Painful hard lumps in the neck may be caused by enlarged lymph nodes, thyroid nodules, etc. Targeted treatment, such as medication and surgery, should be carried out under the guidance of a doctor. 1. Enlarged lymph nodes: usually inflammation of the oral cavity and pharynx leads to lymphadenitis, lymphatic tuberculosis and other diseases will lead to lymph node enlargement, easy to appear in the neck of the enlarged lymph nodes, after the disease, the local will be obvious pain, some patients will also have a low fever, loss of appetite, and the phenomenon of body wasting. Take azithromycin capsule, amoxicillin capsule and other drugs to treat, there are lymphatic tuberculosis anti-tuberculosis treatment. 2. Thyroid nodules: most patients do not have any symptoms, when the nodules increase in size and produce pressure, the patient may have pain around the nodules, foreign body sensation in the throat, and some advanced patients will have neck edema. Treatment with anti-thyroid medications, such as methimazole tablets and carbimazole tablets; if necessary, treatment by thyroidectomy is needed. It may also be caused by other factors such as tumors, and this symptom alone is not enough to diagnose the disease. It is recommended that the patient should consult a doctor in time to clarify the cause of the disease and give targeted treatment.