Finding a new lump or “ball” in the neck can be concerning, but it is a common symptom arising from many different underlying causes. A cervical mass is the medical term for a neck lump, which represents a visible or palpable swelling in a region packed with glands, muscles, and lymph nodes. While this article provides an overview of frequent origins, it is strictly for informational purposes. Any new or persistent swelling requires a prompt professional medical evaluation to determine the exact cause.
The Role of Lymph Nodes
The most frequent cause of a neck lump is temporary swelling of the lymph nodes, a condition known as lymphadenopathy. Lymph nodes are small, bean-shaped structures that act as filters within the lymphatic system, managing fluid balance and immune defense. When the body encounters an infection, the nodes nearest the site accumulate white blood cells to fight the invading bacteria or viruses, causing them to enlarge.
This swelling is typically a sign that the immune system is working effectively against a nearby illness, such as a common cold, tonsillitis, or a dental infection. A lymph node swollen due to an acute infection is often described as soft, movable under the skin, and tender or painful to the touch. Once the underlying infection clears, these nodes usually decrease in size and return to their normal state over a few weeks.
The location of the swollen nodes can sometimes point to the source of the problem, with nodes under the jaw or at the side of the neck often reflecting issues in the throat or mouth. Nodes that remain persistently swollen or continue to grow beyond two or three weeks warrant further investigation. The duration of the swelling is an important factor in distinguishing a normal immune response from a more complex issue.
Glandular Sources of Neck Swelling
Several glands in the neck can enlarge and feel like a distinct lump. The thyroid gland, located centrally in the lower neck just above the collarbone, is a frequent source of masses. A thyroid lump may be a solitary nodule or part of a generalized enlargement of the gland known as a goiter.
Thyroid nodules are common, and the majority are benign growths related to hormone changes or non-cancerous tissue overgrowth. These masses often move upward when a person swallows, which helps distinguish them from other structures. The salivary glands—including the parotid glands near the ear and the submandibular glands under the jaw—can also present as neck masses.
Lumps in the salivary glands are frequently caused by inflammation (sialadenitis), often due to a blockage from a small stone preventing saliva drainage. This can cause sudden, painful swelling, especially while eating. Any persistent mass in these areas requires evaluation to rule out malignant causes.
Benign Structural Causes
Many non-glandular and non-infectious conditions manifest as a lump in the neck, representing structural changes. One common example is a lipoma, a soft, non-tender growth composed of fatty tissue that forms just beneath the skin. Lipomas are harmless, feel rubbery, and are easily moved with light pressure.
Cysts are another type of benign structural lump, which are sacs filled with fluid, air, or semi-solid material. These include sebaceous cysts, which develop from blocked oil glands, or congenital cysts like branchial cleft cysts, remnants of embryonic development. These cysts usually feel smooth and firm and may be present for a long time without symptoms unless they become irritated or infected.
A muscle knot, often occurring in the sternocleidomastoid muscle along the side of the neck, may also feel like a lump. These tight, painful areas are usually related to muscle tension, injury, or poor posture. Unlike other masses, these lumps are part of the muscle tissue itself and are typically tender, often resolving with massage or physical therapy.
Warning Signs and Next Steps
Although most neck lumps are benign, certain characteristics suggest the need for immediate medical consultation. Warning signs that raise suspicion include a lump that feels hard, is fixed in place, and does not move when pressed. A mass that is growing rapidly or has been present for more than a few weeks should be urgently examined by a professional.
Other symptoms linked to a potentially more serious issue include:
- Unexplained weight loss, night sweats, or a persistent fever.
- Difficulty swallowing (dysphagia).
- A voice change or pain that radiates to the ear.
These signs indicate the need for a thorough diagnostic process to exclude malignancy.
A healthcare provider, such as a primary care physician or an Ear, Nose, and Throat (ENT) specialist, will start with a detailed physical examination and history. Diagnostic tools often begin with an ultrasound to characterize the lump’s size and composition, determining if it is solid, cystic, or vascular. If the mass appears suspicious, the next step is typically a fine-needle aspiration (FNA), where a tissue sample is withdrawn for laboratory analysis.