Tightness in the Throat: Causes and Treatments

Medically Reviewed by Sabrina Felson, MD on August 06, 2022
6 min read

Does your throat feel tight or like you can’t swallow your food?

Many things can cause this. Not all are serious. Let your doctor know right away if the tightness doesn’t go away or if you have any other symptoms with it.

 

Depending on what’s causing the tightness in your throat, it might feel like:

  • Your throat is sore or burns.

  • Your throat is swollen or closed up.

  • You find it hard to swallow.

  • You have a lump in your throat.

  • You need to swallow often.

Heartburn or GERD

Heartburn is a common problem that may cause tightness in your throat. Your throat can feel sore or burn. You might find it hard to swallow. It can last anywhere from minutes to hours.

This condition happens when stomach acid rises in your esophagus and creeps into your throat. If this happens often, it may be a sign of gastroesophageal reflux, or GERD.

You can get heartburn after you eat a big meal or if you lie down right after eating. Some foods and drinks can trigger it. This includes tomatoes, spicy or fatty foods, alcohol, or foods with lots of acid, like citrus. Stress, smoking, and obesity make it more likely that you'll get it.

If heartburn causes your throat tightness, you might also have these symptoms:

  • Pain or burning in your chest after meals, when you lie down, or when you bend over

  • Bitter, sour, or salty taste in your mouth

  • A feeling like food is stuck in your throat or chest

To keep it from happening, avoid trigger foods. Stop eating at least 3 hours before you go to bed. It may help to raise the head of your bed 6 inches to keep stomach acid where it belongs while you sleep.

When it does strike, you can try OTC (over-the-counter) antacids.

For intense attacks or if it happens often, see your doctor. You may need prescription medication. For example, H2 blockers or proton pump inhibitors (PPIs) can help slow down your body’s production of stomach acid, while prokinetics and antibiotics speed up digestion to help your stomach get rid of waste after eating. Be sure to ask your doctor about the possible side effects of these medicines, including nausea, diarrhea, and a loss of bone density.

In some serious cases, your doctor might recommend surgery.

Allergic reaction

Anaphylaxis is a fast, strong allergic reaction to something -- often a food, drug, or insect sting. It can cause your throat to tighten up suddenly. You may feel like it’s very hard to swallow. It can happen minutes or hours after your exposure.

If an allergic reaction is the cause of your throat tightness, you might have some of these other symptoms:

If you notice any of these signs, call 911 right away.

Your doctor may prescribe an epinephrine self-injection pen to keep on hand if you know you have any allergies that could cause anaphylaxis. Remember that you'll still need to call 911 right away after you use it. The medicine can wear off, or you could have a second reaction.

Tonsillitis

If you still have your tonsils, you can get tonsillitis. That’s when tonsils become inflamed because of an infection from viruses or bacteria.

Tonsillitis makes your tonsils swell and hurt. Your throat feels very sore. You may find it hard to swallow. Lymph nodes in your throat and neck can swell up too.

If tonsillitis is the cause of your tight throat, you may also have these symptoms:

If it's caused by a viral infection, treat it with rest, warm liquids, throat lozenges, and gargles with saltwater to ease throat pain and tightness. Ibuprofen or acetaminophen may ease fever and pain.

If a bacterial infection is the cause, your doctor can prescribe antibiotics.

If it happens often or makes it hard for you to breathe, swallow food, or sleep, you may need surgery to remove your tonsils.

Goiter

A goiter is when your thyroid swells. This is a big, butterfly-shaped gland at the base of your throat. It makes hormones that keep your metabolism in balance. When it gets bigger, it can make your throat feel tight and closed up.

A goiter can happen if you don’t get enough iodine in your diet. This mineral is an important part of your thyroid’s hormone production.

Most people get enough iodine because it’s added to most table salt. It’s also found in seafood, seaweed, dairy products like yogurt or milk, and grains.

If a goiter is the cause of your throat tightness, you may also have these symptoms:

  • Lump in your neck that you can feel or see under the skin

  • Problems swallowing

  • Trouble breathing

  • Cough

  • Hoarse, scratchy voice

If you think you may have a goiter, see your doctor. Your doctor can feel your throat for any lumps and run tests to find the cause, such as:

  • Blood test to measure your thyroid hormone levels or spot any antibodies that suggest thyroid disease

  • Ultrasound or scan of your thyroid

  • Thyroid biopsy to draw out a fluid sample that’s sent to a lab for testing

Treatment of a goiter depends on the cause. If your case is mild and only causes a little swelling, you may just need to watch it.

To get enough iodine, use iodized table salt and eat fresh fish or shellfish, or seaweed foods like sushi. Cut back on iodine if your doctor says you get too much.

Medications can either raise or lower your thyroid hormone levels to get them back to normal. This can reduce the swelling.

If you have a very large goiter that makes it hard to breathe or swallow food, you can have surgery to remove part or all of your thyroid. Thyroid cancer is also treated with surgery.

Anxiety

Some research shows that anxiety can be linked to feelings of tightness in your throat. For example, globus is the medical term for the feeling of a lump in your throat. People who have this almost always say it’s worse when they’re stressed or anxious. This is at least in part because stress triggers muscle tension. 

Another condition related to tightness in your throat is dysphagia, which is when you have a hard time swallowing or feel like something is stuck in your throat. In one study, doctors were able to predict how severe participants’ dysphagia was based more on whether they said they had anxiety than on the standard physical exam and tests. 

Muscle tension dysphonia (MTD) 

This is when your voice gets strained because you’re having to put more pressure or effort into speaking because of an issue affecting your voice. It can make the muscles in your neck feel tense or tight when you talk. It also can make you sound gravely, hoarse, or raspy and make it hard or painful to speak.

It can be caused by several things, including:

  • A reaction to an upper respiratory infection

  • Stomach acid working its way up to the throat (laryngopharyngeal reflux or LPR)

  • Secondhand smoke

  • Overusing your voice 

  • Stress