Tightness in the Throat: Symptoms, Causes, and Treatments

Your throat might feel tight for a number of possible reasons, from gastroesophageal reflux disease (GERD) to a dangerous allergic reaction or, occasionally, a 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.

This article explains the reasons you might feel tightness in the throat and how specific conditions are diagnosed and treated. It will also help you understand when you may need to see a healthcare provider.

Verywell / Jessica Olah


Symptoms

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

Seek medical attention at once if you also have symptoms of a severe allergic reaction such as:

  • Difficulty breathing
  • Hives, rash, or itching
  • Pale skin or blue discoloration of the skin

Causes

The causes of throat tightness can vary in their severity. For example, gastroesophageal reflux disease (GERD) is a common and treatable condition, but an allergic reaction that closes off the trachea, the tube that carries oxygen to the lungs, is a life-threatening emergency.

Persistent throat tightness can also be a sign of throat cancer. See a healthcare provider for a diagnosis.

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 heartburn, sore throat, coughing, 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 particularly increased among individuals 30 to 39 years of age. The prevalence is approximately 18.1% to 27.8% in North America.

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 also may hyperventilate, with breathing that’s rapid and shallow.

These breathing episodes can dry out your throat. They can cause tightness in the throat, along with symptoms of:

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

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

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 as a result of allergies to insect bites and stings, certain foods and medications, or latex. While allergies to these substances are very common, anaphylaxis is not.

Throat Tightness and Anaphylaxis

Anaphylaxis is a medical emergency. You should call 911 and use an EpiPen (epinephrine) as soon as signs and symptoms appear. These include severe itching, redness, swelling of the tongue or difficulty talking, swelling of the lips, tightness in the throat or chest, or difficulty breathing or swallowing.

Tonsillitis

Tightness in the throat may be caused by tonsillitis. It is an inflammation of the tonsils (usually the palatine tonsils) and is an extremely common condition, although the exact incidence is unknown.

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.

Some consider the adenoids to be the third set of tonsils, but they are located above the other two sets of tonsils and are unlikely to cause throat tightness.

Tonsillitis can be acute or chronic and has a myriad of 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.

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 and swallowing, as well as throat tightness.

Goiters are more common outside of the United States in areas where there are iodine-deficient soils and table salt is not enriched with iodine, but it occurs in the United States also.

Muscle Tension Dysphonia (MTD)

Muscle tension dysphonia (MTD) is a condition where the muscles surrounding the larynx (the voice box) become so tight that they fail to function properly.

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

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

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.

With the exception of an identified panic or anxiety attack, any throat tightness that impairs your ability to breathe or swallow is a medical emergency. You should call 911 or go to your nearest emergency room.

Testing

With throat tightness, an accurate medical diagnosis will be based on your symptoms and personal medical history. Your healthcare provider will want to know how and when you experience symptoms such as throat tightness. For instance, you should note whether the symptoms come on with exercise, during stressful episodes of anxiety, or with other triggers.

A physical examination and one or more of the following tests may be used to diagnose the disorders that can cause tightness in the throat:

  • Esophagogastroduodenoscopy (EGD), an examination of the upper gastrointestinal tract with a flexible scope that is inserted through the mouth and into the throat
  • Tests for infection, such as throat culture, rapid strep test, or mono spot test
  • Blood or skin testing for allergies
  • Blood tests to check thyroid hormone levels
  • Ultrasound or other imaging to look at the structures in the throat/neck
  • Fiberoptic laryngoscopy, an examination of the larynx with a rigid scope that is inserted through the mouth and into the throat

Some conditions, including anxiety disorders and MTD, do not have specific or definitive diagnostic tests. They are diagnosed by carefully considering your symptoms and medical history, and then ruling out other similar conditions that could be causing your symptoms.

Treatment

Tightness in the throat is treated on the basis of its cause. Some treatments are comparatively simple and rely on medication and lifestyle changes. Others may involve surgery.

GERD

While antacids such as Tums (calcium carbonate) may be adequate for treating occasional heartburn, they probably won’t cut it if your symptoms are severe enough that you’re experiencing tightness in the throat.

Medications such as Pepcid (famotidine), an H2 blocker, or proton-pump inhibitors like Prilosec (omeprazole) are better at reducing acid and facilitating the healing of damaged esophageal tissue.

Even though many of these medications are available over the counter, it is recommended that you consult a healthcare provider before taking them.

You should also keep your head elevated rather than lying down flat to sleep at night so that stomach acid is less likely to travel up the esophagus. Pay attention to which foods trigger your symptoms so you can avoid them in the future.

Severe cases of GERD may warrant treatment with surgery. The esophagus can be dilated via endoscopy to improve swallowing, or other procedures such as fundoplication surgery may be needed to reinforce the muscular valve between the stomach and esophagus (called the lower esophageal sphincter).

Anxiety

Treatment for anxiety disorders may include talking to a therapist, joining a support group, or cognitive behavioral therapy (CBT). Treatment also may rely on medication, including:

Adequate treatment can help to reduce the frequency of panic attacks.

If you know you are having a panic attack, there are steps you can take to alleviate it:

  • Sit down so that you don’t pass out and injure yourself
  • Find a comfortable area where you will be safe and not hit your head if you faint.
  • Have another person with you in the rare event that you do need medical attention.
  • Focus on slow, deep breaths. If you cannot slow your breathing down, you can try breathing through pursed lips or into a paper bag to treat hyperventilation.

Don’t breathe into a paper bag if it increases your anxiety, however. You may feel that you are unable to breathe or that you are having a heart attack, but this is not actually the case. Most panic attacks last between five and 20 minutes.

Allergic Reaction

The most important treatment for a serious allergic reaction is epinephrine. If you don’t carry epinephrine with you, you must call 911 or get to a hospital right away to get this crucial medication.

In addition to epinephrine, you may also be treated with oxygen, IV fluids, antihistamines, and steroid medications, but these are all secondary to the prompt administration of epinephrine. Never delay emergency medical care if you suspect you are having a severe allergic reaction.

Tonsillitis

While the treatment for tonsillitis may vary depending on the cause (antibiotics for strep throat, for example), the actual swelling in the tonsils can be treated with steroid medications in some cases.

Swollen tonsils might also respond to cold food and fluids, or you can put an ice pack on your neck. It may be helpful to sleep with a cool mist humidifier next to your bed at night.

For chronic tonsillitis, a complete tonsillectomy may be necessary.

Goiter

The treatment for thyroid goiter varies depending on the root cause. For example, if the cause is iodine deficiency, then iodine supplements may help. In other cases, you may need thyroid hormone supplements. When the goiter cannot be reduced with medications, surgery may be necessary.

Muscle Tension Dysphonia

Voice therapy is the most common treatment for MTD. In some cases, botox injections are used to stop muscle spasms.

Outlook

Once your healthcare provider has identified the condition that’s causing the sensation of tightness in the throat, treatment should lead to improvement or complete resolution of your symptoms. 

Although not all causes of throat tightness are easily prevented, there are things you can do to lower your risk of it happening again:

  • If you have been diagnosed with one of the conditions above known to cause throat tightness, make sure you work with a qualified healthcare professional to develop a good treatment regimen and then stick to it.
  • If you have allergies and are at risk for anaphylaxis, talk to your healthcare provider about carrying epinephrine.
  • Wash your hands and stay away from people who are sick to prevent throat infections. Get plenty of sleep and exercise to bolster your immune response.
  • Pay attention to potential triggers such as allergies or foods that bring on your symptoms so that you can avoid them.
  • If you have anxiety, note potential triggers as well as things that alleviate your symptoms. Practice deep breathing techniques. Consider support groups.
  • If you have acid reflux, avoid lying down flat and instead keep your head elevated. Avoid overeating and instead opt for smaller, more frequent meals.
  • Protect your voice by not overusing or straining it.

Summary

A tight throat can make you feel like you can’t swallow or like you need to keep clearing your throat. If you have a tight throat along with other symptoms of an allergic reaction, such as difficulty breathing, seek emergency medical care at once.

A few different conditions can cause you to have the sensation of tightness in your throat. GERD, anxiety, tonsillitis, and goiter are a few examples. These conditions are treatable, so make sure you see a healthcare provider if you experience this symptom.

Occasionally, a persistent sensation of tightness in the throat can be a sign of throat cancer, and for this reason should not be ignored. You should be checked by a healthcare provider, such as an ear, nose, and throat (ENT) doctor.

Frequently Asked Questions

  • What causes a throat muscle spasm?

    Throat muscle spasms can be caused by muscle tension dysphonia (MTD), a condition that occurs when muscles around the larynx tighten too much. Cricopharyngeal spasm, caused by a muscle in the throat contracting too much, is also a possible cause.

  • Why does my throat feel strained when talking?

    Muscle tension dysphonia (MTD) can cause strained throat or voice straining. Other symptoms include hoarseness, a sore and tender neck, the sensation of a lump in the throat, and feeling the need to clear the throat often.

  • Can you have tightness in the throat with COVID-19?

    It’s possible, but if it’s COVID-19, you’ll also have more common COVID symptoms like fever and a dry cough. The hoarseness and difficulty swallowing linked to throat tightness are more likely to have another cause, such as tonsillitis.

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