Almost always your immune system doing its job. The exceptions have a recognisable pattern.
Assessed by a GMC-registered GP, not a symptom checker
Honest about what needs to be seen in person
Tests and referrals arranged where they are needed
Your NHS records in the room, with your consent
Care led personally by Dr Khan
Attentive, unhurried care that listens properly
Five-star Google reviews from the people we have looked after
Registered with the Care Quality Commission
Seek urgent assessment for:
Go to A&E for: a rapidly swelling neck with difficulty breathing or swallowing; a hot, red, painful swelling with high fever; or swollen glands with a rash that does not fade under a glass.
Lymph nodes are small filters spread throughout the body, concentrated in the neck, armpits and groin. When they encounter infection they enlarge — which is the system working exactly as designed.
Swollen glands are therefore usually a sign of an immune response, not of anything sinister. Most cases follow an obvious infection and settle over two to four weeks, sometimes longer.
What matters is not that a node is enlarged, but how it feels, how long it has been there, and what else is going on. Those three things separate the ordinary from the ones worth investigating, and they are straightforward to describe over a video call.
These are uncommon. But they are the reason a gland that behaves atypically warrants proper assessment rather than reassurance.
This sounds trivial and it is not. Repeatedly pressing a lymph node keeps it irritated and swollen, and destroys your ability to judge whether it is actually shrinking. Almost everyone with a swollen gland checks it several times a day, and it is the single most counterproductive thing you can do.
Instead: measure it once, write it down with the date, and leave it alone for a week. Compare it against something concrete — a pea, a grape, a 5p coin — or photograph it with a coin for scale.
Small, soft, mobile nodes in the neck and groin are present in a great many perfectly healthy people, particularly children and young adults, and often never disappear entirely.
A lump just above the collarbone should always be investigated, however small and however soft. Nodes in that position drain the chest and abdomen, and unlike neck or groin nodes they are not routinely enlarged by ordinary infections. This is worth knowing because it is easy to lump in with an unremarkable neck gland.
Common in teenagers and young adults — sore throat, big neck glands, profound fatigue lasting weeks. Two things matter practically:
Paracetamol or ibuprofen for discomfort, fluids, rest, and treating the underlying infection. Warm compresses ease tenderness. Do not massage the area — it inflames it further.
Most of this assessment is history rather than examination, which makes it well suited to a remote consultation.
We ask about: how long it has been there and whether it is changing; whether it is tender (tender usually means infection, painless is less reassuring); whether it moves under the skin; its size; how many nodes and in how many areas; and — importantly — whether there are systemic symptoms such as weight loss, night sweats, persistent fever or itching.
Photographs help, taken with something for scale. See our guidance on photographing a physical sign.
Testing we commonly arrange: full blood count, inflammatory markers, glandular fever testing, liver function, and HIV testing where relevant.
Where features are concerning, an ultrasound and specialist referral are the right next step, and we arrange both. We would rather over-refer a gland with an unusual feel than reassure remotely on something that needed feeling.
Two to three weeks after the infection has gone is typical, and six weeks is not unusual. Nodes shrink far more slowly than they swell. What matters is direction: a node that is gradually getting smaller is behaving correctly, however long it takes. A node that is static beyond six weeks, or growing at any stage, should be assessed.
Reassuring: tender, soft or rubbery, mobile under the skin, under about 1cm, appeared with an obvious infection, and getting smaller.
Not reassuring: painless, hard, fixed to the tissue beneath, over 2cm, steadily growing, or accompanied by night sweats, weight loss or fever.
Note that tenderness is broadly reassuring and painlessness is not — the opposite of what most people assume.
Because nodes in that position drain the chest and abdomen rather than the head and neck, so they are not enlarged by the everyday sore throats and dental infections that swell the others. A supraclavicular node is regarded as abnormal until proven otherwise, at any size, and always warrants investigation.
It is the possibility people are usually worried about, and it is uncommon — but the pattern is worth knowing plainly. Lymphoma nodes tend to be painless, rubbery-firm, steadily enlarging, and accompanied by drenching night sweats that soak nightclothes, unexplained weight loss, fever, or unexplained itching. That combination needs assessing promptly. A tender node that came up with a sore throat and is shrinking is a different thing entirely.
Only if there is a bacterial infection driving it. Most swollen glands follow viral infections, where antibiotics do nothing. Where a node is red, hot, exquisitely tender and rapidly enlarging — suggesting the node itself is infected — antibiotics are appropriate and we can prescribe them the same day.
Yes, very. Small mobile nodes in the groin are palpable in a large proportion of healthy adults, because the legs and feet pick up minor infections constantly. Small, soft, longstanding and unchanging groin nodes are generally of no significance. The same applies to small neck nodes in children and young adults.
Because that is how glandular fever behaves. Fatigue lasting six to twelve weeks is entirely typical, and the glands can stay up for months. What matters practically is avoiding contact sport and heavy lifting for at least a month because of the risk of splenic rupture, avoiding alcohol while the liver recovers, and pacing yourself rather than pushing through.
Typically a full blood count — which is highly informative here — inflammatory markers, glandular fever testing, and liver function. An ultrasound is the usual next step for a persistent node, and where the appearance is concerning the definitive answer comes from a biopsy, which we can arrange via specialist referral.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 23, 2026
On this page
Ongoing
Time to be seen
Appointment length
Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
Cost
Same day, usually
20 minutes
Yes, with your consent
Included
Yes, and told why
£40 for 20 minutes
Varies by practice
Typically 10 minutes
Yes, your full record
Not routinely
Usually
Free
Same day
Often 10 to 15 minutes
Usually not
Sometimes charged
Varies by provider
Often a subscription
Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
Patient reviews
