When you feel a painful sensation in your neck while swallowing, it is often described as having “sore glands.” This experience signals that your body’s defense system is actively working to fight off an invader. The discomfort felt when swallowing is usually a result of inflammation and swelling in the tissues of the throat and neck. This symptom indicates that the immune system is mounting a localized response to a threat.
What Are the “Glands” That Hurt?
The “glands” people feel when they press on their neck are most often the lymph nodes, specifically the cervical lymph nodes. These small, bean-shaped structures are a concentrated part of the lymphatic system, a network that helps manage fluid levels and protect the body from illness. They are strategically located throughout the neck, including under the jawline and along the sides of the throat.
The primary function of lymph nodes is to filter lymph fluid, trapping pathogens like bacteria and viruses before they can spread to other areas of the body. When an infection occurs nearby, such as in the throat, these nodes begin to accumulate a large number of immune cells, causing them to swell and become tender to the touch. This swelling, known as lymphadenopathy, is the most common source of the pain perceived as “glands hurting” during swallowing.
Other structures in the area can also contribute to the pain, including the tonsils and the salivary glands. Tonsils are large masses of lymphoid tissue at the back of the throat that often swell and become inflamed during an infection, a condition called tonsillitis. The salivary glands, which produce saliva to aid in swallowing and digestion, can also become swollen due to viral infections like mumps or a blockage, leading to pain around the jaw and neck.
Infections That Cause Swollen Lymph Nodes
The most frequent reason for swollen, painful lymph nodes and difficulty swallowing is an infection, which can be broadly categorized as either viral or bacterial. Viral infections are the most common culprits, often affecting the upper respiratory system. The common cold and influenza virus cause throat irritation and are frequently accompanied by swollen neck nodes as the body fights the virus.
Mononucleosis, often caused by the Epstein-Barr virus, is another viral infection known to cause pronounced lymph node swelling. The nodes, particularly in the back of the neck, can become significantly enlarged and remain swollen for weeks, even after other symptoms have improved. Unlike the common cold, mono often presents with severe fatigue and may cause a fever that lasts for several days.
Bacterial infections, while less common than viral ones, are often more severe and require medical treatment. The most well-known bacterial cause of throat pain and swollen nodes is Streptococcus pyogenes, which leads to strep throat. Unlike many viral illnesses, strep throat typically does not involve cold symptoms like a cough or runny nose, but instead presents with a sudden onset of throat pain, fever, and sometimes white patches on the tonsils.
Tonsillitis, which is inflammation of the tonsils, can be caused by either a virus or bacteria, and it frequently leads to tender, enlarged lymph nodes in the neck. Bacterial tonsillitis often requires antibiotics to prevent complications like rheumatic fever, while viral tonsillitis is managed with supportive care.
Irritants and Other Non-Infectious Factors
Painful swallowing and perceived gland discomfort can also arise from factors that are not related to a contagious pathogen. Gastroesophageal reflux disease (GERD) is a common condition where stomach acid flows back up into the esophagus and throat, leading to irritation. This acid wash can inflame the throat lining, causing chronic soreness that is often mistaken for a persistent infection.
When reflux is primarily localized to the throat and voice box, it is called laryngopharyngeal reflux (LPR), which can cause a sensation of a lump in the throat and frequent throat clearing. Allergies also contribute to neck and throat discomfort, mainly through post-nasal drip. The excess mucus running down the back of the throat causes constant irritation, mimicking the feeling of a mild sore throat and triggering lymph node activity.
Environmental elements and habits can similarly irritate the sensitive tissues of the throat, triggering pain upon swallowing. Exposure to chemical irritants, dry air, or the toxins in cigarette smoke can cause inflammation of the pharynx, known as pharyngitis. Even physical overuse, such as yelling or excessive talking, can strain the throat muscles, leading to temporary soreness that feels worse when swallowing.
Symptom Management and When to See a Doctor
Home care is the primary approach for relief from common viral infections. Staying well-hydrated by drinking clear fluids helps to keep the throat moist. Gargling with warm salt water several times a day can temporarily soothe the inflamed tissues in the throat.
Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can manage the pain and reduce any associated fever. Sucking on lozenges or hard candies stimulates saliva production, which helps coat the throat and offers temporary relief from discomfort. Most viral infections resolve themselves within seven to ten days, and the tenderness in the lymph nodes should subside as the illness clears.
You should seek professional help if you have a high fever, especially one over 103°F, or if the pain is so intense that you have significant difficulty swallowing liquids or saliva. Other red flags include difficulty breathing, rapid swelling, or a lump that feels hard, does not move when pressed, or persists for more than two weeks after other symptoms have disappeared.