Small lump on the back of a neck muscle

The back of the neck contains lymph nodes, muscles, skin, and connective tissue. A tender lump can occur while the body responds to a nearby infection, such as an irritated scalp or throat. A blocked skin gland or cyst can also form a rounded lump. Muscle tension may make an area feel thick or prominent, but a distinct mass should not be assumed to be muscle.

A neck lump is not the same as a cancer diagnosis. Some cancers, including lymphoma or head and neck cancer, can present with a neck mass, while thyroid cancer is usually assessed in the front or lower neck. If a clinician cannot identify the source, the evaluation may sometimes be described as cancer of unknown primary.

Note when you first noticed it, whether it changes in size, and whether it moves beneath the skin. Record tenderness, recent infections, dental problems, scalp irritation, fever, night sweats, or unexplained weight change. Do not squeeze, repeatedly massage, or try to drain the lump. Arrange a clinical examination when it remains present or is changing. The clinician may examine the mouth, throat, skin, thyroid, and lymph-node areas and may recommend an ultrasound or other tests based on the findings.

Seek prompt medical care for a lump that is rapidly enlarging, hard, fixed, or associated with trouble breathing or swallowing, persistent voice change, severe pain, or marked weakness. Arrange an appointment soon if it does not settle after a recent illness, returns repeatedly, or is accompanied by ongoing fever, drenching night sweats, or unexplained weight loss. These features do not identify the cause, but they make timely assessment more important.

Ask what structures lie beneath the lump, whether it feels like a lymph node or a skin lesion, and whether an ultrasound is appropriate. Ask which changes should prompt earlier review and whether your recent infections, medicines, dental symptoms, or family history affect the evaluation.