Small painful lump at the back of the neck

The lump may be a swollen lymph node responding to a nearby scalp, ear, throat, or skin infection. It can also be an irritated hair follicle, boil, cyst, or muscle-related swelling. Cancer is less common, but [Head and Neck Cancer](/conditions/head-and-neck-cancer/) and [Lymphoma](/conditions/lymphoma/) can present with a neck lump. A lump itself cannot identify its cause, and pain or tenderness does not provide a diagnosis. The location, skin changes, mobility, growth pattern, and associated symptoms help a clinician decide what to examine next.

Arrange a clinical examination if the lump is new and not settling, keeps returning, becomes larger, or has no clear infectious trigger. Note when it appeared, whether it moves under the skin, and any recent sore throat, dental problem, scalp irritation, or fever. Avoid squeezing or repeatedly pressing it, which can worsen inflammation. A clinician may examine nearby areas and request imaging or a sample if the finding remains unexplained. Thyroid-area concerns may lead to discussion of [Thyroid Cancer](/conditions/thyroid-cancer/) or [Thyroid Removal Surgery](/treatments/surgical-oncology/thyroidectomy/), but those decisions require confirmed findings.

Seek urgent help if swelling is rapidly increasing or causes trouble breathing or swallowing. Arrange prompt review for a hard or fixed lump, skin ulceration, drenching night sweats, unexplained weight loss, persistent fever, or weakness. Seek same-day care for spreading redness, severe tenderness, pus, or feeling acutely unwell, as these may signal a skin infection needing treatment.

Ask whether the lump feels like a lymph node, cyst, or another structure; which nearby areas should be checked; how long to monitor it; and what change should bring you back sooner. Ask whether ultrasound or another test is appropriate and how results will be explained.