If you have tightness in your throat, you may wonder what’s causing it. The cause of the tightness can vary from an infection like strep throat to a more serious allergic reaction. If you have other warning signs, like trouble swallowing or breathing, throat tightness is an emergency that needs to be treated immediately.
Tightness in your throat can take many forms. It might feel like:
- your throat is swollen
- you have a lump in your throat
- a band is around your neck
- your throat is tender and sore
- something is blocking your throat and making it hard to breathe or swallow
Read on to learn more about possible causes for tightness in your throat and how you can manage this symptom.
These are a few conditions that can cause a tight feeling in your throat:
1. Heartburn or GERD
Gastroesophageal reflux (GERD) is a condition that happens when the band of muscles between your esophagus and stomach doesn’t tighten properly. This relaxed opening allows acid from your stomach to back up into your esophagus. When stomach acid irritates the esophagus, it creates a burning sensation called heartburn.
GERD can feel like your throat is tight, or like you have a lump or food stuck in your throat. You might have trouble swallowing.
Other symptoms are:
- a sour taste in your mouth
- burping up liquid
- a hoarse voice
- chest pain that can feel like a heart attack
- a dry cough
- bad breath
- swollen glands
- painful swallowing
- ear pain
- bad breath
- loss of your voice (laryngitis)
- nausea or vomiting (in children)
- red or swollen tonsils
3. Allergic reaction
An allergic reaction happens when your immune system misidentifies something harmless, like peanuts or pollen, as a dangerous foreign invader. It launches a response, releasing chemicals that cause symptoms like a stuffed nose and watery eyes.
The most serious type of allergic reaction is called anaphylaxis. It can happen in response to:
- a food you’ve eaten
- a medicine you’ve taken
- an insect bite or sting
Symptoms of this reaction usually start within a few minutes to hours after the exposure.
The chemicals released during anaphylaxis cause inflammation, which is what makes your throat and airways swell up and tighten. Other symptoms of anaphylaxis include:
- wheezing, or a whistling sound when you breathe
- a cough
- tightness or pain in your chest
- swelling of your face, including your lips, tongue, and mouth
- itchy mouth or throat
- dizziness or fainting
- hives, rash, or itchy skin
- nausea, vomiting, or diarrhea
- stomach cramps
- fast pulse
Anaphylaxis is always a medical emergency. Call your local emergency services or go to an emergency room immediately for treatment.
Though anxiety is an emotional response, it can produce real physical symptoms. During a panic attack, you might feel like your throat is closing and your heart is pounding. These symptoms come on quickly and can resemble symptoms of a heart attack.
Other symptoms of a panic attack include:
- shortness of breath
- cramps or nausea
- numbness or tingling
- feelings of doom
5. Enlarged thyroid (goiter)
The butterfly-shaped thyroid gland in your neck produces hormones that help control your body’s metabolism. An enlarged thyroid gland can make your throat feel tight and make it hard to breathe or swallow.
Other symptoms of an enlarged thyroid include:
- swelling in your throat
- a hoarse voice or changes to your voice
Anaphylaxis is a medical emergency that needs to be treated immediately. If you have symptoms of a severe allergic reaction, like trouble breathing or swallowing, call your local emergency services or go to an emergency room right away.
Make an appointment with your doctor if you have symptoms like these:
- chest pain
- a fever higher than 103°F (39.4°C)
- a sore throat that lasts longer than 48 hours
- a sore throat and swollen glands
- a stiff neck
The tests you get depend on the cause of your throat tightness.
Tests for GERD
Doctors can sometimes diagnose GERD based on symptoms alone. You might have to wear a monitor to measure the amount of stomach acid that backs up into your esophagus.
Other tests to evaluate your symptoms can include:
- Barium swallow or upper GI series. You drink a chalky liquid. Then the doctor takes X-rays of your esophagus and stomach.
- Endoscopy. This test uses a thin, flexible tube with a camera on one end to see inside your esophagus and stomach.
Tests for an infection
Your doctor will first ask about your symptoms. Then they might take a swab from the back of your throat to test for strep throat or other bacteria. This is called a throat culture.
Tests for anaphylaxis
An allergy specialist can do a blood test or skin test to identify your allergy trigger. Learn more about available allergy tests.
Tests for anxiety
Your doctor will do a physical exam. You might get tests like an electrocardiogram (EKG) to rule out any heart conditions or blood tests to check for other problems that can mimic anxiety. A counselor or therapist can help pinpoint the cause of your anxiety.
Tests for an enlarged thyroid
Your doctor will feel your neck and may do blood tests to check your thyroid hormone levels. Other tests used to diagnose an enlarged thyroid gland include an ultrasound and a thyroid scan.
If you have heartburn, the following can help prevent throat tightness and other symptoms:
- avoid overeating
- avoid foods that trigger it
- take antacids or acid-blocking drugs
For a sore, tight throat caused by infection, pain relievers such as ibuprofen (Advil, Motrin) can ease the discomfort. You may also need a prescription for antibiotics from your doctor for bacterial infections like strep throat. You can gargle with a mixture of salt, baking soda, and warm water, or suck on a throat lozenge. Rest your voice until you feel better.
Anaphylaxis is treated under close medical supervision and with a shot of epinephrine. Other medications like antihistamines and corticosteroids may be necessary as well.
The treatment depends on what caused the tightness in your throat.
Several different medications treat heartburn:
- Antacids like Rolaids, Tums, and Maalox neutralize the acid in your stomach.
- H2 blockers like cimetidine (Tagamet HB), famotidine (Pepcid AC), and ranitidine (Zantac 75) reduce the amount of acid your stomach makes.
- Proton pump inhibiters such as esomeprazole (Nexium), lansoprazole (Prevacid), and omeprazole (Prilosec) block stomach acid production.
A few lifestyle changes can also help decrease heartburn symptoms, including:
- eating smaller meals, especially before bedtime
- losing weight if you are overweight
- quitting smoking
- avoiding alcohol
- raising the head of your bed six inches
If you have frequent heartburn symptoms — more than twice a week — see your doctor for a proper diagnosis and evaluation.
Antibiotics treat infections caused by bacteria, but they won’t help if a virus caused your illness.
- Rest and take care of yourself to help your body fight off the infection.
- Avoid getting sick in the future by washing your hands often and staying away from anyone who’s sick.
Anaphylaxis is treated with an injection of epinephrine. Carry an auto-injector (Adrenaclick, EpiPen) if you have severe allergies in case you react to a food, insect sting, or medication. An EpiPen requires a prescription from your doctor.
For some types of allergies, a technique called immunotherapy can help desensitize you to the allergen and prevent a reaction in the future. You’ll get a series of shots over a long period of time. These shots will contain increasing amounts of your trigger until you no longer react as severely. Learn more about allergy shots.
To prevent panic attacks, your doctor might prescribe a combination of talk therapy and medications such as selective serotonin reuptake inhibitors. Relaxation techniques like yoga and meditation can sometimes also help.
If you have a very enlarged thyroid gland or goiter, you might need surgery or radioactive iodine depending on the cause. These treatments remove or destroy part or all of the thyroid gland. You’ll need to take thyroid hormone afterward to replace what your thyroid gland no longer makes.
The conditions that cause tightness in your throat are treatable.
Antacids and other medicines that neutralize or block the production of stomach acids can decrease heartburn. You can also control symptoms by avoiding your heartburn triggers.
Infections will usually get better within a week or so.
You can manage severe allergic reactions by carrying an epinephrine pen, taking allergy medication, and avoiding your triggers.
With therapy and medication, panic attacks should get better over time.
Thyroid gland enlargement may improve once you treat it.