Swollen Glands or Lymph Nodes With Fibromyalgia and ME/CFS

A woman in pain clutches the side of her neck.
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Swollen glands are a fairly common feature of fibromyalgia (FMS), and of the similar disease chronic fatigue syndrome (ME/CFS) as well.

In most cases, we associate swollen glands with getting sick—having acute illnesses such as the flu or the common cold. When your glands puff up, it's a sign that your immune system is working hard to destroy some kind of pathogen in your body, such as a virus or bacteria, pumping out specialized cells that seek out and destroy the things that are attacking you.

It's fairly normal for swollen lymph nodes to ache, even in "healthy, normal" people who are fighting an illness, so they're especially likely to hurt those of us with FMS. That's because of one of the defining characteristics of this illness: our low pain threshold, which is defined as the point at which your brain perceives a sensation as painful. Some people with ME/CFS may have lowered pain thresholds as well.

That feeling of "unwellness" that may accompany the swelling is very likely to mean that you've picked up some acute illness, or that your body is having a harder time than usual in the battle against longer-term pathogens. (Some researchers believe that these conditions, especially ME/CFS, may involve this kind of slow-burning or "smoldering" chronic infection by one or more pathogen.)

What Are Lymph Nodes?

The "glands" that people refer to when they talk about swollen glands are actually lymph nodes, which are little bundles of capsules that contain immune cells. In FMS and ME/CFS (possibly more so in ME/CFS), they're often a symptom of a chronically active immune system—your body is increasing its number of white blood cells to fight off the bug, so the area gets puffed up with them.

However, especially in FMS, they may also be a consequence of what some researchers describe as thick or sluggish bodily fluids. Lymph is a fluid that contains white blood cells, which are key players in your immune system, and moves through your body's lymphatic system. In FMS, the lymph that would normally pass through easily seems to get backed up. We have lymph nodes throughout the body, in these locations:

  • Under the jaw & chin
  • In the groin
  • In the armpits
  • Down both sides of the neck
  • On either side of the spine on the back of the neck
  • On either side of the thyroid gland in the front of the neck
  • Behind the ears
  • On the back of the head

If you have swelling or pressure in the center of your neck, it could be a problem with your thyroid gland, not just a lymph node. Be sure to have your doctor check that out right away as it could be a serious problem that needs to be treated.


Swollen lymph nodes don't require any treatment just because they're swollen. However, if they're painful, you have several options for easing the pain:

  • Heat and/or ice, possibly alternating (Try different combinations to see what helps most.)
  • Ibuprofen, other NSAIDs or other pain medications
  • Manual lymph drainage (a type of massage) if it appears to be stagnant lymph

If you suspect you have pain in one or more lymph nodes, keep track of how you're feeling. Have you been sick recently or exposed to someone who was sick? Are you more tired than usual? Note any upswing or other changes in symptoms and talk to your doctor about it.

If you opt to treat painful nodes with manual lymph drainage, be aware that it's a form of deep-tissue massage and the massage therapist will likely use a lot of pressure. That's not something all of us with these conditions can handle.

Clear communication about your pain levels and about the after-effects of manual lymph drainage are essential for successful treatment that doesn't exacerbate your other symptoms. Make sure you're going to a therapist who understands the unique features of these illnesses.

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