Thick neck

Treatment, causes and complaints

A swollen or thick neck can be caused by a variety of factors. As serious illnesses, such as thyroid cancer, may also be present in these cases, urgent medical help should be sought in recurring or prolonged complaints to determine the causes of the thick neck.

Contents:
definition
Symptoms and complaints
Causes thick neck
Thyroid diseases and other diseases
Diseases of the esophagus
lymphadenopathy
Abscesses, fistulas and cysts
Blood flow in the neck veins
Tumors and other diseases in the neck area
diagnosis
treatment
Treatment for thyroid disorders
Therapy of salivary gland diseases
Treatment of esophageal diseases
lymphadenopathy
Therapeutic options for abscesses and cysts
Treatment for congestion in the jugular veins
Therapy of tumors
Therapy of the Zenker diverticulum
Naturopathy with a swollen neck

definition

The term "Thick neck" is generally not only for actually visible external swelling of the neck or noticeable internal impairments, but is also colloquially used for the emergence of massive anger or annoyance. However, this article is exclusively devoted to medically related complaints.

Symptoms and complaints

The symptoms of a thick neck include not only visible swelling and redness but also a feeling of tightness, internal tension and pain in the neck. Often, the affected feel habitual garments, such as ties, Rollkrangenpullover or shirts as uncomfortable tight. According to the different causes of a thick neck, numerous accompanying symptoms, such as fever, headache, hoarseness, the sensation of a lump in the throat, loss of appetite, hair loss and neck tension, are discussed in more detail in connection with the respective causes.

Causes thick neck

The causes of a thick neck include acute infections and inflammations as well as chronic diseases of the internal organs. In the worst case, the symptoms may be due to a life-threatening cancer.

Thyroid disorders can cause significant swelling in the neck and require surgery. (Image: ladahunt / fotolia.com)

thyroid disease

Thyroid disease is a common cause of a thick neck. The thyroid located below the larynx in the anterior region of the neck can have various diseases that are accompanied by swelling of the organ which is clearly visible from the outside ... For example, in the case of iodine deficiency, a so-called goiter (goiter) forms in the area of ​​the thyroid gland. This can be accompanied by both hyperthyroidism (hyperthyroidism) and hypothyroidism or normal thyroid function. In addition to the iodine deficiency are also known as autoimmune diseases of the thyroid such as Graves disease, certain drugs, cysts in the thyroid and benign and malignant tumors as causes of a goiter.

In rare cases, sarcoidosis (Boeck's disease) can be the cause of a goiter.This systemic connective tissue disease causes tissue formation (granulomas) in different parts of the organism, but usually affects organs such as the lungs, heart or liver. Amyloidosis is also a rare cause of goiter or thick neck. This intracellular incorporation of altered proteins leads to corresponding thickening of the neck. In addition, an infestation with parasites trigger a goiter, but this describes a hardly occurring disease in this country.

parathyroid disorders, such as hyperplasia (enlargement due to increased cell division) or adenomas (benign tumors in the gland), are also associated in rare cases with external swelling of the neck.

In the case of thyroid hormone secretions, cardiac tusks, sweating and significant weight loss despite high appetite can be observed as accompanying symptoms in the case of thyroid disorders. The muscles sometimes appear weak and those affected are at increased risk of osteoporosis. Thyroid hypofunction or insufficient secretion of thyroid hormone leads to weight gain, lower heart rate and dry skin. In addition, there may be psychological problems ranging from rather harmless concentration problems and tiredness to depression.

Diseases of the salivary glands

Different diseases of the salivary glands come into consideration as a trigger for a thick neck. Here are primarily diseases of the three major salivary glands - parotid gland, submandibular gland and Unterzungen salivary gland - to call. But diseases of the numerous smaller salivary glands, such as the cheek glands, tongue glands, palate glands or molar glands, can lead to the feeling of a thick neck. Here, bacterial and viral infections as well as possible blockages by so-called salivary stones or tumors are known as more frequent triggers of corresponding salivary gland diseases.

Bacterial salivary gland infections are usually due to 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 a blockade of the glandular outlet with salivary stones. The blockage in turn leads to a 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, the most well-known viral infection being the salivary gland mumps. In most cases, the mumps viruses infest the parotid glands, which among other things leads to a massive swelling of the face. Also the neck appears clearly swollen in some patients. Since mumps can also affect the pancreas, accompanying symptoms such as abdominal pain, nausea and vomiting are not uncommon. The disease often results in life-threatening meningitis (meningitis). Since today most children in Germany are vaccinated against mumps, the number of illnesses in this country is relatively low. However, other viruses, such as the Epstein-Barr virus or influenza viruses that infect the salivary glands and cause here a corresponding sialadenitis.

As autoimmune diseases, which can lead to inflammation of the salivary glands and a correspondingly thick neck, the Sjögren syndrome may be mentioned. In addition, malignant (for example, adenoid cystic carcinoma) and benign (for example, pleomorphic adenoma) tumors can form in the salivary glands, causing a marked swelling of the neck.

Diseases of the esophagus

Various diseases of the esophagus lead to an internal feeling of tightness, which is also felt by those affected as a thick neck. However, these diseases are usually not recognizable as external swelling. Here are, for example, inflammation of the mucous membranes in the esophagus (esophagitis), Boerhaave's syndrome with spontaneous perforation of the esophagus, the so-called Killian-Jamieson diverticulum (outgrowth of the upper sphincter of the esophagus) or esophageal cancer (esophageal carcinoma). Outwardly recognizable, however, the thick neck in these diseases, as a rule, not. Typical accompanying symptoms of oesophageal disease include difficulty in swallowing and burning pains that can drag from the neck to the back of the groin.

Swelling of the lymph nodes can often be palpated from the outside in the neck area. (Image: Two Brains Studios / fotolia.com)

lymphadenopathy

The lymph nodes on the neck swell slightly in the course of many diseases. This quite 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 pressure sensitive and significantly enlarged. They can also lead to dysphagia and may cause respiratory distress. A corresponding swelling of the lymph nodes, in particular the Kieferwinkellymphknoten and tonsils (almonds), is to 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 involves an unpleasant swelling of the lymph nodes. Measles, rubella and rotavirus infections usually also cause lymph node swelling. Above all, fever and sore throat can serve as evidence of an underlying infectious disease in a thick neck.

The lymph nodes can also be the direct source of illness. For example, so-called Hodgkin lymphomas (malignant tumors in the lymphatic system, see Hodgkin's disease) may form. The affected lymph nodes initially swell up painlessly and without any further typical symptoms, before further symptoms such as disorders of the nervous system or the hormone balance show up.

Abscesses, fistulas and cysts

Under certain circumstances, abscesses (encapsulated pus accumulation in the tissue), which lead to an externally visible swelling, also form in the neck area. Staphylococci are the most common causes of chronic abscesses that spread in the tissue before the body wraps the affected area with granulation tissue to prevent further spread. Inside, the tissue is decomposed and pus forms.

A particular form of abscess is observed in severe cases of bacterial otitis media - the so-called mastoiditis. It manifests as acute inflammation with fluid accumulation behind the ear. On the mastoid process (mastoid process) of the temporal bone, the mastoiditis is usually visible as massive swelling and redness. In the face of increasing pressure inside the abscess, it begins to break outward 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 much thicker on the affected side. The mastoiditis is usually observed only in the extremely advanced stage of bacterial otitis media. However, since these can be treated relatively effectively with antibiotics nowadays, a cure usually already succeeds. Mastoiditis is usually accompanied by massive earache and fever, and possibly impaired hearing.

An abscess may also form in the area of ​​the oral cavity or the pharyngeal area and spread from here in the worst case, for example, towards the floor of the mouth. The floor of the mouth comprises all soft tissues between the lower jaw and the hyoid bone, such as the muscles of the floor muscles, the geniohyoid muscle and the mylohyoid muscle. 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 not infrequently also visible or palpable from the outside.

Cysts describe a tissue cavity in which body fluid accumulates, forming a type of bladder. Cervical cysts are the result of a congenital malformation of the tissue inside the neck and often lead to a clearly visible swelling in the upper anterior cervical area (medial cervical cyst) or laterally of the neck (lateral cyst or branchiogenic cervical cyst). Most of the cervical cyst is detected in childhood.

When a cyst or an abscess forms a connection to the outside or between two internal organs as a result of the increasing internal pressure, it is called a fistula. Through the tubular connection, the accumulated liquid can escape. The symptoms are often similar, as with an abscess or a cyst. A neck fistula may also be noticeable as a thick neck.

Blood flow in the neck veins

A thick neck can also be caused by cervical venous stasis. For example, the outflow of blood via the external jugular vein is disturbed in cardiac insufficiency, which leads to a backflow of the blood in the jugular vein. A thrombosis (obstruction by blood clots) of the jugular veins can cause a painful lateral swelling of the neck, which is usually more likely to affect the internal (internal jugular vein) than the external jugular vein. The concomitant symptoms of congestion in the jugular veins are rather nonspecific and range from dysphagia, lymphadenopathy, hardening and pressure sensitivity of the affected veins to blood poisoning.

Tumors and other diseases in the neck area

Various benign tissue changes such as an atheroma (Grützbeutel), a lipoma (benign tumor from cells of adipose tissue or adipocytes) and a fibroma (benign tumor from cells of the connective tissue or fibrocytes) can cause punctate or flat thickening of the neck. These often show a significant pressure pain when touched, but can also be painless. In addition to the benign tissue neoplasms, malignant tumors of the soft tissues in the neck can trigger a thick neck, but these so-called soft tissue sarcomas are extremely rare.

In very severe forms of the Zenker diverticulum a swelling of the neck becomes visible on the outside. (Image: bilderzwerg / fotolia.com)

Another disease that can cause a thick neck is the Zenker diverticulum. This bulge at the bottom of the pharynx before the transition to the esophagus can fill with food debris and bring with it noticeable dysphagia. In extremely severe forms of this so-called Pulsiondivertikels (Aussackung due to the internal pressure in the esophagus and trash) may also be visible externally on the neck swelling.

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 concerned about the symptoms and possible previous illnesses takes place. As a rule, first conclusions about the causes of a thick neck can be drawn from this. Subsequently, an external examination of the head and neck area and an examination of the internal oral, throat and throat area is required. When palpating the lymph nodes and any visible external visible swelling, there are often other clues to the diagnosis. A look through the ears and throat quickly reveals the possibility of inflammation. A classic throat swab and the endoscopic examination of the inside of the neck can also provide important information on the diagnosis. In case of doubt, a tissue sample is taken during the endoscopy (biopsy) to confirm the findings.

On the basis of a blood test in the laboratory can be found in addition to the inflammatory levels and the thyroid hormone levels and the blood also provide evidence of a possible disease of the parathyroid gland. Imaging techniques such as sonography (ultrasound examination), X-rays, magnetic resonance imaging (MRI), computed tomography (CT) or so-called scintigraphy (X-ray examination with a contrast agent) can help to confirm the diagnosis of thyroid disease. With the help of the imaging techniques can also detect other diseases, such as the salivary glands or esophagus. If a mastoiditis is suspected, it is advisable first to mirror the ear canal (otoscopy) before ultrasound or computed tomography can be used to check the findings.

treatment

The treatment of a thick neck depends on the respective underlying diseases, with the spectrum of therapeutic options ranging from a herbal medicine care through the drug treatment to a surgical intervention.

Treatment for thyroid disorders

Thyroid disorders that are due to iodine deficiency are first treated by the additional administration of iodine. If this does not show the desired success, a so-called radioiodine therapy may follow, in which radioactive iodine isotopes are usually taken orally. Accompanying so-called antithyroid drugs may be used to inhibit the formation of thyroid hormones. However, these sometimes have significant side effects (for example, hair loss, itching rash or even hepatitis). If the thyroid gland is inflamed, anti-inflammatory drugs come to the train. If the drugs have no effect, thyroid surgery may be the last option. In the course of the surgical procedure, for example, parts of the enlarged thyroid or the goiter (so-called Strumaresektion) or the complete thyroid (thyroidectomy) are removed. Especially in thyroid cancer is usually a complete removal of the thyroid provided. Parathyroid disorders may also require surgery.

Therapy of salivary gland diseases

In viral infections of the salivary glands, the therapy is based primarily on the administration of anti-inflammatory and analgesic drugs to relieve the symptoms until the infection is over. Sugar-free chewing gums and sour candies are recommended to stimulate saliva production, which should also wash out any existing saliva stones. Bacterial inflammations of the salivary glands are usually treated with antibiotics. If the inflammation of the salivary gland can not be eliminated in a conventional way, surgery remains the last resort of choice. Inflamed salivary glands are either completely or partially removed. Even blocking salivary stones can be uncovered and eliminated in otherwise unsuccessful treatment by a cut at the gland exit.

Treatment of esophageal diseases

Since inflammations of the esophagus are often associated with a so-called reflux (reflux of gastric acid into the esophagus), it must first be remedied in the context of therapy, this impairment. By changing the diet and avoiding known risk factors, such as alcohol or tobacco, further damage to the esophagus should be prevented. Also drugs can be used to inhibit gastric acid production. If the esophagus is severely constricted due to inflammation or other complications threaten, a (minimally invasive) surgical intervention to eliminate the affected tissue is required. Even with a perforation of the esophagus (Boerhaave syndrome), an operation is required in which the torn tissue is sewn. In esophageal cancer, however, surgical removal is only possible in the earlier disease stages. Accompanying radiation and various anti-cancer drugs for treatment in question. In advanced esophageal cancer, however, the treatment prospects are rather poor and the therapy is aimed primarily at alleviating the symptoms in order to keep the symptoms of the patients in everyday life as low as possible.

lymphadenopathy

While most lymph node swelling is a consequence of a disease and quickly disappears with its treatment, a combination of surgery, chemo- and / or radiotherapy is still the only promising treatment option for malignant tumors in the lymphatic system (Hodgkin's lymphoma).

Therapeutic options for abscesses and cysts

Initially, abscesses are usually treated with antibiotics. If they do not return in the course of the treatment, an operative removal may be necessary in which the abscess is opened and the encapsulated tissue or the pus accumulation is removed. In the case of mastoiditis, in the case of surgical removal, the mastoid process is usually also removed on the temporal bone. In most cases, cysts require an operative removal, whereby the liquid contained must first be sucked off, so that after opening of the cyst no infection of the surrounding tissue threatens. Fistulas are usually also removed surgically.

Treatment for congestion in the jugular veins

If the congestion in the jugular veins is caused by a thrombosis, therapeutic countermeasures, such as the administration of blood-thinning and anticoagulant drugs, should be initiated as soon as possible. If the lysis of the thrombus fails, the possibility of surgery to reopen the occluded vein remains. However, if cervical venous stasis is due to cardiac insufficiency, only removal of this insufficiency can correct the problem. For this purpose, in addition to medicines for high blood pressure and to stabilize the heart rhythm and heart surgery, such as a bypass surgery, heart transplantation or the onset of a cardiac pacemaker into consideration.

Therapy of tumors

Most benign tissue neoplasms in the cervical region are relatively easy to remove in the course of a surgical procedure. For example, skin-like lipomas can be excised under local anesthesia. Also, suction may be considered. If the lipomas cause no further discomfort apart from the visible swelling on the neck, a corresponding procedure is only necessary for cosmetic reasons. If necessary, fibroids and atheromas are also surgically removed.

In soft tissue sarcomas, ie malignant tumors that arise in the soft tissue, the known combination of surgical removal of the tumor, radiotherapy and chemotherapy is available for treatment. Which methods are used depends essentially on the stage of the disease. If the tumor is detected early, surgery may be sufficient to achieve complete healing. In the later stage, radiotherapy or a combination of radiotherapy and chemotherapy is additionally required. In the extremely advanced stage of the disease, with already observed metastasis, only a palliative treatment (alleviation of symptoms, limitation of tumor growth) is possible in order to enable those affected a symptom-free everyday life. However, many patients with an incurable soft tissue sarcoma still survive relatively long (significantly more than five years).

Therapy of the Zenker diverticulum

In the treatment of a Zenker diverticulum surgical distances based on different procedures are possible. For example, an opening of the neck can be made from the outside to eliminate the diverticulum. There is also the option of endoscopic surgery, but the risk of relapse (recurrence) is much higher. However, the procedure can be repeated with relatively little effort.

Naturopathy with a swollen neck

Various naturopathic treatment approaches can be used to treat the underlying diseases of a thick neck. However, in diseases such as esophageal cancer, these are maximally suitable for concomitant treatment; in these cases, healing can not be achieved with the alternative forms of therapy.

Should a simple cold cause a thick neck, phytotherapy remedies may be used to reduce the irritation and help to cough up and release mucus, such as thyme or sage. Here tees can be drunk with honey or sucked as sweets. Insert a laryngitis or pharyngitis behind the symptoms, therapy or self-treatment also according to the cause.

Naturopathy in Thyroid Diseases
For thyroid disorders, from a naturopathic point of view, a change in diet is the first option. For example, those affected are advised to eat more seafood, as they contain a high proportion of iodine. Acupuncture is also used to treat overactive and underactive thyroid glands. The Bach flower therapy promises relief here as well. Herbal medicine and gemmotherapy as their special form, know some approaches to the treatment of thyroid dysfunction, for example, bladderwrack with its high iodine content, valerian, hops, lavender or moor birch are used. Orthomolecular therapy (treatment with high dosages of vitamins and minerals), homeopathy and the use of Schüssler salts offer further naturopathic treatment approaches against thyroid disease, but the selection of the appropriate active ingredients should always be reserved for experienced therapists.

Naturopathy in salivary gland diseases
For inflammatory salivary gland diseases, treatment with antibiotics is usually essential, but concomitant home remedies, such as cooling envelopes, can significantly reduce pain and counteract swelling. Sugar-free candies, chewing gum and sour fruit juices stimulate saliva production, which makes it easier for the salivary glands to free themselves from the bacteria, and also for bacterial colonization in the oral cavity. In order to prevent inflammation of the salivary glands, according to the professional association of the ENT doctors also an intensive oral hygiene is advised (drinking and oral hygiene against salivary gland infection).

Naturopathy in oesophageal diseases
Naturopathy can make a significant contribution to the elimination of the reflux as a trigger of a gullet disease. First, a change in diet or a waiver of alcohol, high-fat food and other strong acid-producing foods is provided. The elimination of the existing acidity of the organism is a key component of the naturopathic treatment of reflux. The acid-base balance should be restored to a balanced state. Various herbal remedies and mother tinctures (for example, chamomile, lemon balm, marigold) are here a positive effect. The same applies to homeopathy and the Schüssler salt therapy.

Naturopathy with lymph node swelling
As lymph node swelling usually goes back to another disease, the naturopathic therapy is directed primarily against these underlying diseases. However, medical massages, such as manual lymphatic drainage, can facilitate lymph node swelling. A similar effect is said to acupuncture or the acupuncture massages according to Penzel. The regulation of the acid-base balance is often taken into account in the naturopathic treatment of lymph node swelling, since a connection is suspected here. In addition, various Schüssler salts are used to facilitate the swelling of the lymph nodes.

Naturopathy offers few to no treatment options for the remainder of the underlying disease, which may be the trigger for a thick neck. An operation is often necessary here. Since there may be serious health consequences, sufferers should not hesitate to see a doctor. However, naturopathic procedures can be used concomitantly with conventional treatment. (Fp)