Last updated: March 9, 2020
Richard Honaker M.D.
Primary Care Physician
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Ever notice than when you get sick, you also get sore? Swollen Lymph nodes behind the ear and in the neck can make swallowing and moving your head painful. So why does this happen?
Your lymph nodes will swell for a variety of reasons, but most commonly it is a reaction to an illness, injury or infection. In fact, when your lymph nodes are not swollen you can’t feel them at all. When lymph nodes swell they can range in size from a small pea to a huge cherry.
So what are lymph nodes? Well lymph nodes play a very important role in your overall health. Read on to learn everything you need to know about your lymphatic system and what swollen lymph nodes behind the ear could mean for your health.
What are Lymph Nodes?
Lymph nodes play an important role in your overall health. They are small ovals of lymphatic tissue that are found along the lymphatic vessels. Your body’s lymphatic system is made up of vessels, nodes and lymph fluid. This system works together to remove impurities from the body’s muscle tissue outside of the blood stream.
Lymph nodes work as a filter to remove impurities from the lymph fluid. The fluid can go through several nodes before reaching its final destination in your chest.
Your Lymphatic System
Your body’s lymphatic system works together to remove waste, fluid, viruses and bacteria from the body. It does this through a system of vessels and nodes.
Read more: Swollen lymph nodes in the neck
The lymph vessels in your body appear similar to veins and run throughout the body. They are larger than capillaries but smaller than your smallest veins.
The lymph vessels carry the fluid that flows from your capillary walls to bathe the cell walls in fluid. It carries important nutrients to the cells such as oxygen and removes impurities and carbon dioxide.
Lymph fluid contains both substances that can benefit the body as well as substances that can harm the body.
Lymph fluid can contain:
Lymph fluid may also contain:
- Damaged cells
- Cancer cells
The lymph vessels carry the fluid away from the different areas of the body and towards the chest. The vessels drain into collecting ducts. These ducts empty their contents in subclavian veins, which are located under the collarbones. When these veins are joined they form the superior vena cava which drains blood from the upper body into the heart.
The Role of Lymph Nodes
Lymph nodes act as a sift to filter out impurities along the vessels. The lymph nodes contain immune cells that help to fight and break down infection by destroying the germs in the lymph fluid called lymphocytes. Lymphocytes are infection-fighting white blood cells.
There are two main types of lymphocytes:
- B lymphocytes (B cells): These cells make antibodies which are proteins to help protect the body from bacteria and viruses.
- T lymphocytes (T cells): Some of these cells destroy germs or abnormal cells which others boost or the activity of other immune cells.
Your body has about 600 lymph nodes. Many of the lymph nodes in the body cannot be felt as they are not close enough to the skin’s surface. When swollen, lymph nodes can be felt on the neck, back of knees, groin, armpit and head.
Often the lymph fluid is filtered through several nodes before entering your bloodstream. For example, your lymph fluid may start in your fingers and then join the fluid in your arm being filtered several times before it reaches the chest. The lymph fluid flows slowly through the body, collecting more and more fluid as it moves towards the chest.
Swollen Lymph Nodes
A swollen lymph node is often your body’s way of telling you something is off inside your body. Sometimes these swellings are relatively minor, and rarely it can be a sign of something much more serious.
Your lymph nodes work hard to filter out substances that are harmful to the body such as damaged cells, cancer cells, viruses and bacteria.
When your lymph nodes detect these types of harmful agents they may swell. Any nodes swollen to more than 1 cm in diameter is considered ‘abnormal’.
Lymph nodes can also swell as a result of injury. This can happen when scarring or blockage of the lymph vessels can cause the lymph nodes to swell.
Stress can also cause swelling of the lymph nodes.
As lymph nodes swell they go from being small and firm to large and tender. In some cases moving your body may be painful. The swelling of a lymph node is usually due to an infection in another area in the body, although lymph nodes can also become infected.
The swelling of one or more lymph nodes is called Lymphadenitis. Although a swollen lymph node may make you automatically fear the worst, in most cases they are the result of a benign infection. Infections can be caused by a virus, bacteria or fungus in the body. The lymph nodes detect these items in the lymph fluid and work together to rid the body of them. This can cause a group of nodes to swell.
Swollen Lymph Nodes Behind the Ear
Lymph nodes usually swell in the area that is infected. Swollen lymph nodes behind the ear or in the neck may indicate an upper respiratory infection such as a cold.
You may notice that your doctor often touches the lymph nodes in this area when you are complaining of cold and flu symptoms. Swelling in the lymph nodes in this area is a sign that your body is trying to fight an infection. In rare cases, it can be a sign of something more serious.
When your lymph nodes swell they will dramatically increase in size. They may be tender to the touch or it may hurt to swallow.
Reasons for Swollen Lymph Nodes Behind the Ear
The lymph nodes behind the ear are called the posterior auricular lymph nodes. If your lymph nodes are swollen it is likely due to an infection, illness or injury. Swollen lymph nodes behind the ear may be a result of:
- Ear infection
- HIV infection
- Sinus infection
- ear infection
- Infected tooth
- Skin infection
- Strep throat
- Rheumatoid arthritis
- Cancer such as lymphoma (where the cancer began in the lymphatic system) or if cancer that originated in other areas moves to the lymphatic system the nodes will swell.
- Antiseizure and antimalarial drugs
- Medication or allergic reactions to medication
- cat scratch fever
- mouth sores
- Sézary syndrome
Read more: The best foods to boost immunity
The medical term for a single swollen lymph node is lymphadenopathy. In most cases, only one area of lymph nodes will swell at a time. This is usually as a result of an infection or injury in the general area. When more than one area is swollen at a time it is called generalized lymphadenopathy.
Generalized lymphadenopathy can be caused by:
- Strep throat
- Chicken Pox
- Certain medications
- Immune system diseases
- Cancer such as leukemia and lymphoma
While lymph nodes are often swollen as a result of an infection, illness or injury elsewhere in the body, it is also possible for the lymph node itself to become infected. An infection in the lymph node will produce additional symptoms.
Symptoms of Infected Lymph Nodes:
- Swollen lymph node
- The area may be tender to the touch
- Nodes may be soft or matted together
- The skin over the nodes may appear red
- Nodes may become filled with pus
- Fluid may drain from the nodes onto the skin
Cancer in the Lymph Nodes
There are two ways for cancer to form in the lymph nodes. The cancer may originate in the lymph nodes or it may originate elsewhere in the body and then move to the lymphatic system.
When cancer begins in the lymph nodes it is known as lymphoma. It is more common for cancer to start elsewhere in the body and then move onto the lymph nodes.
When cancer starts in another area of the body it is possible for the cancer cells to move away from the tumor and travel to other areas in the body through the bloodstream or lymphatic system. In some cases the lymph nodes are able to destroy cancer cells. In other instances, new tumors can form. These tumors could form in the different organs in the body or in the lymph nodes themselves. When cancer spreads to a new part of the body it is referred to as metastasis.
Diagnosis of Swollen Lymph Nodes Behind the Ear
Swollen lymph nodes can generally be easily diagnosed considering the other symptoms observed.
For example, if swollen lymph nodes are accompanied by symptoms of a viral or bacterial infection, it is easy to pinpoint that the infection is the reason for the swelling.
Swelling behind your ears is not necessarily a swollen lymph node. There are many different possible reasons for swelling in this area.
If you have lymphadenitis your doctor will likely rely heavily on your medical history and a physical exam to determine the diagnosis.
Your doctor will likely want to know about any other symptoms you are experiencing as well as any recent exposure that could pinpoint your condition. These exposures includes recent travels, encounters with animals or sign of infection near the swollen nodes.
Your doctor may order a blood test to determine if there are any abnormalities in the blood. You may also need to have an imaging test, such as an MRI, CT scan, x-ray or ultrasound.
In some rare cases, you may need a lymph node biopsy. With this test a small amount of cells are removed from the lymph node with a needle and sent for testing for diseases such as cancer.
Other Possible Diagnosis
Acne: Pores can become blocked with sebum, which is the oily substance secreted at the base of the hair follicle. When the pores become blocked they may become swollen, red and painful to the touch.
Cyst: A cyst is a fluid-filled sac that can form anywhere on the body including behind the ear. Any lump found on the skin should be checked by a doctor. They form a raised dome filled with fluid. They may have a small black dot on the top called a punctum. Cysts are also often able to move under the skin.
Lipoma: Lipoma are growths of fatty tissue under the skin. They are not cancerous, do not spread and can form anywhere on the body. Lipomas are soft to the touch and should not be painful when pressed. The size of lipomas range from the size of a pea to several inches across. You may only have one lipoma or several at once.
How to Check Your Lymph Nodes Behind the Ear
For most people, there is no need to check your lymph nodes for swelling. In fact, lymph nodes can swell due to stress and worrying about swelling would only make the condition worse.
For some people diagnosed with cancer, your doctor may ask you to check your lymph nodes periodically for swelling. This is because one of the reasons lymph nodes will swell is because they have cancer cells in them.
- Start at the lymph nodes in front of the ear (1). Use your fingertips to feel the area in a gentle circular motion
- Check your nodes in the order shown in the image above. Always start with the front of the ear and finish just above the collar bone.
- Check both sides of the body to compare for size. A swelling may only be the size of a pea.
- When checking your neck, tilting your head towards the side you are examining can help relax the muscle.
- Press your fingers under the muscle to look for swelling
- When checking above the collarbone first hunch your shoulder and bring your elbows forward to relax your skin.
Treatment of Swollen Lymph Nodes Behind the Ear
In many cases swollen lymph nodes will resolve themselves without treatment. This is because the nodes have swollen in reaction to an infection in the body and will return to normal size once the infection has been treated.
Your doctor may advise you to take some over the counter pain medication to combat the inflammation and pain associated with the swelling.
If the lymph nodes are swollen due to an injury in the area your doctor will likely need to take further action to clear the scar tissue or blockage in the area in order to let the lymph fluid drain properly.
If the lymph nodes are swollen due to cancer cells they will remain swollen until the cancer has been removed and treated. In some cases, your doctor will advise that the lymph node is removed completely. Your doctor can tell you what treatment will work best for you.
Speak to a Doctor
Swollen areas behind the ear can be caused by many different reasons. Don’t waste time worrying. Connect with one of our doctors right away. Our north american doctors are available 24 hours a day and can provide medical insights through chat, photo and video options. Cure your worry from the comforts of home with Your Doctors Online. Connect today.
*Not her real name.
Disclaimer: This article provides general information and is not intended to diagnose, treat or cure any disease or medical condition. If you require specific advice, please consult one of our medical professionals through the app. However, in case of an emergency, please call 911.
About Richard Honaker M.D.
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