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Are cancerous lymph node lumps painful?

Lymph nodes are small, bean-shaped glands that are part of the lymphatic system. They play an important role in the body’s immune system by filtering lymph fluid and helping fight infections and disease. Lymph nodes are located throughout the body, including in the neck, underarms, chest, abdomen, and groin.

What causes enlarged lymph nodes?

There are several possible causes of enlarged lymph nodes, including:

  • Infection – This is the most common cause of swollen lymph nodes. Infections like strep throat, ear infections, tooth abscesses, or colds can cause lymph nodes to enlarge as they work to filter out bacteria or viruses.
  • Cancer – Lymphoma and cancers that spread from other parts of the body, like breast cancer or melanoma, are another common cause of swollen lymph glands.
  • Immune diseases – Disorders that affect the immune system function, like rheumatoid arthritis, lupus, or HIV/AIDS, can cause lymph node enlargement.
  • Medications – Certain medications used to treat autoimmune disorders, seizures, high blood pressure, and vaccination reactions may cause node swelling.

In most cases, the swelling is a temporary reaction to infection or inflammation and the lymph nodes will return to normal size once the infection clears. However, persistent enlargement of lymph nodes, especially when they are painless, hard, and continue to grow in size, can be a sign of cancer.

Can cancer cause pain in the lymph nodes?

Lymph nodes enlarged due to cancer or metastasis can potentially be painful, but not always. Here is an overview of whether cancerous lymph node swelling is typically painful:

  • Lymphoma – Lymphoma itself usually causes painless swelling of lymph nodes. However, the enlarged nodes can sometimes press on nerves, muscles, veins, or organs and cause pain.
  • Metastatic cancer – Cancer that spreads from areas like the breasts, lungs, thyroid, or skin to the lymph nodes can often produce painless swelling. But rapidly growing metastases can outgrow their blood supply and become painful.
  • Leukemia – Swelling caused by leukemia is typically not painful. The lymph nodes enlarge but remain soft and rubbery.

So while cancerous enlargement of the lymph nodes can potentially cause pain if they compress or infiltrate nerves and tissue, the lymph nodes themselves are not normally painful to the touch if the cancer originated there. Rapid enlargement over days or weeks is more likely to cause pain than slow enlargement over months.

Are enlarged lymph nodes from infection painful?

Unlike cancerous lymphadenopathy which is often painless, swollen lymph nodes due to infection or inflammation are much more likely to be painful.

There are a few reasons for this:

  • The lymphocytes in the nodes rapidly multiply to fight the infection, causing swelling and inflammation.
  • The inflamed nodes can compress nerves and surrounding tissues, leading to throbbing pain and tenderness.
  • Draining lymph fluid can transport bacteria and the inflammatory chemicals they produce into the node, irritating the capsule and nerves.

The pain is often described as tender, throbbing, or achy. Moving the body part near the swollen nodes or touching them will exacerbate the pain. Swollen nodes behind the ear due to a throat or ear infection are a prime example. The node swelling and pain make it difficult to turn the head or lie on that side.

What does cancerous lymph node pain feel like?

While infection is by far the most common cause of painful lymph node enlargement, cancer can sometimes cause pain as well. Here are some of the characteristics of pain caused by cancerous lymphadenopathy:

  • The pain is typically duller and achier than the throbbing pain of infection.
  • It may feel like a pulling or stretching sensation in the node area.
  • The pain is constant, unlike the fluctuating pain from infection which waxes and wanes.
  • Pain usually doesn’t start until the nodes have grown large enough to compress nerves and tissue.
  • Movement or compression exacerbates the otherwise mild baseline pain.

Cancerous nodes don’t always become painful. Small or slow growing metastases may go unnoticed. But larger or rapidly enlarging cancerous nodes that infiltrate muscle or press on nerves can definitely cause discomfort and pain. Any lymph node enlargement that persists longer than 2-4 weeks warrants medical evaluation for cancer.

What does infected lymph node pain feel like?

While the characteristics of pain from enlarged lymph nodes can overlap between cancer and infection, there are some key differences:

  • Pain from inflamed nodes due to infection tends to be more intense and throbbing.
  • It often starts early in the course of node enlargement.
  • The pain fluctuates and frequently worsens with movement or pressure.
  • There is increased warmth, redness and tenderness directly over the swollen node.
  • Other signs and symptoms of infection like fever or chills are usually present.

This type of pain typically starts to improve once antibiotics are started or the immune system successfully clears the infection causing the node inflammation.

What tests diagnose enlarged painful lymph nodes?

If you have enlarged and painful lymph nodes, the doctor will first perform an exam to feel for swelling in areas like the neck, underarms, and groin. From there, tests that may be done to diagnose the cause include:

  • Blood tests – A complete blood count, sedimentation rate, and blood chemistry can detect infection or leukemia.
  • Imaging – Ultrasound, CT scan, or MRI of swollen lymph nodes helps evaluate their size, location, and appearance.
  • Biopsy – A lymph node biopsy involves surgical removal and examination under a microscope. This distinguishes between reactive nodes, lymphoma, and metastatic cancer.
  • Microbiology – A culture of lymph node tissue or fluid may identify bacterial, fungal, or tuberculous infections.

If infection is strongly suspected, your doctor may prescribe antibiotics and follow up closely without extensive testing upfront. However, persisting nodes or risk factors for cancer warrant a more thorough diagnostic workup.

What are the treatment options for painful swollen lymph nodes?

The appropriate treatment depends on the underlying cause:

  • Infection – Antibiotics, antivirals, antifungals, or drainage of an abscess treats the infection and reduces inflammation and pain.
  • Lymphoma – Chemotherapy, radiation, immunotherapy drugs, and sometimes surgery are used to destroy, shrink, and debulk cancers of the lymph system.
  • Metastatic cancer – Treating the primary tumor with surgery, chemotherapy, radiation, or hormonal therapy can slow cancer spread and lymph node enlargement.
  • Inflammation – Anti-inflammatory drugs reduce swelling, pain, and tenderness from inflammatory conditions like lupus or rheumatoid arthritis.

Managing pain is also an important part of treatment using over-the-counter or prescription analgesics and pain relievers. Rarely, surgery may be done to remove severely enlarged and painful nodes compressing structures.

Are there home remedies to reduce lymph node pain and swelling?

Some home remedies that can provide comfort for enlarged and painful lymph nodes include:

  • Warm compresses – Heat applied to the swollen area promotes circulation and can reduce pain and inflammation.
  • Massage – Gentle massage helps stimulate drainage of fluidbuildup and improves blood flow.
  • Over-the-counter pain medication – Ibuprofen or acetaminophen takes the edge off lymph node pain.
  • Immune boosting diet – Citrus fruits, chicken soup, yogurt, and green vegetables supply nutrients to fight infection.
  • Rest – Allowing your body to rest conserves its energy for powering your immune response.

While these self-care tips may temporarily relieve discomfort from swollen nodes, persistent enlargement or unexplained weight loss warrant prompt medical evaluation to determine the cause.

When to see a doctor for painful lymph nodes

You should make an appointment with your doctor if you have any of the following:

  • Lymph node swelling that persists longer than 2 weeks
  • Nodes that continue to enlarge over time
  • Nodes that feel very hard or immobile
  • Severe, constant pain that interferes with sleep or function
  • Presence of systemic “B” symptoms like unexplained fevers, night sweats, or weight loss
  • Risk factors for cancer like smoking history or known malignancy elsewhere

While some temporary pain and inflammation can come with fighting off an infection, lymph nodes that remain rock-hard and enlarging warrant medical evaluation to rule out possible cancers like lymphoma or metastatic disease. Even with painful infection, if antibiotics haven’t improved things within 1-2 weeks, be sure to follow up with your physician.


To summarize key points:

  • Cancerous lymphadenopathy can potentially cause pain, but is often painless compared to swollen nodes from infection.
  • The pain from enlarged cancer nodes tends to be mild, constant and achy versus severe, fluctuating pain with infection.
  • Infections cause localized pain, warmth, redness and tenderness directly over the swollen nodes.
  • Persistent, unexplained lymph node enlargement or systemic symptoms require prompt medical evaluation to assess for underlying cancer.
  • Treatment depends on the cause but may include antibiotics, chemotherapy, radiation, surgery, anti-inflammatories and pain management.

While waiting for a diagnosis, home remedies like heat, massage, over-the-counter pain medicine and rest can provide some comfort from painful lymphadenopathy. But any large, rock-hard or worsening lymph node enlargement warrants urgent assessment to rule out cancers like lymphoma. Catching cancerous lymphadenopathy early optimizes outcomes.