Enlarged lymph nodes: painful or painless and their causes?

Enlarged lymph nodes: painful or painless and their causes?
Photo source: Getty images

The lymphatic tissue has a defensive role. The first contact with the external environment includes the tonsils and the nasal tonsils. But the nodes in other regions are also important. What does their enlargement mean?

Enlarged lymph nodes have various causes, which may not immediately indicate a serious condition, but may indicate a possible health risk.

For this reason too, a specialist examination is advisable, especially when other symptoms are associated.

The lymph is found throughout the body. The lymph vessels and the lymph nodes belong to one system, which can also be affected by disease. It is not always a serious disease. But a definite answer to swollen lymph nodes is provided by a specialist examination.

Enlarged lymph nodes (lymphadenopathy) generally indicate the presence of some inflammatory disease, infection or a change in health in the body. Sometimes enlarged lymph nodes are also painful, usually to touch and feel.

Other times they are just enlarged and no pain is present. While painful nodes in most cases indicate an inflammatory or infectious disease, painless nodes can also indicate the presence of a tumor in that part of the body.

If the enlargement is accompanied by a painful symptom...

As far as symptoms are concerned, painless and enlarged lymph nodes are more dangerous. In most cases, the affected person doesn't even notice them. Because often their enlargement is very gradual and unnoticed.

Sometimes they are located in harder to reach places.

Often other symptoms are more likely to be present, indicating a problem in the body. Examples include fatigue, lack of appetite, weight loss and nausea, or symptoms associated with other organs.

In most cases, the symptom of painless but enlarged lymph nodes can indicate the development of a tumour that originates from the lymph nodes and is formed by cells of the lymphatic tissue.

These tumours then enlarge and start to press on the surrounding organs, which can cause further problems. They can be benign or malignant.

Sometimes, however, it may not be a situation where a tumour "arises". The cause of nodal enlargement may also be a reaction to an autoimmune disease.

For example, leukaemia is often manifested by enlarged nodes, but also oral cancer. If the nodule is enlarged, hard and painless, in most cases, however, it is a symptom of cancer.

On the other hand, a soft and painful swollen nodule usually signals a disease of an infectious nature. If it is an inflammation or infection located near the nodule.

Few diseases manifest with enlargement of all lymph nodes.

Nodules of the head and neck

1. nodes in front of the auricle
2. behind the ears
3. parotid, superficial and deep
4. occipital
5. submandibular
6. under the chin, several small nodes
7-9. lateral cervical, external cervical, superficial and deep
10. anterior cervical
11. nodes above the clavicle

Nodules of the head and neck
Nodules of the head and neck. Source: Getty Images


Lymphoma is an oncological disease of the lymphoid tissue. Its incidence in the world is quite common. More than one million people in the population suffer from this disease. It is a common disease in young age, as early as 15-30 years.

Swollen nodes can occur anywhere on the body. Neck, armpits, groin. It also manifests itself with weakness, sweating, fever, cough. Swelling of one limb or face can also be a warning sign.

It may be Hodgkin's lymphoma, otherwise known as malignant lymphogranuloma. This is further divided into types I, II, III and IV. The second type is non-Hodgkin's lymphoma.

Enlarged lymph nodes in the neck

Lymph nodes are connected to the lymphatic vessels. Their function is to filter and trap harmful substances that are found in the vessels.

It is in the lymph nodes that these substances are then destroyed by the cells of the immune system. This causes swelling and, in the case of infections, pain.

Painful nodal enlargement is more likely to be of infectious origin. Some groups of lymph nodes are characteristic of certain diseases. This is the case, for example, with enlarged nodes in the neck, where they indicate diseases in their surroundings.

These are, for example, inflammatory diseases of the oral cavity and upper respiratory tract, such as tonsillitis, nasopharyngitis, but also infectious mononucleosis, chronic fatigue syndrome, thyroid cancer or scarlet fever.

Most often, the lymph nodes under the jaw become enlarged, which may also respond to inflammatory diseases of the salivary glands. For example, the nodes at the back of the head respond by enlarging to otitis media, and the nodes between the ears and eyes to conjunctivitis.

Ultrasound examination can be used to determine the exact number of enlarged nodes in the neck (but also elsewhere, in the armpits or groin). In the case of painless enlarged nodes, the possibility of cancer must also be considered. However, the final diagnosis can only be made by surgical removal of the lymph node and histological examination.

Lumps and nodules above the clavicle

Lymph nodes can also be found above the collarbone. Their enlargement usually makes it possible to palpate them. If these lymph nodes are at rest, in most cases it is not possible to palpate them at all.

If they are enlarged, it is a painless enlargement. This in itself indicates a cancer. In this case, it is a cancer of the thyroid gland in particular and also of the breast. Both diseases are very dangerous and serious.

In addition to swollen lymph nodes,breast cancer is manifested by palpation of a lump in the breast. Sometimes scaling of the nipple and discharge from the nipple. Painfulness of the entire breast is common.

The lump, on the other hand, is painless, like the lymph nodes. Thyroid cancer is manifested by enlargement of the lymph nodes not only in the area above the collarbone, but also in the neck, as well as increased body temperature. In both diseases, early diagnosis is essential.

The axillary region

The lymph nodes are located in the armpit area, through which the lymphatic vessels from the arm, chest wall and mammary gland pass. An enlargement of these nodes usually indicates a disease or deterioration of health in these areas of the body.

lymph nodes of the chest
The catchment area of axillary and breast lymph nodes in women. Source: Getty Images

If these enlarged lymph nodes are painful, for example, it is an inflammatory disease.

Among infectious diseases, the nodes in the armpit are characterised by inflammation of the mammary gland, for example. This is also characterised by pain in the breast. Similarly in the case of infectious mononucleosis. When the cervical and inguinal nodes may swell.

In the case of painless nodes, it is a cancer. Very often, for example, a breast tumour manifests itself in this form.

Breast cancer is the most common cancer in women. It is characterised by a woman feeling a lump in her breast.

This lump is painless, like a nodule. But it may not always be present, although it is in 3/4 of cases.

Lymph nodes in the groin

Enlarged lymph nodes in the groin(groin) indicate a disease of an infectious or cancerous type in this area and the surrounding area. Lymphatic vessels from the external genital organs pass through the lymph nodes in this case.

If, for example, cancer or infection and inflammation affect them, the lymph nodes become enlarged. Depending on the characteristics and type of disease, they are either painful to the touch or painless.

Groin area and the presence of inguinal nodes. Source: Getty Images

Infectious mononucleosis is also manifested by enlargement and pain in the lymph nodes in the groin. It is a viral disease caused by the EB virus, which belongs to the herpes viruses and is transmitted through saliva.

Similarly, chlamydial infection is caused by sexual transmission of chlamydia. It is a sexually transmitted and infectious disease. Of course, these diseases have other symptoms, not just enlargement of the lymph nodes.

Lymph nodes in the chest and abdomen

Lymph nodes in the chest can cause breathing difficulties, chest pain or circulatory problems. An enlarged lymph node causes oppression of the structure in question (lungs, blood vessels).

Enlarged abdominal nodes can cause abdominal pain, indigestion, a feeling of fullness, as well as pain in the spine. Swollen nodes in the small pelvis can cause swelling of the lower limbs, pain in the kidneys or impaired kidney function.

In HIV, swollen nodes can also be one of the symptoms of the disease.

Whether the swelling of the nodes is generalized or just swollen in a specific part.

Streptococcal infections are another case. Cat-scratch disease or toxoplasmosis can also manifest as nodal involvement. Typhoid fever or measles are also examples of infectious diseases.

If the lymph nodes are swollen, a specialist examination should be sought.

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