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There are several causes behind a lump on the back of the neck but most of them are benign. Most of the lumps are traumatic or inflammatory and are usually self-limiting. It is rare for a neck lump to be malignant before the age of 40. Some of the common causes of a lump on the back of the neck include:

  • A lump arising due to injury to any muscle or tendon in the neck region:

Injury to muscles or tendons present in the neck may arise due to a sudden strenuous exercise without proper guidance, sleeping in some awkward position or after meeting an accident. The damaged portion of the muscle gets swollen up and forms a lump. This type of lump causes stiffness of neck, painful neck movement and difficulty in moving the head. The pain may radiate to the adjoining to the adjoining areas and the patient may even complaint of a dull headache.

The patient gets relief from pain on applying an ice-pack on the lump. There are times when the patient may require a pain-killer medicine as well. Patients are advised to rest and avoid straining their neck in any manner.

  • Enlarged lymph nodes:

Enlarged lymph nodes are the most common cause of a lump in the back of the neck. Bacterial infection of lymph nodes can be very painful. It severely restricts the movement of the neck. The most common cause of enlarged and infected lymph nodes of the neck is a sore throat. Apart from that any infection of the salivary glands and glandular fever can also give rise to a lump at the back of the neck arising because of enlarged and inflamed lymph nodes.

Patients are usually prescribed antibiotics in case of a bacterial infection. Apart from that, they should take adequate amounts of fluids and rest.

  • Tonsillitis:

Tonsillitis is the inflammation of the tonsils, glands situated at the back of the throat. Their inflammation usually causes the enlargement of the lymph nodes in front of the neck, but if the infection is not brought under control, it may spread posteriorly involving the lymph nodes at the back of the neck and form a lump there. Common symptoms of tonsillitis include pain in the throat, fever and difficulty in swallowing food and water.

Gargling with tepid saline water provides relief. However, if the infection is severe, the physician may like to prescribe antibiotics. In case of recurrent infection, tonsillectomy may be the treatment of choice.

  • Boils at the back of the neck:

Any boil present in the back of the neck initially presents as a painful lump. It is only later when it gets filled with pus that the skin over the boil becomes pale yellow in color. The lump becomes tense and extremely painful. It may be accompanied by fever and selling of the lymph nodes in the vicinity of the lump.

Diabetes is a common cause of boils though a poor hygiene may lead to their development in any person. Most of the boils subside on their own though you may need a painkiller. However, some boils may require antibiotics or even surgical drainage.

  • Lymphoma:

Lymphoma is a cancer involving the lymphatic system. When these cancer cells lodge in the lymph nodes at the back of the neck, they may give rise to a lump. These lumps are usually painless and hard and are treated like any other cancer.

  • Dermoid cyst:

A dermoid cyst is a congenital defect in which the layers of the skin have not grown properly. It is basically a pocket under the skin which is lined by the skin epithelium and contains the cells present in the different layers of skin like the hair follicles and the sweat and sebaceous glands. The secretions from these glands may collect inside the cyst resulting in its enlargement. Dermoid cysts are common at the back of the neck. They are painless initially but may become painful as they grow. This may hamper the movement of the neck. In such cases, they are surgically removed.

  • Sebaceous cyst:

It is a benign growth under the skin and is smooth to touch. A sebaceous cyst is formed when the opening of the sebaceous gland on the surface of the skin gets blocked. Sebum, the fluid secreted by these glands collects underneath the skin resulting in the formation of a sebaceous cyst. It becomes painful only when the secretions get infected. A sebaceous cyst generally resolves on its own but rarely, surgical drainage may be required.

  • Lipoma:

Lipomas are benign growths resulting from the growth of the fatty tissue under the skin. The overlying skin is free and the Lipoma tends to slip under the skin. It may occur at any age but is rare in children. It is harmless but the patient may seek its surgical removal for cosmetic reasons.

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