Lumps on the Back of the Neck Near the Spine: When to Worry and When It’s Normal

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lump pain on the back of the neck near the spine

Finding a lump on the back of your neck near the spine understandably causes concern. However, not all neck lumps are dangerous or harmful. Many turn out to be benign fatty tumors, muscle knots, or cysts that do not require intensive treatment. 

According to Kaly medical experts, the emergence of any new lump warrants examination to determine the underlying cause. But in general, neck lumps are common and often non-threatening

Is a lump on the back of the neck near the spine normal, or should I be concerned?

Discovering any new lump or mass is always an appropriate reason to have it medically evaluated. Neck lumps are quite common, but not considered inherently “normal.” The neck contains a complex matrix of muscles, nerves, lymph nodes, and blood vessels – any of which can contribute to lump formation when aggravated or disrupted. 

According to Kaly specialists’ experience, the emergence of a new neck lump warrants examination to determine the underlying cause. This is particularly important if the lump is painful, rapidly growing, or accompanied by other worrisome symptoms.

The Premier Neurology & Wellness Center also highlights the role of neurologists in diagnosing and treating disorders affecting the nerves, brain, and spinal cord. It emphasizes that neurologists can effectively determine if neck pain is caused by nerve damage or compression.

While neck lumps are not always a major concern, it is crucial to partner with your doctor to diagnose the exact cause and rule out potentially serious conditions that require treatment. 

The McGovern Medical School at UTHealth Houston explains that neck pain can be diagnosed through a variety of methods, including medical history, physical examination, and various imaging studies such as X-rays, MRIs, CT scans, and electromyography.

What could be causing a knot on the back of my neck near the spine?

Common causes of knots or tightness near the neck spine include muscular issues like trigger points, strains, and imbalances, as well as benign growths like lipomas and cysts, swollen lymph nodes from infection, and nerve compression from spinal disorders irritating the cervical muscles.

Our medical experts have prepared this table for your better reference:

Common Causes of Neck Lumps Near the SpineKey Details
Trigger Points/Muscle KnotsHyperirritable spots within muscles that cause stiffness and soreness. Can form in neck muscles due to strain, poor posture, injury, or repetitive motions.
LipomasBenign fatty tumors that form soft, movable lumps under the skin. A frequent cause of neck lumps.
Sebaceous CystsDevelop from clogged oil glands/hair follicles and create round, firm neck lumps under the skin that are often painless.
Enlarged Lymph NodesCan swell due to immune response to infections, forming lumps in the neck.
Muscle StrainPostural imbalances strain neck muscles, which may respond by forming knotted trigger points.

A study titled “Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective” discusses the role of Myofascial Trigger Points (MTrPs) in myofascial pain syndrome (MPS). MTrPs are described as hard, discrete, palpable nodules in a taut band of skeletal muscle that may be spontaneously painful or painful only on compression. These MTrPs can develop as a result of muscle overuse in cervical and postural muscles during low-intensity activities of daily living and sedentary work, leading to muscle strain.

A study titled “Lipoma of the Neck” published by NCBI discusses lipomas, which are benign tumors that are usually found in the subcutaneous tissue. They are usually painless and slow-growing, but in rare cases, lipomas can grow significantly and infiltrate musculature, leading to symptomatology and an indication of surgical treatment.

A book titled “Epidermoid Cyst” explains that sebaceous cysts, also known as epidermoid cysts, are benign encapsulated, subepidermal nodules filled with keratin material. They are most commonly located on the face, neck, and trunk, but can form anywhere on the body. These cysts are usually asymptomatic; however, if ruptured, they may resemble a furuncle with tenderness to palpation, erythema, and swelling.

A study titled “Diagnostic Difficulties in Evaluation of Neck Masses – Idiopathic Lymph Node Infarction” the evaluation of neck masses, including enlarged lymph nodes. The study presents several cases where lymph node infarction was the only symptom, with no associated condition occurring. This study was conducted by a team of researchers and presented three cases of neck lymph node infarction.

In general, muscular and structural issues in the neck area are the most common source of knots and lumps near the spine.

How do I distinguish between a painful and non-painful lump on the back of my neck near the spine?

Painful lumps are more likely to warrant priority evaluation, as pain can signal inflammation or irritation of sensitive structures. Asymptomatic or non-painful lumps still require professional examination. However, they present less immediate concern. Benign fatty tumors like lipomas commonly cause no pain, nor do sebaceous cysts.

Merck Manuals explains that neck lumps may be painful or painless depending on what has caused them. Painful lumps could be due to infections, an enlarged salivary gland, or an enlarged thyroid gland. It also mentions that cancerous lumps are more common among older people, but they may occur in younger people. The cancerous lump may be a cancer of a nearby structure, such as the mouth or throat, that has grown into the neck. Cysts, which are hollow, fluid-filled masses, are usually harmless unless they become infected.

The American Academy of Family Physicians (AAFP) mentions that a persistent neck mass in an adult should be considered malignant until proven otherwise. It also states that squamous cell carcinomas of the upper aerodigestive tract are the most common primary neoplasms of the head and neck, and their metastases are often the source of cervical lymphadenopathy of unknown origin. Lymph nodes associated with malignancy are usually firm, fixed, and matted.

It’s vital to monitor lump-related pain patterns, especially increased pain. Worsening pain may indicate an infected cyst, a lipoma that has expanded to put pressure on nerves, or possible cancerous change.

Some painful lumps have benign origins, like muscle knots. But sudden onset of pain or detecting a new painful mass merits prompt medical assessment.

Essentially, while painless lumps are not emergencies, painful ones warrant higher-priority evaluation.

Can a lump on the back of the neck near the spine be harmless, even if it’s painful?

Yes, according to Kaly medical experts, some painful neck lumps near the spine still have harmless origins. Examples include:

Spinal nerve irritation 

Minor inflammation of a cervical nerve root exiting the spine can cause localized pain. This is often harmless.

An NCBI study discusses the case of two patients with benign bone tumors of the cervical spine who experienced persistent neck pain. The study suggests that benign tumors can cause pain due to their encroachment into the spinal canal or neuroforamina, which can lead to nerve irritation. However, the study also emphasizes that such tumors are rare and that most neck pain is not due to serious pathology

Lipoma pain 

While typically painless, a lipoma can sometimes grow and put pressure on nerves, potentially causing mild pain.

Another study published in the NCBI describes a case where a lipoma was causing pain by compressing the sciatic nerve. While this case involved the hip rather than the neck, it demonstrates that lipomas can potentially cause pain if they grow large enough to press on nearby nerves.

Should I be worried about a small lump on the back of my neck near the spine?

lump pain on the back of the neck near the spine

In general, smaller lumps present less concern. However, other factors beyond size determine a lump’s severity. Small lumps may still require medical assessment to rule out problems.

Key considerations from Kaly providers surrounding small neck lumps include:

  • Size alone does not dictate whether a lump is non-threatening. Some serious growths begin small.

A study with the subject “Management of lateral neck masses in adults” states that more than 75% of lateral neck masses in patients older than 40 years are caused by malignant tumors. The study also emphasizes the importance of fine needle aspiration cytology in diagnosing neck masses, especially in the absence of overt signs of infection. This study suggests that any lump, regardless of size, should be evaluated by a healthcare provider to rule out serious conditions like cancer.

  • Many common small lumps like lipomas, cysts and lymph nodes are harmless. But it’s essential to verify this through evaluation.

An article by Lawrence Otolaryngology Associates states that neck lumps are common and most often harmless, but there are a few types of lumps that could be a sign of a more serious condition. The article also mentions that lipomas can resemble a type of cancer called liposarcoma, further emphasizing the need for medical evaluation of any lump.

Consult a Kaly doctor if you discover any lump near the neck spine. Together you can determine if a “wait and see” approach is appropriate based on its characteristics, or if further diagnostic steps should be taken.

Is there a connection between poor posture and a lump on the back of the neck near the spine?

Yes, Kaly medical providers confirm that poor neck and upper back posture often contributes to lump formation near the spine. When the head tilts forward, the cervical spine drifts out of alignment. This places chronic mechanical stress on the muscles and connective tissues. 

Common postural habits that can spark neck lumps include:

Forward head posture 

Holding the head protruded forward of the shoulders shortens the back of the neck muscles. This encourages knots and trigger points to develop.

Dr. Candice Price from the Cleveland Clinic states that poor posture is the most common cause of a dowager’s hump. This condition results from a chronic, forward-leaning posture that’s too common in our world of computer screens and other devices. 

Over time, a habit of poor posture can cause you to develop an abnormal curve of your upper vertebrae. Weak muscles of the upper back and neck, as well as tight muscles in the neck and chest, often cause this forward-leaning humped posture.

Another study conducted by Lau et al. found a positive relationship between sagittal postures of the thoracic and cervical spine and neck pain. The study concluded that forward head posture (FHP) and thoracic kyphosis were accompanied by neck pain.

Shoulder slumping 

Droopy, slouched shoulders roll the spine forward out of ideal curvature in the upper back and neck. Muscles must overwork to support the misaligned spine.

A study on “Dropped Shoulder Syndrome,” a condition that can cause lower cervical radiculopathy, found that compression of the cervical roots by muscle spasm could be a cause of the syndrome. 

The study suggested that a diagnosis of dropped shoulder causing lower cervical radiculopathy is based on a visually detectable dropped shoulder and is supported by X-ray and electromyography (EMG) abnormalities.

What should I do if I discover a painful lump on the back of my neck near the spine?

Seek prompt medical attention if you detect a new painful lump near the cervical spine. A study published in the journal “Otolaryngology–Head and Neck Surgery” emphasizes the importance of timely diagnosis of a neck mass due to metastatic head and neck squamous cell carcinoma (HNSCC), as delayed diagnosis can worsen the prognosis.

Recommended steps include:

  • Contact your healthcare provider to arrange priority evaluation of the lump. Pain indicates some form of irritation requiring assessment.
  • Noting and tracking characteristics of the lump like size, texture, appearance, and any changes.
  • Reporting associated symptoms that accompany the lump, such as impaired nerve sensations, stiffness or spasms, discharge or bleeding.
  • Undergoing a physical exam of the neck and lump followed by appropriate diagnostic testing. This may involve imaging like an ultrasound, CT scan, or MRI to visualize the lump’s anatomy.
  • Discussing options for treating the source of the pain based on the diagnostic results. These will vary depending on the cause.
  • Asking your provider to refer you to a specialist like a surgeon, neurologist, or oncologist for targeted treatment if specialized care is needed.

Are there any home treatments for a lump on the back of the neck near the spine?

For some types of neck lumps, Kaly providers recommend complementary self-care between doctor visits to help manage discomfort. However, these do not replace medical treatment. 

Suggested conservative home remedies include:

  • Applying a cold pack wrapped in a towel to numb mild lump-related pain and swelling. Use for 10-15 minutes several times per day.

A narrative review published in the National Center for Biotechnology Information (NCBI) discusses the use of cold and compression in managing musculoskeletal injuries and post-operative procedures. The review suggests that the application of cold can suppress the metabolic rate of the surrounding soft tissue, reducing blood flow and swelling. This can alleviate pain and speed up functional recovery.

  • Taking over-the-counter non-steroidal anti-inflammatory medications like ibuprofen to temporarily reduce inflammation causing pain and lump enlargement.

A meta-analysis of prospective cohort studies published in the NCBI indicates that non-steroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, can significantly reduce the risk of head and neck cancer. This suggests that these medications can help manage inflammation and pain associated with neck lumps.

  • Gently massaging and stretching knotted neck muscles after applying heat through a warm compress. Use light pressure and avoid direct massage of solid neck lumps.

Medical News Today explains that the neck is a common site for muscle pain and tension, which can lead to the formation of muscle knots. Massage can help with these knots, and gentle neck stretches, frequent breaks, and good posture can also be beneficial and may prevent muscle knots from forming.

  • Performing gentle neck rotations and stretches to release muscle tension potentially exacerbating the lump. Avoid overstretching or straining the neck.

The same article on Medical News Today also suggests that gentle neck rotations and stretches can help release muscle tension that might exacerbate the lump.

  • Improving posture through targeted neck exercises prescribed by a physical therapist. Poor posture contributes to neck muscle knots.

A single-blinded randomized controlled trial found that thermotherapy combined with neck stabilization exercises can effectively alleviate pain and improve somatosensory function in individuals with chronic neck pain. This suggests that targeted neck exercises can help manage discomfort associated with neck lumps.

When should I seek medical attention for a lump on the back of my neck near the spine?

Kaly providers recommend seeking prompt medical evaluation for any neck lump near the spine that is painful, growing rapidly, hard, or has attached to the skin

A study on primary bone tumors of the cervical spine found that neck pain is a common presenting symptom for these tumors, which can go undiagnosed for months to years.

A case report of a cervical rib presenting as a hard, immobile lump in the neck emphasizes the importance of considering this rare cause when assessing neck lumps.

Additionally, a study on soft tissue neck lumps in rugby union players discusses the development of dorsal neck masses in these athletes, which can be misdiagnosed as lipomas but may actually be fibrous and deeply connected.

Again, don’t delay seeking expert advice if your lump is:

  1. Painful 

Pain is a worrying symptom warranting investigation to determine the cause. Do not wait to see if pain worsens or spreads.

  1. Growing quickly 

Rapid enlargement indicates potentially aggressive or dangerous abnormal tissue growth needing analysis.

  1. Very firm or hard 

Rock-hard lump consistency raises concerns about possible malignancy and other disorders. Have it examined urgently.

  1. Adhered to skin 

Lumps that are immobile or attached to skin surface are unable to be pressed beneath the skin. This is a red flag for assessment.

  1. Associated with numbness 

Tingling or loss of sensation can mean a lump is putting pressure on nerves.

Found a Neck Lump? Get Peace of Mind Through Kaly’s Expert Medical Guidance

consultation on lump pain on the back of the neck near the spine

Discovering a new lump on your neck understandably causes anxiety. However, not all lumps are cause for alarm. Many turn out to be harmless fatty tumors, muscle knots, or cysts. Kaly equips you to make informed, proactive decisions about your neck lump. 

Tracking the lump’s characteristics and being evaluated promptly when concerning symptoms appear allows for early treatment if required. Our network of medical experts can efficiently diagnose the cause of your neck lump, providing the answers and high-quality care you deserve. 

We encourage you to utilize Kaly as an ongoing resource as you navigate next steps for lump assessment and pain relief. Through education and physician access, you can address your neck lump in a timely, thorough manner.