A swollen gland is almost always your immune system doing its job. Lymph nodes filter infection, and when they are working hard they enlarge. In a review of unexplained lymph node enlargement in American Family Physician (Gaddey and Riegel, 2016), the large majority of cases seen in general practice were reactive and settled on their own. The useful question is not "why is it swollen" but "how long has it been there, what does it feel like, and what else is happening".
Most swollen glands from a throat infection, cold or ear infection settle within two to four weeks. A gland that persists beyond that, keeps growing, feels hard and fixed, or sits just above the collarbone should be examined promptly. A phone consultation is £59, a video consultation from £150, and a same-day urgent in-person assessment is £220.
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The common causes, in order of likelihood
Infection explains most swollen glands. Throat infections, colds, ear infections, dental problems and skin infections near the node are the everyday causes. Glandular fever (infectious mononucleosis) classically causes larger, tender nodes in the neck with a prolonged fatigue. Less common causes include immune conditions and, in a small minority, cancer such as lymphoma. That minority is exactly why the pattern matters more than the lump itself.
The features that change the answer
Location. Nodes above the collarbone (supraclavicular) are taken more seriously at any age and warrant prompt assessment. Neck, armpit and groin nodes after local infection are usually reactive.
Feel. Tender, soft, mobile nodes suggest infection. Hard, fixed, painless nodes need examining.
Duration. Reactive nodes settle within two to four weeks of the illness. Persistence beyond four weeks without a clear cause needs assessment.
Company. Night sweats that soak clothing, unexplained weight loss, persistent fever, or an inexorable fatigue change the picture. NICE guidance (NG12) lists unexplained lymph node enlargement among the findings that warrant a suspected cancer pathway referral, particularly with these systemic features.
What a doctor actually does at the appointment
The examination takes minutes and answers most of the question. Your doctor maps which nodes are enlarged, checks the throat, ears, teeth and skin that drain to them, feels the liver and spleen, and takes the history that separates a reactive node from one that needs testing. Where testing is right, first-line bloods are a full blood count and inflammatory markers, with infection screens where the history suggests them. Ultrasound is the first imaging step for a persistent node. Most people leave with reassurance and a review date. A minority leave with a fast referral, made the same day.
WhatsApp us a photo and timeline of the swelling | or call 020 3951 3429
Free checklist: before your appointment
Note when you first felt the node and whether it is still growing.
List recent illnesses, dental work, travel, and new medicines.
Weigh yourself if you can, and note drenching night sweats or fevers.
Feel for other nodes: both sides of the neck, armpits, groin.
Write down what you fear it is. It changes what your doctor rules out first.
When it is not us
A hard, growing supraclavicular node, or a node with drenching night sweats and weight loss, belongs on an urgent pathway, and where that is the right route we arrange it the same day. Swollen glands with severe throat swelling, difficulty swallowing saliva or breathing need emergency care, not an appointment.
Ready when you are: WhatsApp, call 020 3951 3429, or email team@thewellnesslondon.com
Frequently asked questions
Q: How long is it normal for a swollen gland to last?
A: Nodes swollen from a throat or ear infection usually settle within two to four weeks of the illness. A gland that persists beyond four weeks, keeps growing, or feels hard and fixed should be examined.
Q: Are swollen glands a sign of cancer?
A: Rarely. The large majority in general practice are reactive to infection (Gaddey and Riegel, American Family Physician, 2016). The features that raise concern are persistence, a hard fixed feel, a supraclavicular location, and systemic symptoms such as drenching night sweats or weight loss.
Q: Can this be assessed by video?
A: Partly. A video consultation covers the history, visible inspection and most of the risk assessment, from £150. If examination or same-day bloods are needed, an urgent in-person appointment is £220.
Q: Will I need a scan or biopsy?
A: Most people need neither. A persistent unexplained node is usually assessed with blood tests and an ultrasound first; biopsy is reserved for the small number where imaging and bloods do not settle the question.
References
Gaddey HL, Riegel AM. Unexplained lymphadenopathy: evaluation and differential diagnosis. American Family Physician, 2016.
NICE Guideline NG12. Suspected cancer: recognition and referral. 2015, updated.
Reviewed by The Wellness Clinical Team. Last updated 18 October 2026.