Discovering a lump on the back of the neck can be concerning. Many neck lumps are benign and result from common conditions. This article provides an overview of common causes and guidance regarding neck lumps.
Understanding Potential Causes
One frequent reason for a lump on the back of the neck involves swollen lymph nodes, a condition known as lymphadenopathy. These small, bean-shaped glands are part of the immune system, filtering substances and housing immune cells. They often enlarge in response to infections such as common colds, the flu, ear infections, or minor skin infections on the scalp or neck.
Cysts are sac-like pockets of tissue. Epidermoid cysts, often called sebaceous cysts, are benign, slow-growing bumps under the skin. They form when skin cells move deeper into the skin and multiply, creating a sac filled with keratin, a soft, cheese-like protein. These cysts typically feel soft or firm and are movable.
Lipomas are common benign growths: soft, fatty lumps just beneath the skin. They consist of mature fat cells encased in a thin fibrous capsule. Lipomas are usually painless, feel rubbery, and are easily movable under the skin. They grow slowly and are not cancerous.
Tight bands within muscles, often referred to as muscle knots or myofascial trigger points, can also present as firm lumps. These knots commonly form in the neck and shoulder muscles due to muscle tension, injury, or poor posture. They can be tender to the touch and may cause localized pain or discomfort, sometimes extending to other areas.
Skin conditions and infections can also cause lumps. Folliculitis, an inflammation of hair follicles, causes small, red, tender bumps resembling pimples. Boils and abscesses are deeper skin infections from bacteria entering the skin, leading to painful, pus-filled lumps that are often red and warm.
Less common benign growths can also develop. Fibromas are firm, benign fibrous tumors. Neurofibromas, tumors of nerve tissue, can also appear as lumps under the skin, though less frequent. In rare cases, infections like tuberculosis or cat scratch disease could lead to persistent swollen lymph nodes.
When to Seek Medical Attention
While many neck lumps are benign, certain characteristics or symptoms warrant medical evaluation. Seek professional advice if a lump is growing rapidly or changing. Any lump that becomes painful, tender, red, or warm to the touch should also be examined.
Consult a doctor if the lump feels hard, fixed, or immovable. Systemic symptoms like unexplained fever, persistent chills, significant weight loss, or night sweats also warrant attention. Difficulties with swallowing, breathing, or speaking alongside a neck lump are serious indicators.
If a lump persists for more than a few weeks, seek a medical opinion. Any new lump, particularly in an adult, should be evaluated by a doctor to determine its nature.
What to Expect at the Doctor
When you visit a doctor for a lump, the initial assessment will typically involve a detailed medical history. The doctor will ask about when you first noticed the lump, how long it has been present, and if you have experienced any associated symptoms like pain, fever, or changes in your overall health. They will also inquire about your past medical conditions and any recent infections.
Following the history, a physical examination will be performed. The doctor will carefully feel the lump, assessing its size, consistency, mobility, and tenderness. They will also examine the surrounding area and may check other lymph node regions in your neck, armpits, and groin to detect any widespread swelling. This hands-on examination provides important clues about the lump’s nature.
Depending on the initial findings, the doctor may recommend various diagnostic tests. Blood tests might be ordered to check for signs of infection, inflammation, or other systemic conditions. Imaging scans, such as an ultrasound, CT scan, or MRI, can provide a clearer picture of the lump’s internal structure, its depth, and its relationship to surrounding tissues. These scans help determine if the lump is solid, fluid-filled, or composed of fat.
In some cases, a biopsy may be necessary to obtain a definitive diagnosis. This procedure involves taking a small tissue sample from the lump for microscopic examination. A fine needle aspiration (FNA) uses a thin needle to extract cells, while an excisional biopsy involves surgically removing the entire lump or a portion of it. The choice of biopsy depends on the suspected nature of the lump and the information needed. Treatment for a neck lump will vary significantly based on the diagnosis, ranging from observation for benign conditions to antibiotics for infections or surgical removal for cysts, lipomas, or suspicious masses.