Bumps and Lumps at the Back and Side of the Neck

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Published: November 19, 2016
Last reviewed: June 16, 2017

A bump is a small raised area of the skin caused by an abnormal tissue on the skin surface or within the skin. Common causes of small red bumps at the back of the neck are insect bites, ingrown hair and bacterial folliculitis. Epidermoid cysts and shingles are rare. Larger red bumps include boils and skin cancer.

A lump is an abnormal mass of tissue under the skin, which can appear normal or reddish. Soft lumps at the back of the neck include infected swollen lymph nodes, lipomas, buffalo humps and congenital abnormalities, such as angiomas. Hard lumps include muscle knots, bone spurs and cancerous lymph nodes.

A. Small Red Bumps or Rashes (<1 cm)

Folliculitis - red bumps at the back of the neck1. Bacterial Folliculitis

Bacterial folliculitis is an infection of the hair follicles. It appears as itchy acne-like pimples (red bumps with white centers). It can heal on its own in few weeks; a topical antibiotic, such as mupirocin, can speed up healing..

Picture 1. Bacterial folliculitis: small red bumps with white centers (source: Raimo Suhonen, DermNetNZ, CC license)

2. Ingrown Hair (Razor Bumps)

Ingrown hair (razor bumps) usually appears as a group of small (1-3 mm) red or dark brown bumps and hair loops–hair exiting and re-entering the skin. Ingrown hair mostly occurs on a recently shaved skin in people with curly hair. Prevention is by avoiding shaving close to the skin.

Lice bites - red bumps on neck3. Lice Bites

Lice bites can cause multiple flat red itchy bumps at the back of the neck. One or more small (~1 mm) white lice are usually tightly attached to the hair (dandruff, which can look similar, is only loosely attached).

Mosquito or other insect bites can cause similar red bumps.

Picture 3. Lice bites – red bumps at the back of the neck (source: Wikimedia, CC license)

Shingles (herpes zoster) with red bumps at the back of the neck4. Shingles

Shingles (Herpes zoster) appears as a group of translucent, itchy and burning blisters surrounded by the reddened skin on either right or left side of the neck and shoulder. Shingles results from a reactivation of the Varicella-zoster virus, that has remained in the roots of the spinal nerves from the previous infections. Eventually, the vesicles crust over and heal in several weeks. Antiviral ointments can speed up healing.

Picture 4. Shingles (Herpes zoster) at the back of the neck (source: Samuel Freire da Silva, MD, Dermatology Atlas)

Folliculitis keloidalis - red bumps at the nape of the neck5. Folliculitis Keloidalis

Folliculitis keloidalis is inflammation of the hair follicles of an unknown cause, which appears with red bumps, usually on the nape of the neck. It is more common in dark-skinned people than in whites. The condition can persist for years.

 

Picture 5. Folliculitis keloidalis on the nape of the neck (source: DermNet NZ, CC license)

B. Large Red Bumps (>1 cm)

Carbuncles - red bumps at the back of the neck1. Boil (Furuncle, Carbuncle)

A boil appears as a red, tender bump with a white center or opening. Smaller boils (furuncles) are pea-sized and larger ones (carbuncles) can be cherry-sized or bigger. Some boils can spontaneously drain pus. A boil is caused by an infection of the hair follicles, usually by the bacterium Staphylococcus aureus or, sometimes, with methicillin-resistant Staphylococcus aureus (MRSA) [2].

Picture 6. Carbuncles: fleshy bumps at the back of the neck (source: Wikispaces, CC license)

An inflamed epidermoid cyst - red bump at the back of the neck2. Epidermoid Cyst

Epidermoid cyst is an overgrowth of the cells from the uppermost skin layer (epidermis) in the deeper skin layer (dermis). A cyst, which develops slowly, usually does not cause any problems, but when inflamed, it can have a fleshy appearance and can be tender or painful [3]. A cyst can have an opening that oozes a greasy material. The size of the cyst can range from few millimeters to few centimeters. Treatment is by surgical removal [4].

Epidermoid cysts are often wrongly referred to as sebaceous cysts. True sebaceous cysts (steatocystomas), which develop from the sebaceous glands, are rare.

Picture 7. Epidermal inclusion cyst – a firm lump at the back of the neck (source: Steven Fruitsmaak, Wikimedia, CC license)

Keloid at the back of the head3. Keloid

Keloid is a scar-like overgrowth that develops as a reaction to an ingrown hair, injury or surgical wound. It occurs in genetically predisposed individuals, mainly in dark-skinned people. Some keloids can partially heal on their own. Treatment can include emollients, steroid injections, surgical removal or a topical chemotherapeutic mitomycin-C [8,9].

Picture 8. Keloids appear as raised fleshy plaques (source: Samuel Freire da Silva, MD, Dermatology Atlas)

Cancer red bump at the back of the neck4. Skin Cancer

Basal cell carcinoma is a type of skin cancer that appears as a raised plaque or nodule on sun-exposed areas, mainly on the face and back of the neck. It usually develops in older individuals who have been commonly exposed to sunlight, for example, fishermen and farmers. The tumor can ulcerate and can be locally aggressive but rarely spreads to distant areas. Treatment can include various ointments, cryotherapy, radiotherapy and surgical excision [10].

Picture 9. Basal cell carcinoma as a large ulcerated plaque at the back of the neck (source: Samuel Freire da Silva, MD, Dermatology Atlas)

C. Soft Lumps

Lumps grow under the skin.

1. Injury

A direct hit to the back of the neck can cause a bruise – a soft, tender lump that changes color from red to purple, black, green and brown or yellow.

A whiplash injury, fall or other cause of strain of the neck muscles can cause soft, tender lumps at the nape of the neck.

Swollen lymph node a lump at the back of neck2. Swollen Lymph Nodes

The most common cause of swollen lymph nodes at the back or side of the neck are bacterial or fungal infections of the head and neck skin, systemic viral infections in children (flu, pharyngitis) and seborrheic dermatitis. Soft lumps at the hairline (at the base of the skull) develop within several days after onset of infection; they are covered by normal or reddened skin and have well-defined borders. The lumps, which can be painless or painful, have no openings in the skin.

Picture 10. Swollen lymph node (the lump below the ear) caused by a tick bite (the dark spot behind the ear) (Wikimedia, CC license)

Lipoma a large lump at the back of the neck3. Lipoma

A lipoma is a slow-growing benign tumor of the fat tissue that grows under the skin. It usually appears as a soft lump with normal overlying skin that slips over the lump. Its size can range from few to more than 15 cm. Usually, it does not cause any symptoms, but it can interfere with the neck movements. Treatment is by surgical removal.

Picture 11. Lipoma as a large lump at the back of the neck (source: Dr. Ghorayeb, MD, Ghorayeb.com, CC license)

Buffalo hump - neck lump4. Buffalo Hump

Buffalo hump is excessive fat in the form of a soft dome-shaped bulge at the nape of the neck. It can develop in Cushing’s syndrome or other conditions with increased release of the hormone cortisol and after prolonged treatment with steroids [1]. The excessive fat can be surgically removed.

Picture 12. Buffalo hump – a big soft lump at the back of the neck as a side effect of highly active antiretroviral therapy (HAART) of HIV/AIDS (source: Journal of Medical Cases, CC license)

5. Congenital Abnormalities in Children

Cystic hygroma is a congenital abnormality in children; it appears as a large soft lump in the neck; it can exceed 10 cm [6].

Cervical meningocele - a lump at the back of the neckMeningocele, a type of spina bifida, is a congenital abnormality of the spine and spinal cord; it appears as a fluid-filled sac, which can exceed 10 cm [7].

 

Picture 13. Cervical meningocele at the back of the neck in a small child (source: Neurology International, CC license)

D. Hard Lumps

1. Muscle Knot (Myofascial Pain Syndrome)

Muscle knots appear as pea-sized rubbery nodules covered by normal skin. The causes include overuse of the muscles in the neck (trapeziuslevator scapulae), bad posture and painful conditions in the neck, such as a herniated disc. The knots may not be visible but can be palpable under the fingers.

2. Bone Spur (Osteophyte)

Bone spurs at the back of the neck appear near the vertical midline of the neck as small, hard and fixed lumps. They are usually not visible but can be palpable. They represent an overgrowth of the bone tissue of the spine. They can result from osteoarthritis (cervical spondylosis) or rheumatoid arthritis or an injury. They by themselves do not cause any symptoms, but when they press upon the spinal nerves, they can cause pain, tingling and numbness in the neck, shoulder or upper arm (cervical radiculopathy). Symptoms of arthritis include neck stiffness and swelling of the joints, mainly in the hands. Bone spurs can be detected by an X-ray, but for a diagnosis of the underlying disorder, an MRI is usually required.

3. Cervical Kyphosis

Cervical kyphosis is an abnormal outward curvature of the neck spine with a hump at the nape of the neck [11]. Common causes include:

  • A congenital abnormality (present from birth)
  • A dowager’s hump, which develops in some individuals with forward head posture (mainly in older women)
  • Degenerative disc disease or spinal osteoarthritis
  • A fracture of the upper thoracic or lower cervical vertebra due to osteoporosis or bone tumor (can occur without pain) or injury

An X-ray or MRI may be needed to get a diagnosis.

4. Cancerous Lymph Nodes

“Stone-hard” pea-sized and fixed lumps near the hairline can be cancerous lymph nodes. Such nodes usually result from a spread of cancer on the scalp or back of the neck. Lymph nodes affected by lymphoma usually have a rubbery consistency.

5. Spinal Tumors and Pseudotumors

Tumors and pseudotumors in the cervical spine appear as hard lumps near the neck midline.

Bone tumors can arise from the vertebra or intervertebral discs or can spread to the spine from other organs [14].

A pseudotumor can be caused by tuberculosis of the cervical vertebra [13].

 

55 Responses to Bumps and Lumps at the Back and Side of the Neck

  1. Gail Drake says:

    I had extravasion on both of my upper arms from CT contrast & MRI contrast while ER Dr was looking for bleeding on the brain in early Oct of this year, as I had a TIA. The CT showed small scattered cervicle nodes(?). I was admitted for Observation and sent home the next day. My labs then, and since then have shown Ovalocytosis, Neutropenia with bands, Esinophilia, and my RBC is borderline low. I had painful, swolken nodes from the front and back of my neck, on my clavicle, under my arm and down to my elbow. Even a swollen node on my mid back between my scapula and spine and a funny sensation across my lower abdomen with some pain. Now all nodes, but a few, have gone down and not painful. A Hematologist is ordering new labs and a periferal smear. Do I have anything to be concerned about or could it be sequae from the extravasion?

  2. James says:

    James says: November 12, 2017 at 5:51 pm
    Thanks for the previous reply, This is an update, the lump has not gone but lower down from the lump, below the hairline and slightly left of the center of my neck I can feel another lump beneath the surface. This lump is pea sized, not really risen above the surface, slightly hard, immobile and painful when pressed in. I am very worried, do you have any ideas? I also found this lump a few days ago. I am 17 years old.

    Reply

    • Gerald says:

      Wow James I have the exact issue. Mine is well was lower but seems to have moved more up to the base of head. It’s like near my spine per say. Now it hurts when I press on it. I’m freaked out about also.im going to ask my doctor tomorrow again about it. Last time he gave me antibiotics thinking it might be an infection. those didnt help. I’ve had it for like a yr. I just thought it was the way I was sleeping, bit I’ve bought neck pillows and everything and now that it’s starting to hirt when I press on it has me really worried. Well even more so. I’ll try and let u know what my doctor says.

  3. Danielle says:

    Hi Jan sorry for asking but I’m extremely worried, I have a small (between pea and marble sized) lump as hard as bone at the top of the back of my neck. The lump can move from all the way from the right side of the top back of my neck to the left side horizontally.

    When it’s in the centre it feels like bone as I described, but when it moves to the side it goes under the muscle of my neck and I can’t feel it directly – I only feel something under the muscle.

    To elaborate – this bump can not be felt on top of the skin, I can only feel the bone by pressing it with my fingers when it’s in the center. When it’s under the muscle on the side however, I can feel a slightly elevation of the skin there that goes away when I turn my head to the centre. (It also doesn’t hurt at all)

    I’ve felt other’s people’s neck and seemingly they don’t have it. I also think I have poorer posture than the average person and spend a lot of time hunched over, if that helps.

    Does this sound like anything unusual to you and should I go to the doctor? Or is this just a normal part of the cervical spine (i.e. axis bone)?

    • Jan Modric says:

      Normal spinal vertebra, including the axis, do not move horizontally that way. I’m pretty skinny and I can’t feel any hard lump from my upper cervical vertebra. Next, did you have any neck injury from which you would suspect you have a broken vertebra? Or you have a long-term heavy osteoporosis? You don’t mention any pain, so a fracture is unlikely.

      A lipoma, epidermoid cyst, muscle knot or an enlarged lymph node could be possible. All these things can be movable; an enlarged lymph node sounds most likely to me. Such lymph node can be completely normal. Or it can appear as a reaction to a small injury or infection on the back of the scalp. It doesn’t sound very likely that this would be from cancer.

      A muscle knot comes from excessive exercise or bad posture. Applying pressure to the knot would likely trigger pain and you would likely have neck pain from bad posture, anyway.

      So, yes, it is a bit unusual and I didn’t answer what it is or is not. You may want to go to check this with a doctor.

      • Danielle says:

        No, as far as I know I’ve suffered no neck injury; I haven’t had any neck pain and I’ve never actually broken anything so doubt it would be osteoporosis. I’m glad you think it most likely isn’t cancerous, I know cancerous bumps are usually immobile so hopefully it’s an easily solvable problem as you listed instead.

        Thank you so much for helping me, I really appreciate you taking time to answer our questions. I’ll go to the doctor’s ASAP.

  4. James says:

    I have a small marble sized soft/hard round lump that is not visible. It is not painful nor tender, it is at the left side of the base of my skull where the top of the neck reaches the base of the skull. Any ideas of what this could be/ whether it is serious? I am 17 years old.

    • James says:

      Skin seems normal over the lump and I only noticed it 3 days ago.

      • Jan Modric says:

        Common causes of such a lump are a muscle knot, swollen lymph node, an epidermoid cyst and lipoma (a benign tumor made of fat). They are all described above in the article. An epidermoid cyst would likely have a small opening, which would allow squeezing a greasy material out of it.

        These things are not dangerous, but an enlarged lymph node could be from an infection or, theoretically, from a cancer. I suggest you to go and check this with a doctor.

        • James says:

          Thanks for the previous reply, This is an update, the lump has not gone but lower down from the lump, below the hairline and slightly left of the center of my neck I can feel another lump beneath the surface. This lump is pea sized, not really risen above the surface, slightly hard, immobile and painful when pressed in. I am very worried, do you have any ideas?

          • James says:

            I only found this lump a few days ago.

          • Jan Modric says:

            If it’s more than one lump it’s possible they are enlarged lymph nodes. I can’t say from here what it is and is it dangerous or not. I suggest you go and check this with a doctor.

  5. vicki says:

    Is it true that if there is a swelling about 4 1/2″ below the base of the skull, directly in the middle of spine, is not hard, appx size of nickel, perfectly round, that it could be a thyroid issue?

  6. Robert Meyer says:

    I have a fleshy painful lump directly at the top center of the back of my neck. It appeared suddenly last night after I had been resting my head on the couch for a long period of time. It seems to be able to be massaged out, but it re-forms right away. Is this just a muscle knot, or is it something I should be concerned about? Thanks.

    • Jan Modric says:

      Regarding you said it’s in the upper back center of the neck, it could be also something related to the spine or base of the skull. I would probably go to the doctor in such case.

  7. Janie says:

    I have an small like pink-ish lump on my lower back to my left side. It’s like hard but soft too. It’s the size of an pea. It do kinda hurt around the area of the bump. And when you press on it, it does hurt too. Should I go see an doctor.

  8. Becky says:

    2 days ago I started having pain in the bottom left side of my head in my hairline. I felt a penny sized hard lump and a few smaller lumps underneath the larger one. There is no redness of my skin or any marks. I thought at first it was just a bit, but there should be some sign of a mark if that was the case. And I had a few people check. They all say the same they feel it but couldn’t find any marks. A week ago I did start a new yoga workout. Not sure if that has anything to do with it or not. This is very painful like a mirgrane going up the left side and down into my neck. The pain today is worse then yesterday. Does anyone know what this could be? Please help. I can’t afford to go to the Drs if it’s nothing.

    • Becky says:

      And painful when touched.

    • Jan Modric says:

      Have you been doing any specific exercises for neck that put a lot of strain there? In this case, muscle knots (as part of myofascial pain syndrome) can develop. Muscle knots are usually painful if you press on them and the pain typically radiates out.

      I should very clearly say that the bumps could be also swollen lymph nodes and I can’t help you differentiate between the nodes and knots. Painful nodes are usually from an acute infection (in your case this could be on the back part of the scalp or outer ear).

      Both muscle knots and lymph nodes are usually covered by normally looking skin.

      You may know some health worker who can check the bumps and guide you further.

  9. Darrell says:

    I have some gristle type knots on the back left side. They are moveable, but make my neck very stiff. I’ve had them for about 5 years now, and I’m starting to feel them on the left side of my neck.

  10. Lee Evans says:

    I have two lumps at the bottom of th back of my head on the. Right hand side and one on the side of my head that one has had loads of puss coming out of it and it feels like neck if stiff wet and painfull should i get it checked out

  11. JO says:

    I have one small (marble size) fleshy lump on the left hand side of my neck when I am layer on my side I can feel it but when I am stood up straight I cannot I am sat down a lot not sure if it is bad posture. help??

    • Jan Modric says:

      I suggest you to get this checked by a doctor. It could be an enlarged lymph node or lipoma, for example, which can sink deeper when you change the position.

  12. Angela davis says:

    I have had what started as 3 small knots about the size of a bug bite very sore they went down and one stayed and seemed to be getting better my husband said it looked like maybe a tick had bit me and i scratched it off all of a sudden i got 2 more and they are at the base of scull and down the back of my neck on left side only they are sore bad and fill like they are tight and very sore what could it be anyone who looks says it looks like a small red spotswe opened the skin and only clear fliud help

  13. TG says:

    I have one firm very moveable marble size lump on left side of neck and 2 small hard ones on right side of neck
    Had them for at least 2-3 years
    No other symptoms expect Sore neck and what feels like inflammation on to of shoulder area
    Any thoughts

    • Jan Modric says:

      If they are there for 2-3 years and not growing fast, they could be cysts or lipomas, for example. But go and check with a doctor. The smaller ones could be also muscle knots.

  14. Mr Musa says:

    The lymph node about the upper the main neck on right hand side.Caused of swollen lymph node at the side of neck was infections on the head already abscesses bursted recently.The lymph abscess bursted inside and urine and stools has comes out with abscess ,I vomiting abscess too. Pls help

  15. Samantha says:

    I have a pinkish bump on my side with a crusty layer of skin over it. It feels soft and when I touch it, it feels puffy and like there is nothing underneath it.

  16. Robert Mason says:

    Hi, I recently noticed four lumps on the right side of my neck, ranging from pea size to cherry size, they go from the nape of my neck to my hairline and are fairly solid, however they can be pushed around, I’m fairly concerned as I’m only 17

    • Jan Modric says:

      Please go to a doctor who can examine you and tell more reliably than I what it is. They could be enlarged lymph nodes, for example. Just go to the doctor soon.

  17. May says:

    Hi! I recently discovered a hard, small, painful bump on the back of my neck close to my ear. I have several lymph nodes and they feel and look nothing like this. This is not visible but can be felt with your fingers. It hurts when touched :(. I am 17 years old. Does this sound serious?

    • Jan Modric says:

      It can still be a swollen lymph node. Not all nodes feel the same. A common cause of such lumps is an epidermoid cyst, which has a small opening in the center and allows squeezing the oil out of it.

  18. JANICE says:

    I have large fluid like lump on the back of my neck. I have noticed more and more now a pain at the bottom half of my back at the left hand side. Also I’ve noticed when I stand up at times my feet feel like my toes are curled and take a few steps before they flatted out. It’s like a crap feeling which probably unrelated to the lump

    • Jan Modric says:

      Please go to a doctor who can tell what is the nature of the lump – in most cases, such lumps are cysts or benign tumors, like lipomas.

      The pain in the lower back and cramps in the feet can occur in a herniated disc in the spine in the lower back. Again, ask a doctor.

  19. Violet says:

    Can I see what is the cure for the lump and bumb at the back of your neck

  20. David says:

    I’ve had a”lump” on the back of my neck just above the hair line for some time now, probably close to a year. I have no insurance and my family physician wanted to send me to a specialist which I can’t even start to afford. So I’ve just dealt with it. It doesn’t hurt, it’s just aggravating, and embarrassing when people notice it. Well I got out of the shower a while ago and sat down near my wife and she started looking at it, and then started picking at it. After a minute or two she said, “There’s something black inside”. After some more digging, she started pulling out a wad of hair. I kid you not, my knot had hair in it. It’s kinda gross, I know. She got quite a bit out, some of them were pretty long, and now it feels better. Anybody ever heard of such a thing?

    • Jan Modric says:

      Cysts that contain hair include ingrown hair, dermoid cyst (search online) and pilonidal cyst – bu this occurs mainly above the tailbone and less likely in the scalp.

  21. Beth L Lamont says:

    I have in the baseline of my neck a slight raised area about an inch in diameter. I call it a ridge because it is raised on both sides and concaved in the middle.

  22. Joe Schmidt says:

    Hi, my posture is relatively bad and has been for a while and am currently 18, there’s a hard, static bump in my neck that I can’t feel if my head is lying back, if I stand straight it’s subtle but can be felt by rubbing my neck, and if I slouch it’s more noticeable.

    I’m asking here because I only really became conscious of it recently, and am currently travelling

  23. paul says:

    I have some neck pain also some under arm pain,and sore shoulder blade all symptoms are on the right hand side of the body advice on weather it could be a muscle problem or something more serious

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