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When a node is felt under the armpit, many people fear that it may indicate a malignant cancer or another dangerous illness. Knobs under the arm are mostly due to relatively harmless causes such as sweat gland inflammation or infection. Accordingly, they often disappear on their own as soon as the body's own defense system has successfully combated the causative agents.
In rare cases, lymph node swelling can hide cancer, with breast cancer being of major importance. Therefore, especially long-standing knots should always be examined immediately by a doctor in order to identify the exact cause and to distinguish harmless from malignant swellings.
What are armpit knots?
If small "knobs" can be felt under the skin under the armpit, these are usually swollen lymph nodes (medical: nodus lymphoideus). This means small glands that act as "filters" for the tissue water (lymph). The nodes belong to the so-called "lymphatic system", which is an important part of the body's immune system (immune system). It consists of the lymphatic organs (such as the spleen, liver or tonsil tonsils) and lymphatic vessels.
Lymph nodes are located everywhere in the body (e.g. in the armpits, groin or neck) and are mostly embedded in fat or connective tissue. While the structure is always similar, the size can vary and range from approximately two millimeters to two centimeters. The watery-white lymph reaches the lymph nodes through several finest lymph channels (vasa afferentia), where it is cleaned of germs, foreign bodies or tumor cells and then returned to the bloodstream.
Normally, the nodes cannot be felt in healthy people. If they are swollen and subsequently noticeable, this is a sign that the immune system is active and is "in the fight" against an infection or certain pathogens.
Pain in knots under the arm
Swelling or nodular thickening under the armpit usually indicate a particularly active immune system that reacts to changes in the organism. Accordingly, the nodes are in most cases a signal for a disease or disorder - even if there are no other symptoms and / or the person concerned actually appears to be "healthy".
Nevertheless, swollen lymph nodes do not necessarily have to indicate a serious illness. Rather, in most cases they can be traced back to a relatively harmless reason. If the thickening is still palpable after a few days and is accompanied by further complaints such as pain, tenderness, fever, night sweats or weight loss, a doctor should always be consulted as a precaution. This can clarify the exact cause and initiate any necessary treatment measures.
Causes of lymph node swelling
Lymph node swelling can have various causes. These are by no means always serious, but instead are often relatively harmless. It is usually an indication of an infection, with the thickening usually feeling firm, very painful and very sensitive to pressure.
For example, the Epstein-Barr virus (EBV), which belongs to the herpes virus, comes into question. The RBV triggers the so-called "Pfeiffer glandular fever" (infectious mononucleosis), a common but mostly harmless viral disease. This is transmitted primarily via the mouth or while kissing, which is why the fever is called “kissing disease” in English and affects young people and young adults in particular.
Typically, an infection with the Epstein-Barr virus initially shows flu-like or cold-like symptoms such as headache, limb and sore throat, swallowing problems, mild fever, exhaustion and fatigue. At the same time, there is a swelling of the lymph nodes, whereby the neck and neck, but also the armpits and the chest or abdomen are particularly often affected.
Often there is an enlarged spleen (splenomegaly) and tonsillitis (angina tonsillaris), which is characterized by a reddened throat and heavily swollen, grayish-white tonsils (tonsils). In rare cases, enlargement of the liver and itchy rash are possible, as well as loss of appetite, dizziness and night sweats.
Inflammation of the lymphatic vessels and lymph nodes
Lymph node swelling in the armpits can be caused by inflammation of the lymphatic vessels and lymph nodes (lymphangitis). These arise, for example, from neighboring tissue infections that extend to the lymphatic system.
Another possibility is bacteria (especially streptococci or staphylococci), which penetrate the lymphatic system through an open skin wound and thus reach the lymph nodes. The main symptom of acute lymphangitis is a pressure-sensitive red stripe that extends from the area around the injury towards the heart. As a result, the inflammation is often incorrectly referred to as sepsis ("blood poisoning"). The lymph nodes in the immediate vicinity of the inflamed lymphatic vessel swell painfully, the skin is overheated and reddened. There is a risk that a purulent abscess will form.
Swelling of the lymph nodes in case of breast inflammation
A possible cause for the complaints is the so-called "mastitis", which is an inflammation of the (predominantly female) mammary or mammary gland (Greek: "mastos"). This usually occurs in breastfeeding women about two to four weeks after childbirth (mastitis puerperalis), but a disease is also possible regardless of the puerperium (mastitis non puerperalis).
In most cases, mastitis puerperalis is a bacterial infection with staphylococci or streptococci, which get into the body through small skin injuries to the nipple. The pathogens mainly come from the nasopharynx of the mother, father or other caregivers, who initially transmit them to the child through close physical contact. The breastfeeding then brings the bacteria to the mother's nipple. Since the wart often shows small injuries when suckling the baby, it offers an ideal "entry point" for pathogens.
Inflammation outside of breastfeeding can also be caused by a bacterial infection by entering the pathogens into the ducts of the mammary gland. In this case, the bacteria often encounter an optimal nutrient medium in the form of increased secretions (e.g. through the overproduction of prolactin), which builds up in the milk channels. Mastitis non puerperalis can also occur as a concomitant disease of another, usually chronic disease. Examples include tuberculosis, syphilis or fungal infections.
Breast inflammation is characterized by a burning sensation in the chest, pain, swelling and hardening on the affected side, as well as redness and overheating. At the same time, there is often swelling of the lymph nodes in the armpit, fever, chills and a general feeling of illness; in rare cases, purulent abscesses or fistulas develop. Symptoms are usually less pronounced with inflammation outside of breastfeeding, but there is a greater risk that mastitis will break out again.
Lymph node swelling in HIV infection
In rare cases, serious causes can also be considered for a thickening under the armpit. An acute HIV infection is conceivable, for example, in which symptoms similar to a cold (flu-like infection) often appear about one to six weeks after infection. These include limb, sore throat and headache, fever, diarrhea and vomiting. In addition, there are lymph node swellings that are sensitive to pressure pain and can occur in various parts of the body.
Breast cancer as a cause of armpit lumps
In an emergency, cancer can be considered in which cancer cells settle in the lymph nodes and cause them to swell. Breast cancer (breast cancer) is particularly relevant here, which is the most common malignant tumor in women with around 70,000 new cases each year. In rare cases, however, it can also affect men.
Breast cancer occurs much earlier than most other cancers. According to the Robert Koch Institute, around one in four of those affected is younger than 55 at the time of diagnosis, and one in ten women is even under 45. Breast cancer develops in the female mammary gland, although the exact causes have not yet been fully elucidated. However, there are a few known risk factors that may favor breast cancer. Above all, this includes an advanced age and certain benign changes in the breast tissue (mastopathy), but e.g. also childlessness, a late first pregnancy and a generally unhealthy lifestyle (high-fat diet, nicotine, alcohol etc.).
The problem with breast cancer is that it usually does not cause any symptoms for a long time and is therefore often only discovered through a medical examination or self-examination of the breast. Regular and careful assessment and palpation of the breast is therefore a very important part of cancer screening.
In addition to palpable nodules or hardening, a number of other changes can indicate a disease. These include the retraction of a nipple, a sudden difference in breast size, secretions from a wart and a noticeable swelling of the lymph nodes in the armpit, which cannot be attributed to other causes. In the advanced stage, there are usually other typical cancer signs and symptoms such as fatigue, weight loss, night sweats or fever.
Lymph node swelling due to other rare cancers
In rare cases, certain cancers, such as Leukemia (blood cancer) leads to swollen lymph nodes all over the body and thus also in the armpit (generalized lymph node swelling).
Likewise, the lymphatic system itself can be affected by a malignant disease (med .: "malignant lymphoma"), which is often colloquially referred to as "lymph gland cancer". These include the relatively rare cancer Hodgkin's disease (Hodgkin's lymphoma), which is mainly characterized by painless swelling of the lymph nodes. The thickening occurs primarily on the neck, neck, under the armpit and in the groin region. Other symptoms are possible, e.g. Fever, night sweats, weight loss, itching all over the body, persistent cough and back, stomach or chest pain.
Thickening under the armpit in non-Hodgkin lymphoma
In contrast to this, the term “non-Hodgkin lymphomas” includes all malignant diseases of the lymphatic system in which the typical characteristics of Hodgkin's disease cannot be detected by means of a histological examination (Sternberg-Reed cells or Hodgkin / Reed- Sternberg cells).
This includes a number of very different diseases such as Burkitt's lymphoma or chronic lymphatic leukemia (CLL), which also manifests itself primarily through painlessly swollen lymph nodes in the area of the neck, neck, armpit or groin. In addition, there are often non-specific symptoms such as Fever, weight loss, fatigue, paleness of the face, nausea or night sweats.
Other causes of hardening under the armpit
Swollen lymph nodes on the neck, armpits or groin are often associated with rheumatic diseases such as systemic lupus erythematosus (SLE). SLE is a relatively rare inflammatory disease of the connective tissue, which is one of the autoimmune diseases because the immune system is directed against your own body tissue.
Such a malfunction of the body's defense system is also the basis of rheumatoid arthritis (rheumatism). As a result, in addition to the typical symptoms such as Joint pain, swelling and morning stiffness of the joints, swollen lymph nodes occur.
Sweat gland or hair root inflammation is often the trigger for hardening under the armpit. Furthermore, intolerances to certain medications can be considered. These include penicillin and quinidine, which is used to treat some cardiac arrhythmias such as rapid heartbeat or atrial fibrillation.
Course and diagnosis of lymph node swelling
Since the nodes often appear in connection with infections or other harmless diseases such as sweat gland inflammation, no specific treatment is often necessary. Instead, the swellings usually go away on their own once the body's own defenses have successfully fought the pathogens. Nevertheless, both men and women should always have noticeable hardening in the armpit clarified by a doctor in order to prevent more serious diseases such as to rule out breast inflammation or breast cancer.
For the diagnosis, the doctor carries out a careful tactile examination (palpation) after the anamnesis in order to be able to get an exact picture of the knots in the armpit. If these do not go away on their own after a few days and / or show an enlargement or change, further steps are usually initiated to clarify the cause. These include blood or ultrasound examinations, in some cases a tissue sample (biopsy) is required to obtain more precise information or to be able to diagnose a disease safely.
Help and treatment for knots under the armpit
Therapy depends on the cause. For example, if there is an infection with the Epstein-Barr virus, in most cases the body will be able to successfully combat the disease by rest, sleep, as well as avoiding stress and physical exertion.
If necessary and after consultation with the doctor treating you, painkillers and antipyretic medications (ibuprofen, paracetamol etc.) can also be used. Antibiotics, however, are only indicated if a bacterial infection occurs in parallel. However, special care should be taken here, as certain broad-spectrum antibiotics (such as ampicillin) can cause an hypersensitivity reaction in the form of itchy skin rashes in whistling glandular fever.
The infection usually heals without consequences after about two months, complications are less common, e.g. an inflammation of the pericardium or a splenic tear. Pfeiffer's glandular fever can take a chronic course, which means that those affected suffer from an elevated temperature and physical exhaustion for months without an identifiable cause.
Treatment measures for breast inflammation
If the breast is inflamed in the puerperium (mastitis puerperalis) - regardless of its form - the fastest possible treatment is particularly important to prevent purulent encapsulated abscesses. Some women have the option of reducing the milk production of the affected breast with medication. In this case, the mother continues to breastfeed the child in order to empty the breast accordingly and not risk a milk jam. Thereafter, antibiotics can be used if necessary.
The non-drug therapy consists primarily in cooling the breast with curd wrap, ice packs or the like. Affected women should pay attention to a well-fitting and stabilizing bra. It is important to prevent further problems from learning a good breastfeeding technique, in which the baby always puts the whole areola in its mouth.
Anti-inflammatory ointments are possible, which are applied directly in the armpit. If the swelling is very advanced or an abscess has formed, surgery is necessary in some cases.
In most breast cancer patients, the removal of one or more lymph nodes from the armpit is an integral part of tumor surgery. This can be used to determine whether tumor cells have already spread. Furthermore, the removal of affected armpit lymph nodes should prevent further tumor growth in the armpit.
Lymphomas such as Hodgkin's disease also requires special tumor treatment, whereby the specific therapeutic measures depend on how far the disease has already progressed. In general, chemotherapy and radiation therapy, or a combination of both, can be used to destroy the affected tissue and fight cancer. Surgical treatment is not possible in this case, however, because Hodgkin's lymphoma is a systemic disease that does not remain restricted to a specific region of the body, but affects the entire organ system.
Important for knots under the skin: rest and strengthen the immune system
As a “filter station” for the tissue water, the lymph nodes belong to the body's immune system (immune system) and swell primarily in connection with an infection or inflammation. Lymph node swellings like this are usually benign and usually take an unproblematic course by going back on their own accord after the infection has passed.
Accordingly, in the case of noticeable thickening in the armpit, greater attention should be paid to protecting the body and strengthening the immune system in order to support self-healing in the best possible way. Sufficient fluid (at least 2 liters of water a day), sleep and (depending on your state of health) gentle exercise in the fresh air are important.
Nutrition plays a central role so that the immune system can work optimally. Among other things, an adequate supply of nutrients such as iron or zinc, vitamins and secondary plant substances is important. In general, care should be taken to ensure a balanced, high-fiber and low-fat diet. Eat lots of vegetables and fruits to help defend yourself.The main immune vitamins are:
- Vitamin A
is mainly in carrots, spinach, pumpkin, lamb's lettuce, celery, kale, bell pepper, chicory, dried apricots, honeydew melon
- vitamin C
You get plenty from lemons, oranges, kiwi, elderberry juice, sea buckthorn, black currants, rose hips, peppers, broccoli, tomatoes, spinach, Brussels sprouts and parsley
- Vitamin E.
is in wheat germ, soy and sunflower oil, nuts, linseed, salsify, cabbage and avocado
Recommended foods that strengthen the immune system are still almonds and spices such as ginger, cinnamon or caraway. The immune system is weakened e.g. Sugar, unhealthy fats (e.g. refined vegetable oils, lard), fast food and large amounts of red meat.
Support from nature with Schüssler salts
Schüssler salts can provide effective support for swollen armpit lymph nodes. Among others, salt 4 (potassium chloratum) comes into question, which can help with inflammation and unwanted side effects of vaccinations or medication.
Salt No. 11 (Silicea) is used to strengthen the tissue. Calcium phosphoricum (No. 2) is indicated for eczema and susceptibility to infection, as well as for regeneration and recovery after a long illness. Other suitable salts for a knot under the arm are potassium arsenicosum (No. 13), magnesium phosphoricum (No. 7) and sodium phosphoricum (No. 9).
Effective home remedies and naturopathic treatments
Manual lymphatic drainage can be very effective to support lymphatic flow and facilitate lymph node swelling. However, it should only be carried out by an experienced expert, because in certain cases this procedure may not be used. These include severe circulatory disorders, open wounds, febrile diseases, heart failure and an existing pregnancy.
Penzel (APM) acupoint massage is said to have a positive effect on the flow of energy in the body. In contrast to classic acupuncture, no needle-stick techniques are used. Instead, the patient works with external mechanical pressure by gently stroking the so-called “meridians” with a massage stick.
Aromatherapy is well suited for strengthening the body's defenses. The essential oils activate and support the immune system, have a harmonizing effect and can e.g. help fight colds. Fragrances of bergamot, eucalyptus, tyme or angelica (angelica) are recommended. Put a few drops of your preferred oils in the aroma lamp and place it in the room where you are most often. (No)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dipl. Social Science Nina Reese, Barbara Schindewolf-Lensch
- Falk G. Bechara; Schapoor Hessam: "Constantly inflammatory nodes and abscesses in the armpit and groin", in: MMW - medical progress, Volume 158 Issue 15, 2016, Springer Link
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- Ertan Mayatepek: Pediatrics: basics, clinic and practice, Urban & Fischer, 2019
- Sigrid Nesterenko: The underestimated Epstein Barr Virus: What to do if you have a chronic EBV infection, ersa Verlag, 2018
- Norbert Suttorp; Martin Mielke; Wolfgang Kiehl; Burghard Stück: Infectious diseases arise, recognize, treat, Thieme, 2004