A swollen or thick neck can be caused by a variety of factors. Since this also includes serious illnesses, such as thyroid cancer, medical help to determine the causes of the thick neck should be sought urgently in the case of recurring or prolonged complaints.
Table of Contents
- Fat neck – symptoms, causes and treatment
- Fat neck – the most important facts
- Symptoms and discomfort
- Causes thick neck
- Thyroid disease
- Diseases of the salivary glands
- Diseases of the esophagus
- Lymph node swelling
- Abscesses, fistulas and cysts
- Blood build-up in the throat veins
- Tumors and other diseases in the neck area
- diagnosis
- Fat neck treatment
- Treatment for thyroid disorders
- Therapy of salivary gland diseases
- Treatment of esophageal diseases
- Lymph node swelling
- Therapy options for abscesses and cysts
- Treatment for congestion in the neck veins
- Therapy of tumors
- Therapy of the Zenker diverticulum
- Naturopathy for a swollen neck
- Naturopathy for salivary gland diseases
- Naturopathy for esophageal diseases
- Naturopathy for lymph node swellings
Fat neck – the most important facts
A fat neck can go back to numerous causes, many of which are harmless in nature, but some pose serious health risks that should be treated as soon as possible by a doctor. Basically, a visit to the doctor is advised when the symptoms appear. Here is a brief overview:
- Definition: The term “thick neck” generally does not only stand for actually visible external swelling of the neck or noticeable internal impairments, but is also used colloquially for the appearance of massive anger or annoyance. However, this article is only devoted to medical-related complaints.
- Symptoms: tightness, inner tension and pressure feelings up to clearly visible swellings.
- Causes: for example thyroid diseases, diseases of the salivary glands, diseases of the esophagus, lymph node swellings, abscesses, fistulas and cysts, blood congestion in the neck veins, Zenker diverticula, tumor diseases.
- Diagnosis: thorough medical history with systematic questioning about the symptoms and possible previous diseases, external examination of the head and neck area as well as an examination of the inner mouth, throat and pharynx, palpation of the lymphatic accounts and existing swellings, throat swab, endoscopic examination of the inside of the neck (if necessary with biopsy), blood test, imaging procedures such as ultrasound, X-ray, MRI, CT or scintigraphy, and if necessary, an examination of the ear canal.
- Treatment: Alignment with the causes, whereby simple changes in diet can sometimes help, but in other cases surgery is required or there is no prospect of healing.
- Naturopathy and holistic medicine: for example accompanying use of lymphatic drainage and acupuncture for lymph node swelling; Medicinal plants such as lemon balm, chamomile and marigold in the case of esophageal disease due to reflux; cooling wraps for inflammation of various types.
The symptoms of a thick neck can range from slightly swollen lymph nodes to massive, clearly visible swellings. (Image: Two Brains Studios / fotolia.com)
Symptoms and discomfort
The symptoms of a thick neck include, in addition to possibly visible swelling and redness, a feeling of tightness, inner feelings of tension and pain in the neck area. Those affected often find familiar items of clothing, such as ties, turtleneck sweaters or shirts, as uncomfortably tight. According to the different causes of a thick neck, numerous different accompanying symptoms such as fever , headache , hoarseness , the feeling of a lump in the throat , loss of appetite , hair loss and neck tension can be observed, which are explained in more detail in connection with the respective causes.
Causes thick neck
In addition to acute infections and inflammation, the causes of a thick neck also include chronic diseases of the internal organs. In the worst case, the symptoms can be based on a life-threatening cancer.
Thyroid disease
Thyroid diseases are particularly common triggers for a thick neck. The thyroid gland located below the larynx in the front area of the neck can have various diseases that are accompanied by swelling of the organ that is clearly visible from the outside. This can be accompanied by an overactive thyroid (hyperthyroidism) as well as an underactive thyroid (hypothyroidism) or normal function. In addition to iodine deficiency, autoimmune diseases of the thyroid gland such as Graves’ disease, certain medications, cysts in the thyroid gland as well as benign and malignant tumors are known as causes of a goiter.
In rare cases, sarcoidosis (Boeck’s disease) can also cause a goiter. This systemic connective tissue disease leads to the formation of new tissues (granulomas) in different places in the organism, although organs such as the lungs, heart or liver are usually more affected. Amyloidosis can also be mentioned as a rare cause of a goiter or thick neck. This intracellular storage of modified proteins leads to corresponding thickening of the neck. Furthermore, an infestation with parasites can trigger a goiter, but this describes a rarely occurring clinical picture in this country.
Diseases of the parathyroid glands, such as hyperplasia (enlargement due to increased cell division) or adenomas (benign tumors in the gland), are also rarely accompanied by an external swelling of the neck.
Accompanying symptoms in diseases of the thyroid gland in the case of an excessive release of the thyroid hormones, for example, palpitations , sweats and a significant weight loss can be observed despite a high appetite. The muscles may also appear weakened and those affected are at increased risk of osteoporosis . The underactive thyroid or the insufficient release of the thyroid hormones were more likely to lead to weight gain, a lower heart rate and dry skin. In addition, there may be psychological complaints, ranging from rather harmless lack of concentration and tiredness to depression .
Diseases of the thyroid gland can cause significant swelling in the neck area and may require surgery. (Image: ladahunt / fotolia.com)
Diseases of the salivary glands
Different diseases of the salivary glands can be considered as a trigger for a thick neck. Diseases of the three large salivary glands – the parotid gland, the submandibular gland and the sublingual salivary gland – are of primary importance. But diseases of the numerous smaller salivary glands, such as the cheek glands, tongue gland, palate glands or molar glands, can also lead to the feeling of a thick neck. Bacterial and viral infections and possible blockages caused by so-called saliva stones or tumors are known to be more common triggers of corresponding salivary gland diseases.
Bacterial salivary gland infections usually result from the spread of staphylococci (Staphylococcus aureus) or streptococci (Streptococcus viridans) in the salivary glands. They cause a painful inflammation of the salivary gland (sialadenitis), which is often associated with a marked swelling of the organ. The bacterial infections are favored by blocking the gland exit with saliva stones. The blockade in turn leads to painful swelling, since the saliva can no longer drain to the required extent.
A thick neck can also be caused by viral infections of the salivary glands, whereby the best known viral infection of the salivary glands is mumps. Mostly the mumps viruses infect the parotid gland, which among other things leads to massive swelling of the face. The neck also appears to be significantly swollen in some patients. Since mumps can also affect the pancreas, there are accompanying symptoms such as abdominal pain , nausea and vomitingnot uncommon. The disease often results in life-threatening meningitis (meningitis). Since most children in Germany are vaccinated against mumps today, the number of diseases in this country is relatively low. However, other viruses, such as the Epstein-Barr virus or flu viruses, can also affect the salivary glands and cause a corresponding sialadenitis.
Sjogren’s syndrome is an autoimmune disease that can lead to inflammation of the salivary glands and a correspondingly thick neck. In addition, malignant (e.g., adenoid-cystic carcinoma) and benign (e.g., pleomorphic adenoma) tumors can form in the salivary glands, which cause a significant swelling of the neck.
Diseases of the esophagus
Various diseases of the esophagus lead to an inner feeling of tightness, which those affected also perceive as a thick neck. However, these diseases are usually not recognizable as external swelling. For example, inflammation of the mucous membranes in the esophagus (esophagitis), Boerhaave syndrome with spontaneous perforation of the esophagus, the so-called Killian-Jamieson diverticulum (sacking on the upper sphincter of the esophagus) or esophageal cancer (esophageal carcinoma) can be mentioned. However, the thick neck is usually not externally recognizable in these diseases. Difficulty swallowing and burning pains, which can extend from the neck to the rear of the breeding bone, are known as typical accompanying symptoms of esophageal diseases.
Lymph node swelling
The lymph nodes on the neck swell slightly as a result of numerous diseases. This completely normal reaction of the organism is often described by those affected with the feeling of a thick neck. The otherwise barely palpable lymph nodes are sensitive to pressure and significantly enlarged. They can also cause difficulty swallowing and, in some circumstances, shortness of breath. A corresponding swelling of the lymph nodes, especially the maxillary lymph nodes and tonsils (tonsils), can be observed in the context of tonsillitis (tonsillitis).
Viral infections and acute bacterial infections are the most common causes of lymph node swelling . For example, Pfeiffer’s glandular fever – triggered by the Epstein-Barr virus – often includes an unpleasant swelling of the lymph nodes. Measles, rubella and infections with rotaviruses also usually lead to swelling of the lymph nodes. Fever and sore throat in particular can be used to indicate an underlying infectious disease with a thick neck.
The lymph nodes themselves can also be the immediate focus of the disease. For example, so-called Hodgkin’s lymphomas (malignant tumors in the lymphatic system; see Hodgkin’s disease ) may form. The affected lymph nodes initially swell painlessly and without further typical symptoms, before other symptoms such as disorders of the nervous system or hormonal balance become apparent.
Abscesses, fistulas and cysts
Under certain circumstances, abscesses (encapsulated accumulation of pus in the tissue) also form in the neck area, which lead to an externally visible swelling. Triggers are usually bacteria, with chronic abscesses usually staphylococci, which first spread in the tissue before the body covers the affected area with granulation tissue to prevent further spread. Inside the tissue is broken down and pus is formed.
A special form of the abscess is in severe cases of bacterial otitis mediato observe – the so-called mastoiditis. It shows up as an acute inflammation with fluid accumulation behind the ear. On the mastoid process (mastoid process) of the temporal bone, mastoiditis is usually visible as massive swelling and redness. In view of the growing pressure inside the abscess, it begins to break out over time. Under certain circumstances, however, the neck muscles can also be affected. If the abscess grows in the direction of the so-called head turner muscle (sternocleidomastoid muscle), the neck appears significantly thicker on the affected side. Mastoiditis can usually only be observed in the extremely advanced stage of bacterial otitis media. However, since these can be treated relatively effectively with antibiotics these days, As a rule, a cure is achieved beforehand. Mastoiditis is usually massiveEarache and fever, and possibly accompanied by hearing impairment.
An abscess can also form in the area of the oral cavity or the pharynx and, in the worst case, spread from here in depth, for example towards the floor of the mouth. The floor of the mouth covers all the soft parts between the lower jaw and hyoid bone, such as the floor muscles of the geniohyoid and mylohyoid muscles. If the floor of the mouth is affected by an abscess, this may also lead to the feeling of a thick neck, whereby the abscess is often visible or palpable from the outside.
Cysts describe a tissue cavity in which body fluid collects so that a kind of blister forms. Neck cysts are due to a congenital malformation of the tissue inside the neck and often lead to a clearly visible swelling in the upper front neck area (median neck cyst) or to the side of the neck (lateral neck cyst or branchiogenic neck cyst). The cervical cyst is usually diagnosed in childhood.
If a cyst or abscess forms a connection to the outside or between two internal organs in the course of increasing internal pressure, this is referred to as a fistula. The accumulated liquid can escape via the tube-like connection. The symptoms are often similar to those of an abscess or cyst. A neck fistula may also show up as a thick neck.
Blood build-up in the throat veins
A thick neck can also be caused by a neck vein congestion. For example, the outflow of blood via the external jugular vein (external jugular vein) is impaired in the case of heart failure, which leads to a backflow of blood in the jugular vein. Thrombosis (occlusion by blood clot) of the jugular veins can also cause painful lateral swelling of the neck, whereby the internal (internal jugular vein) is usually affected rather than the external jugular vein. The accompanying symptoms of a blood congestion in the neck veins are rather non-specific and range from difficulty swallowing to swelling of the lymph nodes, hardening and tenderness of the affected veins to blood poisoning.
Tumors and other diseases in the neck area
Various benign tissue changes such as an atheroma (groats pouch), a lipoma (benign tumor from cells of the adipose tissue or adipocytes) and a fibroma (benign tumor from cells of the connective tissue or fibrocytes) can cause punctiform or areal thickening of the neck. These often show significant pressure pain when touched, but can also be painless. In addition to the benign formation of new tissues, malignant tumors of the soft tissues in the neck can also trigger a thick neck, but these so-called soft tissue sarcomas are extremely rare.
In the case of very severe forms of the Zenker diverticulum, a swelling on the neck becomes visible on the outside. (Image: bilderzwerg / fotolia.com)
Another disease that can cause a thick neck is the Zenker diverticulum. This bagging at the lower end of the throat before the transition to the esophagus can fill with food waste and cause noticeable swallowing difficulties. With extremely severe forms of this so-called pulsation diverticulum (sagging due to the internal pressure in the esophagus and garbage), swelling may also be visible externally on the neck.
diagnosis
In order to determine the causes of a thick neck, a detailed medical history should first be carried out, in the context of which a systematic questioning of those affected is carried out about the symptoms and possible previous illnesses. From this, you can usually already draw initial conclusions about the causes of a thick neck. An external examination of the head and neck area and an examination of the inner mouth, neck and throat area are then required. When scanning the lymphatic accounts and any visible external swellings, there are often further indications for the diagnosis. A look in the throat and ears quickly shows whether there is an inflammation. A classic throat swab and endoscopic examination of the inside of the neck can also provide important information for the diagnosis. If in doubt, a tissue sample is taken as part of the endoscopy (biopsy) to ensure the finding.
A blood test in the laboratory can be used to determine the level of inflammation as well as the thyroid hormone level and the blood values also provide information on a possible disease of the parathyroid gland. Imaging methods such as sonography (ultrasound examination), X-rays, magnetic resonance imaging (MRI), computed tomography (CT) or so-called scintigraphy (X-ray examination with the aid of a contrast agent) can help to diagnose a thyroid disease. With the help of imaging methods, other diseases, such as the salivary glands or esophagus, can also be detected. If mastoiditis is suspected, a reflection of the ear canal (otoscopy) is recommended before the findings are checked using ultrasound or computed tomography.
Fat neck treatment
The treatment of a thick neck depends on the respective underlying illnesses, with the spectrum of therapy options ranging from herbal care to medicinal treatment and surgical intervention.
Treatment for thyroid disorders
Diseases of the thyroid gland that are based on iodine deficiency are first treated with the additional administration of iodine. If this does not show the desired success, a so-called radio iodine therapy can follow, in which radioactive iodine isotopes are usually taken orally. At the same time, so-called thyrostatics may be used to inhibit the formation of thyroid hormones. However, these sometimes have considerable side effects (for example hair loss , itchy rashor even hepatitis). If the thyroid is inflamed, anti-inflammatory drugs come into play. If the medication does not work, thyroid surgery may be the last option. In the course of the surgical procedure, for example, parts of the enlarged thyroid or goiter (so-called stroma resection) or the entire thyroid (thyroidectomy) are removed. With thyroid cancer in particular, complete removal of the thyroid is usually provided. Disorders of the parathyroid gland may also require surgery.
Therapy of salivary gland diseases
In the case of viral infections of the salivary glands, the therapy is primarily based on the administration of anti-inflammatory and pain-relieving medication to relieve the symptoms until the infection has been overcome. Sugar-free chewing gum and sour candies are recommended to stimulate salivation, which should also wash out any existing saliva stones. Bacterial inflammation of the salivary glands is usually treated with antibiotics. If the inflammation of the salivary gland cannot be eliminated by conventional means, surgery remains the last resort of choice. Inflamed salivary glands are either completely or partially removed. If the treatment is otherwise unsuccessful, even blocking saliva stones can be exposed and removed by a cut at the gland exit.
Treatment of esophageal diseases
Since inflammation of the esophagus is often associated with a so-called reflux (reflux of gastric acid into the esophagus), this impairment must first be remedied as part of the therapy. Changing the diet and avoiding known risk factors, such as alcohol or tobacco, are intended to prevent further damage to the esophagus. Medications can also be used to inhibit gastric acid production. If the esophagus is massively narrowed due to the inflammation or if there are other complications, a (minimally invasive) surgical intervention is necessary to remove the affected tissue. If the esophagus is perforated (Boerhaave syndrome), an operation is also required in which the torn tissue is sewn. In the case of esophageal cancer, surgical removal is only possible in the earlier stages of the disease. In addition, radiation and various anti-cancer drugs can be used for treatment. However, the treatment prospects for advanced esophageal cancer are rather poor and the therapy aims above all to alleviate the symptoms in order to keep patient complaints as low as possible in everyday life.
Lymph node swelling
While most lymph node swellings are the result of a disease and quickly resolve with its treatment, a combination of surgery, chemotherapy and / or radiation therapy is still the only promising treatment option for malignant tumors in the lymphatic system (Hodgkin lymphoma).
Therapy options for abscesses and cysts
First, abscesses are usually treated with antibiotics. If they do not go back during treatment, surgical removal may be necessary, in which the abscess is opened and the encapsulated tissue or pus collection is removed. With mastoiditis, the mastoid process on the temporal bone is usually also removed in the event of surgical removal. In most cases, cysts require surgical removal, and the liquid they contain must first be aspirated so that no infections of the surrounding tissue threaten after the cyst is opened. Fistulas are also usually surgically removed.
Treatment for congestion in the neck veins
If thrombosis in the neck veins is caused by thrombosis, therapeutic countermeasures, such as the administration of blood-thinning and anticoagulant drugs, should be initiated as soon as possible. If thrombus lysis is unsuccessful, surgery remains to open the closed vein. However, if the neck vein congestion is due to heart failure, only an elimination of this insufficiency can remedy the problem. In addition to medication for high blood pressure and to stabilize the heart rhythm, operations on the heart, such as a bypass operation, a heart transplant or the use of a pacemaker, are also possible.
Therapy of tumors
Most benign neoplasms of tissue in the neck area can be removed relatively easily as part of a surgical procedure. For example, lipomas close to the skin can be cut out under local anesthesia. Suctioning may also be considered. If the lipomas cause no further symptoms apart from the visible swelling on the neck, an appropriate intervention is only necessary for cosmetic reasons. Fibromas and atheromas are also surgically removed if necessary.
In the case of soft tissue sarcomas, i.e. malignant tumors that develop in the soft tissue, the known combination of surgical removal of the tumor, radiation therapy and chemotherapy is available for treatment. Which methods are used essentially depends on the stage of the disease. If the tumor is discovered early, surgery may be enough to achieve a complete cure. In the later stage, radiation therapy or a combination of radiation and chemotherapy is also required. In the extremely advanced stage of the disease, with the formation of metastases that can already be observed, only palliative treatment (relief of symptoms, limitation of tumor growth) is still possible in order to enable those affected to have a daily life that is as symptom-free as possible.
Therapy of the Zenker diverticulum
When treating a Zenker diverticulum, surgical removal is possible based on different procedures. For example, the neck can be opened from the outside to remove the diverticulum. There is also the option of endoscopic surgery, but here the risk of relapse (recurrence of the disease) is significantly higher. However, the intervention can be repeated with relatively little effort.
Naturopathy for a swollen neck
Various naturopathic treatment approaches can be used to treat the underlying diseases with a thick neck. However, in the case of diseases such as esophageal cancer, these are at most suitable for accompanying treatment; in these cases, cure cannot be achieved with the alternative forms of therapy.
If a simple cold causes the thick neck, then phytotherapy agents that reduce irritation and help to cough up and dissolve phlegm, such as thyme or sage, are suitable. Here teas can be drunk with honey or sucked as sweets. If there is an inflammation of the larynx or pharynx behind the symptoms, therapy or self-treatment are also carried out according to the cause.
Naturopathy for thyroid diseases
In the case of thyroid diseases, from a naturopathic point of view, a change in diet is initially possible. For example, those affected are recommended to increase their intake of seafood and fish because they contain a high proportion of iodine. Acupuncture is also used to treat over- and under-functions of the thyroid gland. Bach flower therapy also promises relief here. Herbal medicine and gemmotherapy as their special form know some approaches for the treatment of thyroid dysfunction, for example bladder wrack with its high iodine content, valerian, hops, lavender or black birch. Orthomolecular therapy (treatment with high doses of vitamins and minerals), homeopathy and the use of Schuessler salts offer further naturopathic treatment approaches against thyroid diseases, although the choice of suitable active ingredients should always be reserved for experienced therapists.
Naturopathy for salivary gland diseases
Antibiotic treatment is usually essential for inflammatory salivary gland diseases, but accompanying home remedies , such as cooling compresses, can significantly reduce pain and counteract swelling. Sugar-free sweets, chewing gum and sour fruit juices stimulate saliva production, which means that the salivary glands can get rid of the bacteria better and the bacterial colonization in the mouth also decreases. To prevent inflammation of the salivary glands, according to the professional association of ear, nose and throat doctors, intensive oral hygiene is also advisable ( drinking and oral hygiene against salivary gland infection ).
Naturopathy for esophageal diseases
Naturopathy can make a significant contribution to eliminating reflux as a trigger of an esophageal disease. Initially, a change in diet or a waiver of alcohol, high-fat food and other strongly acid-forming foods is provided. Eliminating the existing acidity of the organism is a key component of naturopathic reflux treatment. The acid-base balance should be brought back into a balanced state. Various herbal active ingredients and mother tinctures (e.g. chamomile, lemon balm, calendula) are said to have a positive effect. The same applies to homeopathy and Schüssler salt therapy.
Naturopathy for lymph node swellings
Since lymph node swelling usually goes back to another disease, naturopathic therapy is directed primarily against these underlying diseases. However, medical massages, such as manual lymphatic drainage, can make swelling of the lymph nodes easier. A similar effect is said to be acupuncture or acupuncture massages according to Penzel. The regulation of the acid-base balance is often also taken into account in the naturopathic treatment of lymph node swelling, since a connection is suspected here. Various Schuessler salts are also used to facilitate the swelling of the lymph nodes.
For the rest of the underlying disease, which can be considered as a trigger for a thick neck, naturopathy offers little or no treatment options. An operation is often unavoidable here. Since there may be serious health consequences, sufferers should not hesitate to see a doctor. However, the naturopathic methods can be used to accompany the conventional treatment
