Question
Hello Doctor,

A few days ago I noticed a vaguely uncomfortable feeling when tilting my head back and pushing it against the back of my neck. Not pain, but more like a swelling feeling. I've had this feeling before in my life but this is the first time I paid more attention to it.

I felt it with my hand and there is a lump that I can feel right above my spinal C7 process, in the middle of the neck (maybe very slightly to the right). It's about 1 inch below the hairline and its size is around 1/2 inch and rather round-ish. I can only feel it when I tilt my head back. If I press on it, it can be compressed and it disappears (until I feel the C7 process behind) and comes back on release, like a rubber button of some sort.

When I lean my head forward I can feel the C7 process which is quite prominent but there's no squishy lump.

Can this be something serious, like a lymph node or perhaps something related to my spine? I've read that lymph nodes are not situated as low on the back of the neck. I can't feel this squishy lump in other positions.

I'm a 30 year old woman.

Answer
Hi Rebecca,

1) It sounds like a fatty tumor, which is most often not a problem. A problem with a lymph node is usually painful and more rigid.

2) These types of tumors are typically only a problem if they grow and interfere with other structures. Sometimes, when surgically removed, they can grow back.

3) You have mentioned similar issues in the past, which I assume have not caused problems. If you have no other health issues; no fever, pain, malaise or family history of problematic tumors, it is most likely not a problem. However, this is something that obviously concerns you and, as much as one can guess, it would be prudent to have it checked out to make sure and to be able to ease your mind. The more you feel it, the more sensitive your touch becomes and the more it will bother you. It does not have the cardinal signs of something to be concerned about, but it would be nice to have it examined by your doctor to make sure.

4) The location is somewhat confusing. C7 is at the bottom of the neck. T1 is the first thoracic vertebra and sits below C7. T1 is usually very prominent, basically at the top of the shoulders. You can tell C7 by placing a fingertip on T1 and another on C7, just above. If you move your head by looking up and then down, C7 will move, but T1 will not.

The bottom of the hairline sounds more like around C2, which has a large spinous process that is very easy to feel and it moves a lot when you tilt your head to the left and right side. There are muscles that attach around this area and it is common to feel a muscle mass more prominent towards on side in this area and it can also be somewhat sore. This can also be a location for a fatty tumor.

There is also a ligament that runs on top of the spinous processes and this is somewhat moveable and can make a kind of snapping feeling when moving it from side to side.

5) So, please have it checked out and hopefully it is nothing to be concerned about and just a good lesson in anatomy. If you will, please let me know what the doctor says.

Kind regards,

Dr. Steve