often comes with swollen glands.

Can an online doctor help with swollen lymph nodes?

A video visit can help you decide what is going on: a tender node with a sore throat during a cold is usually managed at home, and a doctor can advise and, if needed, treat the throat infection. But a lump needs hands. If any red flag above applies, the doctor will direct you to an in-person examination, which is the right next step rather than a limitation. Our guide on when to go to the ER versus an online doctor in Spain explains how to choose.

When to call 112

• Difficulty breathing or swallowing, drooling, or a muffled voice with a swollen neck.
• A stiff neck with fever and a severe headache.
• A rash that does not fade when you press a glass against it.
• A node that is rapidly swelling, hot and red, with high fever and feeling very unwell.

Getting a medical assessment

If you are not sure what a swollen gland means, you can book a video consultation with Dr. Pedro Yelamo Vera, a physician registered in Spain. You can also read more about sore throat and tonsillitis. A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.

Frequently asked questions

Sources

• NHS: Swollen glands
• MedlinePlus: Swollen lymph nodes
• Mayo Clinic: Swollen lymph nodes
• MSD Manual (consumer): Swollen lymph nodes

This guide is general information. It does not replace the advice of your doctor or the laboratory report you were given.