Swollen Lymph Nodes and Nighttime Hand Discomfort

Lymphadenopathy and nocturnal hand swelling?

Hello Doctor,
Currently, my symptoms are as follows: I received a Moderna vaccine injection at the clinic on August 13.
On August 18, I noticed a round, movable lump in the indentation above my clavicle.
I visited the clinic on August 31, and the doctor suggested it might be lymphadenopathy.
I was prescribed a 5-day course of antibiotics, and after a neck ultrasound, it was noted that the lump is oval and approximately 1.3 cm in size.
The recommendation was to monitor it for 3-6 months.

On September 28, I went to the ENT department at Chang Gung Memorial Hospital, where the doctor performed another ultrasound and indicated that the lump had decreased to 0.2 cm.
Therefore, no further testing was done as I am very anxious about the possibility of a malignant mass or any undetected issues in my body.

Since August 18, I have also experienced frequent soreness in my left shoulder, and upon touching both sides, I can clearly feel that the left side is more swollen.
Additionally, I have been experiencing some soreness in my lower back on the right side.
At night, I sometimes wake up due to numbness and swelling in my hands.

I would like to ask the doctor if I should continue to monitor the lymph nodes for 3-6 months to see if they remain unchanged or if I need to consult other specialties (if so, which specialties should I see?).
Does the reduction in size of the lymph nodes indicate that my body is effectively fighting off the virus, and should I not worry about the presence of any other serious conditions (especially cancer)? Thank you, Doctor.

Kiki, 30~39 year old female. Ask Date: 2021/10/01

Dr. Chen Sirong reply Oncology

Kiki / 30 years old / Female
1.
I would like to ask the doctor whether I should wait 3-6 months to observe if the lymph nodes do not enlarge, or if I need to see a specialist (if so, which specialty).

A: If there is no enlargement, even if there is a residual size of 0.2 cm, there is no need to see a doctor again; you can monitor it yourself.
If it enlarges, then you should see an Ear, Nose, and Throat (ENT) specialist or a general surgeon.
2.
Does the reduction in lymph node size indicate that the body is effectively fighting off the virus, and should I not worry about other potential issues (the most concerning being cancer)?
A: If the lymph nodes are shrinking, there is no need for further concern.
Wishing you health and happiness,
Taoyuan Hospital, Chen Si-Rong

Reply Date: 2021/10/01

More Info

Understanding swollen lymph nodes and associated symptoms can be quite concerning, especially after receiving a vaccine like Moderna. It’s important to clarify that swollen lymph nodes are often a normal response to vaccination, as they indicate that your immune system is actively working to build protection against the virus.
In your case, you first noticed a movable, round mass above the clavicle about five days after your vaccination. This was assessed by your doctor and identified as likely being an enlarged lymph node. The fact that it was oval-shaped and measured approximately 1.3 cm is not uncommon, as lymph nodes can swell in response to infections or vaccinations. The subsequent ultrasound showing a reduction in size to 0.2 cm is a positive sign, indicating that your body is responding appropriately and the lymph node is returning to its normal state.

The symptoms you describe, such as left shoulder discomfort and nighttime hand numbness, can be multifactorial. The discomfort in your shoulder may be related to muscle strain, posture, or even anxiety about your health concerns. The nighttime numbness in your hands could be due to several reasons, including nerve compression, poor sleeping positions, or even anxiety-related hyperventilation, which can lead to temporary tingling sensations.

Regarding your concerns about the lymph nodes and the potential for serious conditions such as cancer, it’s reassuring that the lymph node has decreased in size. Generally, persistent enlargement of lymph nodes, especially if they are hard, fixed, or associated with systemic symptoms (like weight loss, fever, or night sweats), warrants further investigation. However, the reduction in size you experienced is a good indicator that your body is managing the situation well.

As for your follow-up, it is reasonable to continue monitoring the lymph node for the next 3-6 months as advised by your healthcare provider. If you notice any changes, such as further enlargement, new symptoms, or if the discomfort in your shoulder and hands persists or worsens, it would be prudent to consult with your doctor again. They may refer you to a specialist, such as an ENT (Ear, Nose, and Throat) doctor or a rheumatologist, depending on the symptoms and findings.

In summary, the reduction in size of the lymph node is a positive sign, and while your symptoms warrant attention, they do not necessarily indicate a serious underlying condition. Maintaining open communication with your healthcare provider and following their recommendations for monitoring will help ensure that any potential issues are addressed promptly. If you have further concerns or if your symptoms change, do not hesitate to seek medical advice.

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