Tightness in the throat can make you feel as if your airway passage is narrowed, with symptoms of difficulty swallowing or breathing. You may feel as if there's a lump in your throat, or that it's swollen or closed off, in ways that are different from a sore throat or common cold.
The causes of throat tightness can vary in their severity. For example, gastroesophageal reflux disease (GERD) is a common and treatable condition affecting the esophagus, the tube that carries food to the stomach. But an allergic reaction that closes off the trachea, the tube that carries oxygen to the lungs, is a life-threatening emergency.
This article explains tightness in the throat, and how it is diagnosed and treated. It will help you to know which structures and muscles may be involved, and why you may need to see a healthcare provider.
Causes of Throat Tightness
Throat tightness often arises with other symptoms, including a sense of burning in the throat or the frequent need to clear the throat. These symptoms may occur at specific times, like when you have tightness in throat after eating or when you first wake up.
The pattern of symptoms can help you and your healthcare provider to understand the cause.
GERD or Acid Reflux
Gastroesophageal reflux disease (GERD) is extremely common throughout the world, and the incidence is escalating in the United States. Since 2010, it has particularly increased among individuals 30–39 years of age. The prevalence is approximately 18.1% to 27.8% in North America.
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.
Anxiety disorders can result in what is called anxiety or 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.
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.
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.
Muscle Tension Dysphonia (MTD)
Symptoms of MTD include:
- 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, since there is evidence it is common in people who have severe asthma.
A goiter is a benign (non-cancerous) enlargement of the thyroid gland. It is 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.
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.
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 epinephrine (if you carry it) 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.
When to See a Healthcare Provider
Tightness in the throat tightness doesn't always impair your ability to breathe or swallow. You should still see a healthcare provider even though it's not a medical emergency. For example, in rare cases, untreated strep throat can lead to kidney and heart problems.
If you carry epinephrine and go into anaphylaxis, you should still call 911 or go to the emergency room even after giving yourself epinephrine, as further treatment is usually necessary. It is 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.
Diagnosing Throat Tightness
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 with exercise or during stressful episodes of anxiety.
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:
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.
Throat Tightness and 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 or Acid Reflux
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.
Even though many of these medications are available over-the-counter, it is recommended that you consult a healthcare provider before taking them.
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 may be needed.
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. They include:
- Sitting down so that you don’t pass out and injure yourself
- Finding a comfortable area where you will be safe and not hit your head if you faint
- Having another person with you in the rare event that you do need medical attention
- Focusing 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.
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.
For chronic tonsillitis, a complete tonsillectomy 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.
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.
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.
There are a few simple things you can do at home to help relieve throat tightness. If you have acid reflux, for example, taking an over-the-counter antacid may provide some immediate relief.
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 what foods trigger your symptoms so you can avoid them in the future.
Swollen tonsils can respond to cold food and fluids, or you can put an ice pack on your neck. It may also be helpful to sleep with a cool mist humidifier next to your bed at night.
Not all causes of throat tightness are easily prevented, but there are things you can do to lower your risk. Use the following tips to prevent throat tightness:
- 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 risk 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.
A Word From Verywell
Tightness in the throat may not have a serious underlying medical cause, but it's still important to see a healthcare provider for a diagnosis. Once you've identified the cause, you'll learn more about treatment options for the condition.
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, also is 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.