What Causes Tightness in the Throat? (2024)

Your throat might feel tight for several reasons, including gastroesophageal reflux disease (GERD), allergic reactions, anxiety, throat infection, or, rarely, cancer.

A tight throat can make you feel like your airway passage is narrowed, causing symptoms such as difficulty swallowing or breathing or the sensation of a lump in your throat.

What Does a Tightening Throat Feel Like?

Throat tightness often occurs with other symptoms. These symptoms may occur at specific times, like tightness in the throat after eating or when you first wake up. The pattern of symptoms can help you and your healthcare provider understand the cause.

Some of the things you might experience along with a tight throat include:

• A lump in the throat
• Difficulty swallowing or excessive swallowing
• Frequent need to clear the throat
• The sensation that your throat is swollen or "closed up"
• Pain or burning sensation in the throat

Multiple conditions can cause throat tightness.

GERD

Gastroesophageal reflux disease (GERD) causes stomach acid to reflux into the esophagus, sometimes even reaching the back of the throat. Stomach acid is very damaging to the tissue of the esophagus and throat. This creates symptoms such as sore throat and coughing, heartburn, hoarseness, and, in some cases, throat tightness.

A narrowing of the esophagus can occur when the tissue is damaged, and scar tissue is formed. This can make it difficult to swallow, create a feeling of tightness in the throat, or make it feel like you constantly have a lump in your throat. Food may also become lodged in the esophagus.

GERD is extremely common throughout the world, and the incidence is escalating in the United States. Since 2010, it has notably increased among individuals 30 to 39. The prevalence is approximately 18.1% to 27.8% in North America.

Treatment

Diet and lifestyle changes can help to reduce or eliminate GERD symptoms. These include:

• Weight loss
• Elevating your head when lying down or sleeping
• Quitting smoking
• Modifying eating habits (smaller meals, slower eating)
• Reducing or eliminating foods that trigger your GERD symptoms
  

Medications for GERD include over-the-counter (OTC) or prescription drugs. If your symptoms don't improve with OTC options, see your healthcare provider.Some common medications for GERD include:

• Antacids: Tums, Maalox, Rolaids, or Mylanta
• Bismuth subsalicylate: Pepto-Bismol
• ​​Baclofen: Prescription medication to reduce lower esophageal sphincter relaxation
• H2-receptor blockers: Axid AR (nizatidine), Zantac 360 or Pepcid AC (famotidine), or Tagamet (cimetidine)
• Proton pump inhibitors (PPIs): Nexium (esomeprazole), Prevacid (lansoprazole), or Prilosec (omeprazole)
• Prokinetic agents: Medications that improve the activity of muscles in the gastrointestinal tract

Surgery or other medical procedures may also be necessary in some cases.

Anxiety

Anxiety disorders can result in panic attacks. During these episodes, you may feel an overwhelming sense of anxiety and fear, which causes your heart to pound.

You may also hyperventilate, with breathing that's rapid and shallow. These breathing episodes can affect your throat, causing tightness along with other symptoms like:

• Dizziness and lightheadedness
• Air hunger (feeling like you can’t get enough air)
• Excessive sweating
• Body chills and trembling

Treatment

Although it feels like a medical emergency, anxiety and panic attacks typically are not imminently dangerous.

There are multiple treatment options to help people manage the symptoms of anxiety disorders. The most common include prescribed medication and/or psychotherapy. Those with a panic disorder often try both, plus practicing self-help and coping techniques.

Allergic Reaction

Anaphylaxis is a life-threatening allergic reaction that can cause a dangerous swelling in your throat, closing off your airway and preventing you from swallowing and breathing properly.

It usually occurs due to allergies to insect bites and stings, certain foods and medications, or latex. While allergies to these substances are prevalent, anaphylaxis is not.

Treatment

If you suspect you are experiencing anaphylaxis, seek medical help immediately.

Epinephrine is the standard treatment for anaphylaxis. Oxygen, IV fluids, antihistamines, and steroid medications may also be administered.

Tonsillitis

Tightness in the throat may be caused by tonsillitis, an inflammation of the tonsils (usually the palatine tonsils). A second set of tonsils called the lingual tonsils, is located in the throat below the palatine tonsils. While less common, the lingual tonsils can also become swollen and inflamed.

Tonsillitis can be acute or chronic and has many underlying causes, including bacterial infections such as strep throat, viral infections such as mononucleosis, and allergies.

Symptoms of tonsillitis include sore throat, red throat, and difficulty swallowing. In rare cases, when the tonsils become very large, you may feel throat tightness or even have difficulty breathing.

Treatment

Tonsillitis is typically painful but not serious. It usually requires little medical intervention:

• Viral tonsillitis treatment focuses on relieving pain and fever with OTC pain relievers like Tylenol (acetaminophen) or Advil (ibuprofen). Prescription drugs, including antivirals, are typically not needed.
• Bacterial tonsillitis is commonly treated with antibiotics. Penicillin and amoxicillin are the first-line choices, although newer antibiotics may be used in cases of drug resistance.

If the tonsils are so large that they interfere with breathing, your healthcare provider may prescribe an oral corticosteroid (steroid) to reduce their size.

For chronic tonsillitis, a complete tonsillectomy may be necessary.

Goiters

A goiter is a benign (non-cancerous) enlargement of the thyroid gland. If the thyroid becomes too large, it can compress the trachea and/or esophagus and create problems with breathing, swallowing, and throat tightness.

Goiters are more common outside the United States in areas with iodine-deficient soils and table salt that is not enriched with iodine; however, cases do occur in the United States.

Treatment

Monitoring without treatment may be recommended if the goiter is small with no symptoms and no other underlying thyroid disease.

In most cases, treatment is necessary and customized to the underlying cause of the goiter. Treatments include:

• Thyroid hormone replacement drugs (hypothyroidism)
• Antithyroid drugs (hyperthyroidism due to Graves' disease)
• Radioactive iodine treatment (RAI) (the thyroid gland is overactive)
• Thyroidectomy (surgery to remove part or all of the thyroid)
• Iodine replacement (supplementation to correct goiters resulting from iodine deficiency)
  

Muscle Tension Dysphonia (MTD)

Muscle tension dysphonia (MTD) occurs when the muscles surrounding the larynx (the voice box) become so tight that they fail to function correctly. Symptoms of MTD include:

• Hoarseness
• Voice straining
• A sore and tender neck
• Sense of a lump in your throat
• Needing to clear your throat a lot

MTD may be more prevalent than researchers think and there is evidence it is common in people who have severe asthma.

Treatment

In most cases, MTD can be treated at home with rest and time. The following strategies may also help alleviate the symptoms:

• Talking only when necessary until hoarseness goes away
• Drinking plenty of fluids to keep airways moist
• Using a vaporizer to add moisture to the air
• Avoiding actions that strain the vocal cords (e.g., whispering, shouting, crying, and singing)
• Treating gastroesophageal reflux disease (GERD) if hoarseness relates to that condition
• Avoiding decongestant use
• Quitting smoking

If MTD persists for more than one to two weeks, consult your healthcare provider or an ear, nose, and throat specialist (ENT), also called an otolaryngologist.

Vocal Cord Dysfunction

In cases of vocal cord dysfunction (VCD), the vocal cords partially or fully close when they should remain open, producing throat tightness and trouble breathing. Due to similar symptoms, VCD attacks can be mistaken for asthma attacks.

Treatment

Treatment of vocal cord dysfunction is typically a team effort involving an ENT, a pulmonologist, and a speech therapist. They work together to help those with VCD learn to relax their vocal cords as they breathe. VCD treatment may also include breathing exercises.

Eosinophilic Esophagitis

Eosinophilic esophagitis (EoE) is a chronic allergic/immune condition of the esophagus (the tube that moves food between the mouth and the stomach). Because the esophagus is chronically inflamed, those with EoE experience symptoms like difficulty swallowing solid or dry foods and vomiting. The esophagus sometimes narrows so severely that food can become lodged there.

Treatment

EoE is a complex condition.Treatment centers around removing foods from the diet that may trigger allergies (e.g., dairy, wheat, eggs, and soy). Sometimes, a more strict elemental diet is recommended.

Dupixent (dupilumab) is the only medication approved by the U.S. Food and Drug Administration (FDA) to treat EoE. Other drug options include proton pump inhibitors (PPIs) and corticosteroids.

Laryngeal Dystonia

Laryngeal dystonia (LD) is a chronic disorder characterized by spasms of the muscles of the voice box (larynx). The spasms can cause throat tightness, recurring hoarseness, and difficulty speaking or altered speech. The most common indication of LD is short lapses of the voice which happen suddenly.

Treatment

LD is often treated with botulinum toxin therapy, which blocks nerve activity that controls the laryngeal muscles, reducing spasming. Speech or voice therapyis helpful for some people, and surgery is an option.

Dysphagia

Dysphagia, or difficulty swallowing, can range from mild difficulty to a painful inability to swallow. In severe cases, eating becomes a challenge, making it impossible to maintain a healthy weight.

Dysphagia can have many causes but occurs most often among older adults (e.g., those with Parkinson’s disease or dementia).Any condition that weakens or damages the muscles and nerves used for swallowing may cause dysphagia.

Treatment

Treatments for dysphagia vary. Strategies may include:

• Changing food textures or temperature
• Adjusting head position when swallowing
• Facial exercises to improve muscle tone
• Transitioning to a feeding tube, either temporarily or permanently

Cancer

One of the symptoms of throat cancer is feeling a lump in your throat. Swelling in one or more lymph nodes in the neck is a common early sign of throat, head, and neck cancers. A lump that comes and goes may not be due to cancer; cancerous lumps usually grow slowly bigger over time.

Treatment

Throat cancer may be treated in several ways, including:

• Surgery
• Radiation therapy
• Chemotherapy

Depending on the stage of the cancer, one or more types of treatment may be necessary. Where the cancer begins in the throat also affects the type of treatment(s) used.

When to See a Healthcare Provider

Tightness in the throat doesn't always impair your ability to breathe or swallow. You should still see a healthcare provider even when it's not a medical emergency, however. For example, in rare cases, untreated strep throat can lead to kidney and heart problems.

If you carry an EpiPen (epinephrine) and go into anaphylaxis, you should still call 911 or go to the emergency room even after using the EpiPen because further treatment is usually necessary. In fact, it's possible to go back into anaphylaxis even hours after your initial symptoms have subsided.

Summary

A tight throat can make you feel like you can't swallow or need to keep clearing your throat. If you have a tight throat and other symptoms of an allergic reaction, such as difficulty breathing or swelling of the lips, throat, or tongue, seek emergency medical care immediately.

Multiple conditions can cause a sensation of tightness in the throat. GERD, anxiety, tonsillitis, and goiter are a few very treatable examples.

A persistent tightness in the throat is rarely a sign of a more serious condition, like throat cancer, so this symptom should never be ignored, especially if it doesn't clear up within a week or two or is accompanied by other symptoms.

See your healthcare provider or an ear, nose, and throat (ENT) doctor.