Pain from Submandibular Lymphadenitis: Duration and Relief - Internal Medicine

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Severe pain in the submandibular lymph nodes?


Hello, I have been experiencing pain only in the area below my ear, and it has gotten so severe that I was awakened by the pain the night after it started, making it difficult to sleep.
The day before, I visited a clinic, and they diagnosed me with lymphadenitis.
I have been taking medication for a day, and while the pain is somewhat alleviated after meals, I still wake up in the middle of the night due to the pain.
How long does it typically take for lymphadenitis to improve? Is it normal to still experience significant pain at night after taking medication for a day?

Nura, 10~19 year old female. Ask Date: 2021/06/18

Dr. Lin Wufu reply Internal Medicine


Hello: Lymphangitis often takes nearly a week to show significant improvement! Additionally, be cautious about the possibility of a bacterial infection or mumps, among other conditions.
Medication can help alleviate pain, but it may not provide immediate relief.
It is recommended that if there is no noticeable improvement after taking medication for more than three days, you should visit a hospital or return to your original clinic for a follow-up.
Besides adjusting anti-inflammatory and analgesic medications, it is also necessary to evaluate for other differential diagnoses.

Reply Date: 2021/06/18

More Info


Submandibular lymphadenitis, which is an inflammation of the lymph nodes located beneath the jaw, can cause significant discomfort and pain. The symptoms you are experiencing, including pain that disrupts your sleep, are common in cases of lymphadenitis. The duration and relief of symptoms can vary based on several factors, including the underlying cause of the lymphadenitis, the effectiveness of the treatment, and individual patient factors.

Typically, lymphadenitis can be caused by infections, which may be viral or bacterial in nature. If the lymphadenitis is due to a bacterial infection, symptoms may improve within a few days of starting appropriate antibiotic therapy. However, if the underlying cause is viral, the symptoms may take longer to resolve, as viral infections generally have a self-limiting course.

In your case, since you have been taking medication for only one day, it is not unusual to still experience significant pain, especially at night. Pain that awakens you from sleep can be particularly distressing and may indicate that the inflammation is still quite active. It is important to continue taking the prescribed medication as directed, and you may also consider using additional pain relief methods, such as over-the-counter pain relievers (e.g., ibuprofen or acetaminophen), unless contraindicated by your healthcare provider.

As for the duration of recovery, it can vary widely. Some patients may start to feel relief within a few days, while others may take a week or more to notice significant improvement. If you do not see any improvement after a few days of treatment, or if your symptoms worsen, it is crucial to follow up with your healthcare provider. They may need to reassess your condition, possibly perform additional tests, or adjust your treatment plan.

It is also worth noting that persistent pain, especially if it is severe and unresponsive to medication, may warrant further investigation. This could include imaging studies or laboratory tests to rule out other potential causes of your symptoms, such as abscess formation or other complications.

In summary, while it is common to experience significant pain with submandibular lymphadenitis, especially in the early stages of treatment, you should expect gradual improvement as the underlying infection resolves. If your pain persists or worsens, or if you have concerns about your symptoms, do not hesitate to reach out to your healthcare provider for further evaluation and management. Your comfort and well-being are paramount, and there are various strategies that can be employed to help alleviate your pain and improve your quality of life during this time.

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