Lump on neck and ear pain

Lymph nodes in the neck can become tender and enlarged when the throat, ear, sinuses or upper airways are inflamed. Ear pain may also come from earwax buildup, a middle-ear infection, sinus pressure or tonsillitis. A common cold can cause congestion that changes pressure around the ear. The lump may be a lymph node, but it can also be a skin cyst or another local swelling. Its size, tenderness, mobility, duration and position help a clinician assess it. Earache is the symptom being assessed; it does not by itself identify the cause.

Arrange a primary-care assessment if the lump is new and does not start settling, if ear pain persists, or if hearing changes or discharge develops. Do not squeeze the lump or put cotton buds, oil or other objects into the ear. Rest, drink fluids and use a suitable pain reliever only as directed on its label, taking account of pregnancy, allergies and other medicines. Antibiotic treatment is useful only when a clinician finds a bacterial infection; it does not treat every cause of ear pain. Ear wax removal should be performed safely when wax is confirmed.

Seek urgent medical help for trouble breathing or swallowing, rapidly increasing neck swelling, severe pain behind the ear, a stiff neck with severe illness, new facial weakness, confusion, or a sudden major hearing change. Get prompt assessment if the lump is hard, fixed, repeatedly enlarges, or remains after the associated illness has cleared.

Ask: Could this be a lymph node, cyst or ear-related swelling? Do you need to examine my ear, throat and teeth? How long should I monitor it, and what change would require review?