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Tightness in the throat has many possible causes. It may be constant or intermittent, and it can range from mild to severe.

Tightness in the throat does not necessarily indicate anything serious. However, a person needs to seek emergency treatment if the tightness co-occurs with breathing difficulties or trouble swallowing.

This article discusses tightness in the throat, including its causes and treatment options.

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Some of the possible reasons for tightness in the throat include the following:

Allergies

An allergic reaction occurs when the immune system mistakenly identifies something such as food or pollen as a threat to the body. The immune system then releases chemicals to combat these allergens, which leads to such symptoms as a stuffy nose or an itchy, tight throat.

Allergies are very common. Over 50 million people in the United States experience different types of allergies annually, with allergy being the sixth leading cause of chronic illness in the U.S.

In many cases, allergy symptoms can be mild. In some cases, however, a person can experience an acute allergic reaction that health experts call anaphylaxis. This is a life threatening allergic reaction that requires immediate treatment.

The most common triggers for anaphylactic reactions are:

  • certain foods
  • insect venom
  • medications

Research indicates that 1 in 50 people in the United States experience anaphylaxis, but the actual rate may be closer to 1 in 20.

At least one-fourth of these reactions happen in adolescents and children under the age of 17, and one out of 20 cases will require hospitalization.

The condition is not fatal if an individual receives treatment quickly. However, fatal reactions are most common among African Americans and older adults.

African Americans tend to have more allergies and asthma, which predispose them to these reactions. They also experience anaphylaxis more frequently as a reaction to drugs, which may reflect more comorbidities and less access to healthcare. These factors may contribute to increased fatalities in this population.

Older adults show higher morbidity from anaphylaxis regardless of the cause, which indicates that the body may have a harder time coping with such a severe reaction at an older age.

Anyone with symptoms of anaphylaxis should get emergency medical treatment. In addition to tightness in the throat, symptoms include:

Anxiety

Anxiety can manifest with physical symptoms, including tightness in the throat. Difficulty breathing and the sensation that the throat is tightening are typical signs of a panic attack.

Other symptoms of a panic attack include:

In addition to throat tightness, a person may feel as if they have a lump or ball in their throat. Health experts call this sensation globus pharyngeus or globus hystericus.

Some people may have esophageal symptoms due to the body’s oversensitivity to discomfort or pain. Anxiety and stress may also play a role in triggering the sensation.

Gastroesophageal reflux disease

When acid from the stomach moves up into the esophagus, or food pipe, it can cause a burning sensation in the chest known as heartburn.

If a person experiences heartburn more than twice per week, they may receive a gastroesophageal reflux disease (GERD) diagnosis. According to the American College of Gastroenterology, at least 20% of people in the U.S. have this condition.

Heartburn can also cause tightness in the throat. If left untreated, GERD can lead to ulcers and permanent esophageal damage and can increase the risk of esophageal cancer.

GERD manifests with symptoms such as:

Goiter

A goiter occurs when there is an abnormal enlargement of the thyroid gland, which is a butterfly-shaped gland in the neck.

The thyroid gland produces hormones that influence the metabolic rate of the body, among other bodily functions.

There is a link between a goiter and a thyroid gland producing too much hormone, which is known as hyperthyroidism, or too little hormone, which is called hypothyroidism.

However, a thyroid that produces the right amount of hormone can also cause a goiter, according to the American Thyroid Association.

Along with throat tightness, symptoms of a goiter include:

  • cough
  • difficulty breathing or swallowing
  • hoarseness
  • swelling in the front of the throat and neck

Infection

Infections can develop in the throat and tonsils. They may be viral or bacterial.

An example of a common bacterial infection that affects the throat is strep throat. When the infection develops in the tonsils, health experts refer to it as tonsillitis.

Symptoms of a throat infection include:

Other causes

Other causes of tightness in the throat include the following conditions:

  • eosinophilic esophagitis, which is an autoimmune disease that affects the esophagus
  • laryngeal dystonia, a voice disorder that causes the larynx to spasm
  • dysphagia, which is difficulty swallowing that can co-occur with throat tightness and can be a symptom of a variety of neurological conditions

Tightness in the throat may feel as if:

  • the throat is swollen
  • the throat muscles are locked
  • there is a lump in the throat
  • a tight band is wound around the neck

An individual may also experience tenderness, pressure, or pain in the throat or a feeling of needing to swallow frequently.

Treatment for tightness in the throat depends on the underlying cause:

Allergic reactions

A shot of epinephrine is a key medication that treats anaphylaxis. People with known acute allergies should carry with them an auto-injector, such as Adrenaclick or EpiPen, to use if they have an attack.

Some individuals with allergies may benefit from immunotherapy, which is a treatment that desensitizes people’s bodies to specific allergens.

If a person benefits from allergy shots, a doctor will inject small doses of allergens under their skin over time. This process may last for at least a few years until the individual’s allergy is no longer triggered.

Anxiety

A person can receive treatment for anxiety in the form of psychotherapy, medications, or a combination of the two. It can also be helpful to try meditation, relaxation techniques, and healthy lifestyle changes.

GERD

Treatment for GERD may include medications, dietary and lifestyle changes, or both.

Some of the medications healthcare professionals use to treat GERD include:

  • Antacids: Several antacids, such as Rolaids and Tums, are available to purchase online and are also available over the counter.
  • H2 receptor blockers: These drugs, which a person can buy online as Pepcid or Tagamet, help reduce stomach acid production, with famotidine’s effect lasting the longest, often up to 12 hours. They are available over the counter or on prescription.
  • Proton pump inhibitors (PPIs): PPIs, which individuals can purchase online as Nexium, Prevacid, or Prilosec, work by blocking acid production for longer periods than H2 receptor blockers. They help alleviate GERD symptoms while allowing esophageal tissue time to heal. PPI therapy is available on prescription or over the counter.

In April 2020, the Food and Drug Administration (FDA) requested that all forms of prescription and over-the-counter (OTC) ranitidine (Zantac) be removed from the U.S. market. It made this recommendation because unacceptable levels of NDMA, a probable carcinogen (or cancer-causing chemical), were present in some ranitidine products. People taking prescription ranitidine should talk with a doctor about safe alternative options before stopping the drug. People taking OTC ranitidine should stop taking the drug and talk with a healthcare professional about alternative options. Instead of taking unused ranitidine products to a drug take-back site, a person should dispose of them according to the product’s instructions or by following the FDA guidance. In 2021, the pharmaceutical company Sanofi released a new version of Zantac to the market called Zantac 360. This version contains famotidine instead of ranitidine.

Rarely and in severe cases of GERD, surgery may be necessary.

Goiter

People with a goiter may require surgery or, in some cases of hyperthyroidism, radioactive iodine therapy.

Others may notice symptoms improve with medication for hypothyroidism or hyperthyroidism.

Infections

A doctor can treat bacterial infections with antibiotics. However, antibiotics are not effective for viral infections, so these need to resolve on their own.

It is important to rest and stay hydrated when fighting any infection. People can prevent future infections by washing their hands regularly and avoiding contact with individuals who have gotten sick.

While medical treatment is often necessary for persistent tightness in the throat, some symptomatic treatments can be achieved without a prescription.

  • People with food allergies should avoid any known triggers. Antihistamines may help relieve allergy symptoms when these do occur.
  • A person may be able to relieve heartburn-induced throat tightness with dietary changes. It is essential to eat slowly and avoid overeating. Also, it helps to wait at least 3 hours before lying down after meals and to reach or maintain a moderate body weight. Antacids can assist when used once in a while.
  • Ibuprofen or other nonsteroidal anti-inflammatory drugs may help people with throat inflammation or pain related to an infectious or noninfectious cause. Gargling with warm water and salt several times per day can also reduce pain and swelling in the throat.
  • An individual can also use numbing lozenges or mouth spray, which can provide short-term relief from pain in the throat.

Tightness in the throat can be annoying and uncomfortable, as well as debilitating. Therefore, a person should contact a doctor if the sensation persists for more than a few days.

It is important to get prompt medical attention if the following symptoms are present:

Experiencing some or all of these symptoms can indicate a number of conditions, including:

Tightness in the throat can be life threatening. People with allergies should take any sudden tightness in the throat seriously, as it could be a sign of anaphylaxis.

It is vital to seek emergency medical treatment, especially after exposure to an allergen, before symptoms become severe.

Many of the conditions that underlie throat tightness, such as GERD and common throat infections, are easily treatable. Others, including thyroid disorders, can be managed through medical interventions and perhaps lifestyle changes.

Individuals with severe acute allergies should carry an epinephrine pen and avoid their triggers, whenever possible.