Swollen lymph nodes: how long they last, causes and when to see a GP

The NHS says swollen glands caused by an infection will usually get better by themselves within 1 to 2 weeks, and that swollen glands should go down within 1 to 2 weeks depending on the cause. Patient.info says that after an infection it can take a week or so for the glands to gradually go back to normal, and that they usually return to their pea size when the infection is over.

The NHS advises seeing a GP if swollen glands are getting bigger or have not gone down within 1 week. Patient.info gives a similar rule of thumb of 2 weeks: see your doctor if your glands have not gone down after 2 weeks, or have been there for 2 weeks or longer. The earlier NHS threshold is the one to follow if the glands are enlarging.

The NHS says swollen glands feel like tender, painful lumps on each side of the neck, under the chin, in the armpits and around the groin. Glands, also known as lymph glands or lymph nodes, swell near an infection to help your body fight it. Sometimes a gland on just one side of the body swells, and you might also have other symptoms such as a sore throat, cough or high temperature.

Patient.info explains that lymph glands are found throughout the body, often in groups such as the sides of the neck, the armpits and the groin. They are part of the immune system and are normally pea-sized, but can swell to the size of marbles or larger. Glands deep in the chest or tummy cannot be seen or felt but can swell too.

The NHS says swollen glands are often caused by common illnesses such as colds, tonsillitis and ear or throat infections, and sometimes by viral infections such as glandular fever. You may also have a sore throat, cough or high temperature.

Patient.info describes how the pattern follows the source. Throat infections, colds and tooth infections tend to swell neck glands. Scalp problems or head lice can swell glands at the back of the head, skin infections of the arm swell the armpit, and infections of the leg or genitals swell the groin. Viral illnesses such as flu, chickenpox or glandular fever can swell glands in several places.

Patient.info adds that after an infection it can take a week or so for the glands to settle back to normal.

Patient.info lists rarer causes, including reactions to certain medicines, dental work, sarcoidosis, systemic lupus erythematosus, rheumatoid arthritis, and less common infections such as HIV and tuberculosis.

It also explains how cancer can swell glands. Cells from a cancer elsewhere may spread to nearby glands, for example breast cancer to the armpit or throat cancer to the neck. Cancers of the lymph and blood systems, such as lymphoma and leukaemia, can cause many glands to swell.

As a rule, swelling from these causes develops more slowly than from infection and tends to be painless at first, according to Patient.info. It stresses that swollen glands are most likely to be caused by infection.

The NHS asks you to see a GP if swollen glands are getting bigger or have not gone down within 1 week, feel hard or do not move when pressed, come with night sweats or a very high temperature, appear with no other sign of illness or infection, or are just above or below the collarbone.

Patient.info gives a similar rule of thumb: tell your doctor if you do not know why they swelled, if they are near the collarbone, or if they have been there for two weeks or longer, and notes that hard, painless lumps that have not gone in two weeks deserve attention.

Urgent help is needed if you are finding it very difficult to swallow or have difficulty breathing. Ask for an urgent GP appointment or contact NHS 111.

• Lump not going down after 1 to 2 weeks.

• Hard, fixed or steadily growing lump.

• Night sweats, very high temperature or weight loss.

• Swelling in the lower neck above or below the collarbone.

• Glands that swell with no obvious illness.

For swollen glands from infection, the NHS suggests resting, drinking plenty of fluids and taking painkillers such as paracetamol or ibuprofen. Do not give aspirin to children under 16.

Do not squeeze, poke or repeatedly press the lump, which can make it sore. Keep track of whether it is getting smaller. If it is not clearly shrinking within a week or two, arrange a GP review. The NHS advises not to self-diagnose and to see a GP if you are worried.

A GP will ask about recent illness, medicines and other symptoms, and will feel the glands and examine areas they drain. Blood tests may be arranged. The NHS says a GP can recommend treatment depending on the cause, which might include antibiotics, although antibiotics do not work on viral infections.

Cancer Research UK explains that the guidelines for GPs vary slightly between UK nations. In England and Wales, a GP should arrange to see a haematologist if you have swollen lymph nodes or an enlarged spleen that cannot be explained. For under-25s, this should be within 48 hours.

Cancer Research UK also notes that the Scottish guidance advises urgent referral or biopsy for a swollen node with no obvious cause that is at least 2 cm long, does not go away after 6 weeks or is getting bigger. A swollen gland on its own is not a diagnosis; a referral means tests are needed.

Tests a specialist may use include ultrasound of the lump and a needle or surgical biopsy of the node.

The NHS says not to give aspirin to children under 16 for swollen glands, and suggests paracetamol or ibuprofen with rest and plenty of fluids. Glandular fever is most common in people aged 15 to 24, according to the NHS, and can cause swollen glands in the neck, head, armpits, elbows or groin, with a high temperature, sore throat, rash, headache and tiredness.

Cancer Research UK explains that for people aged 24 or younger in England and Wales, a GP should arrange to see a haematologist within 48 hours if they have unexplained swollen lymph nodes or an enlarged spleen. This is an urgent suspected cancer referral and does not mean cancer has been found.

Swollen glands themselves are not contagious, but the infection that causes them may be. The NHS says glandular fever is spread through spit, so you can get it through kissing or by sharing cups or cutlery, and that you are infectious for up to 7 weeks before you get symptoms and may be infectious for several months after being unwell.

For other infections such as colds or tonsillitis, the NHS says that if you have a high temperature or do not feel well enough to do your normal activities, try to stay at home and avoid contact with other people until you feel better.

Most people are assessed by a GP. If cancer is possible, the NHS route is an urgent suspected cancer referral, which Cancer Research UK stresses does not mean you definitely have cancer. Blood tests, ultrasound and biopsy are arranged through that pathway. Use NHS 111 for the urgent signs above, and 999 for severe breathing difficulty.

Some people choose a private consultant, for example in ENT or haematology, to arrange an ultrasound or sampling of a persistent lump. If you do, share the results with your GP so that any monitoring is not duplicated.