Painful Swallowing

Try OTC medication and home remedies to ease your pain. You may have an infection or temporary illness that you can treat effectively at home. However, you should call your doctor if your pain becomes more severe or if your pain doesn’t subside within three days.

Painful Swallowing: Possible Causes and How to Treat It

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Painful swallowing is relatively common. People of all ages may experience it. This symptom has many possible causes.

Difficulty swallowing along with pain is generally a symptom of an infection or an allergic reaction. See your doctor if the pain is severe or if it interferes with eating, drinking, or breathing.

The most common causes of painful swallowing are:

• the common cold
• the flu
• chronic cough
• throat infection, such as strep throat
• acid reflux
• tonsillitis

Other possible causes of painful swallowing include:

• swollen lymph nodes in the neck
• a throat injury
• an ear infection
• swallowing large pills
• improperly swallowing jagged food, such as chips or crackers

In rare cases, painful swallowing can indicate certain types of cancer, such as esophageal cancer.

Conditions that cause painful swallowing can lead to complications such as:

• chest infections
• worsening bacterial or viral infections
• a loss of taste, which may be temporary or permanent
• swollen lymph nodes in the neck, which may make it difficult to turn your head or to lean your head back

You may experience the following symptoms along with painful swallowing if you have an infection:

• a fever
• chills
• a headache
• a dry cough
• sweating
• red, inflamed tonsils

Call your child’s pediatrician if they experience the following symptoms along with painful swallowing:

• difficulty breathing
• problems swallowing
• an unusual or significant amount of drooling
• a visibly swollen throat

Go to the hospital right away if you’re an adult and experience the following symptoms:

• difficulty opening your mouth
• problems swallowing
• extreme throat pain that gets worse
• trouble breathing

Schedule an appointment with your doctor if your painful swallowing occurs along with any of the following:

• blood when you cough
• symptoms that last one week or longer
• a hoarse voice that lasts longer than two weeks
• joint pain
• a lump in your neck
• a rash

Always call your doctor if you’re experiencing any other symptoms that concern you.

When visiting your doctor, make sure to mention every symptom you’re experiencing. You should also tell them if any symptoms are new or getting worse. Describing all of your symptoms will help your doctor determine the cause of your pain.

If a physical examination isn’t enough to determine a diagnosis, your doctor may order certain tests, such as the following:

• A blood test called a complete blood count measures the amount of different types of blood cells in your body. The results can help your doctor determine whether your body is fighting off an infection caused by a virus or bacteria.

• MRI and CT scans can produce detailed images of your throat, allowing your doctor to check for any abnormalities. These imaging tests might also be used to detect the presence of tumors in the throat.
• A throat swab culture involves taking a sample of mucus from the back of your throat. This test can check for the presence of certain kinds of organisms in the throat that could cause an infection.
• A sputum culture consists of obtaining a sample of sputum, or phlegm, and testing it for the presence of certain organisms. This simple, painless test can help your doctor determine whether an infection is causing your painful swallowing.

Barium swallow test

A barium swallow test includes a series of X-rays of your esophagus. You get the X-rays after you swallow a special liquid containing a harmless element called barium.

Barium temporarily coats your esophagus and shows up on an X-ray, allowing your doctor to trace the pathway of your food. The barium swallow test can show your doctor whether food is traveling from your mouth to your stomach properly.

Treatment for painful swallowing can vary depending on the cause of the pain. Your doctor will likely prescribe antibiotics to treat infections of the throat, tonsils, or esophagus. Your doctor may give you a mouthwash that can numb your throat while you take oral antibiotics.

This numbing agent helps to block any pain you may feel when swallowing the pill. For severe pain, a throat spray can help numb the pain. Your doctor may also prescribe anti-inflammatory medications to reduce inflammation in the esophagus, throat, or tonsils.

If you frequently experience painful swallowing due to recurring tonsillitis or if your tonsillitis doesn’t respond to medication, your doctor may recommend surgery to remove your tonsils.

This surgery is called a tonsillectomy. It’s an outpatient procedure, which means you can go home the same day as the surgery. You and your doctor can discuss your risks and determine whether a tonsillectomy is appropriate for your condition.

Home remedies

Over-the-counter (OTC) antacids may relieve swelling in the esophagus due to acid reflux. However, your doctor will prescribe medications that are specifically designed to provide relief from symptoms if you have chronic acid reflux or gastroesophageal reflux disease (GERD). Taking OTC antacids sometimes isn’t enough to treat the symptoms of GERD.

Other treatments you can try at home include the following:

• Drink plenty of fluids. Aside from keeping you hydrated, drinking at least eight glasses of water per day also soothes and moistens your throat.
• Mix 1 teaspoon of salt in 8 ounces of water, and then gargle it in the back of your throat. This helps to relieve swelling and pain.
• Sip warm liquids, such as warm water or tea mixed with honey, to relieve swelling and pain in the throat.

• Avoid substances that are known to irritate your throat. These include allergens, chemicals, and cigarette smoke.

Breathe in moist air

A humidifier is a machine that converts water to moisture that slowly fills the air. A humidifier increases the humidity in a room. Breathing in this moist air can ease throat inflammation and provide relief from a sore throat. Taking a hot shower also has a similar effect.

Try herbal lozenges and teas.

Though they haven’t been scientifically proven to ease sore throats, herbal lozenges and teas can reduce throat pain. Examples include sage, licorice root, and honeysuckle flower. You may able to find these at your local drugstore or health food store.

Try OTC medication and home remedies to ease your pain. You may have an infection or temporary illness that you can treat effectively at home. However, you should call your doctor if your pain becomes more severe or if your pain doesn’t subside within three days.

You should also contact your doctor if you’re experiencing any other symptoms that concern you. You can book an appointment with a primary care provider in your area using our Healthline FindCare tool.

Wash your hands regularly and to avoid sharing eating utensils or drinking glasses with other people to prevent spreading any possible infection. Staying hydrated and getting plenty of rest are also important for ensuring your recovery.

Last medically reviewed on April 20, 2016

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

• Ear Infection. (n.d.). Kids Health. Retrieved July 20, 2012, from
  kidshealth.org/kid/ill_injure/sick/ear_infection.html
• Healthy Kids: Tonsillitis. (n.d.). American Academy of Pediatrics. Retrieved July 20, 2012, from
  kidshealth.org/kid/ill_injure/sick/tonsillitis.html
• Sore Throat. (2010, September 25). Mayo Clinic. Retrieved July 20, 2012, from
  mayoclinic.com/health/sore-throat/DS00526

Painful Swallowing

Heather M. Jones is a freelance writer with a focus on health, parenting, disability, and feminism.

Published on February 02, 2023

Kimberly Brown, MD, MPH is an emergency medicine physician, speaker, and best-selling author.

Table of Contents
Table of Contents

Painful swallowing can feel like discomfort or pain or may feel like a burning or squeezing sensation. It may be felt anywhere from the neck to the breastbone. Pain in the throat or chest during swallowing is called odynophagia .

Painful swallowing can be caused by several things, including infection, acid reflux, or damage to the esophagus (food tube). This article will discuss what can cause painful swallowing, when to be concerned, and what to do about it.

Symptoms of Painful Swallowing

In addition to pain or discomfort while swallowing, a person with odynophagia may also experience:

• Soreness or ulcers in the mouth
• Pain and a burning sensation after swallowing
• Feeling as though food is “stuck”
• Reflux (stomach acid flows back into the food tube) or indigestion

Painful swallowing often feels like a sensation of squeezing or burning. It may be felt high in the neck or down lower behind the breastbone.

Medical Emergencies

Sudden symptoms of difficulty swallowing can indicate a condition that is a medical emergency, requiring calling 911 or getting immediate transport to an emergency room. These include:

• Stroke: Signs of a blockage of blood flow or bleeding in the brain can include sudden difficulty or inability to swallow, weakness or drooping of one side of the face or body, speech difficulties, vision loss, dizziness, confusion.
• Angioedema: Swelling of the lower layer of tissue under the mucous membranes in the mouth and throat can cause difficulty swallowing. It can be a medical emergency as it may impact breathing. It may be accompanied by lip and tongue swelling, hoarse voice, drooling, and more.

Causes of Painful Swallowing

Painful swallowing can be caused by many different things, including:

Infections, such as:

• Sore throat from a virus such as a cold or flu
• A bacterial infection such as strep throat
• Herpes simplex virus
• A gum or tooth infection or abscess
• Cytomegalovirus (closely related to the viruses that cause chickenpox and mononucleosis )
• Candida albicans (fungal infection commonly called thrush usually affecting the mouth but can affect the esophagus, particularly in people with a compromised immune system)
• Tonsillitis (infection of the tonsils)
• Peritonsillar abscess (an area of pus-filled tissue at the back of the mouth beside one of the tonsils)
• Middle ear infection (otitis media)

Conditions affecting the mouth, throat, or esophagus, such as:

• Gastroesophageal reflux disease (GERD) (when acidic stomach contents flow back up into the esophagus)
• Esophagitis (inflammation and irritation of the lining of the esophagus)
• Esophageal spasms
• Nutcracker esophagus (powerful swallowing contractions, often caused by gastroesophageal reflux)
• Gingivitis (gum disease)
• Ulcers (sores) in the mouth, esophagus, or throat
• Laryngitis (inflammation of the larynx/voice box causing swollen vocal cords)

Damage to the mouth, esophagus, or throat, such as:

• An object or food stuck in the throat
• Scratches, tears, cuts, or irritation in the mouth, throat, or esophagus
• Burns

What Medications Can Cause Painful Swallowing

Some medications may cause ulcers in the esophagus, including:

• Tetracyclines (antibiotic)
• Aspirin
• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil/Motrin (ibuprofen) and Aleve (naproxen)

How to Treat Painful Swallowing

Painful swallowing is treated by addressing what is causing the underlying problem (such as antibiotics for strep throat) and with symptom relief.

Ways to help relieve painful swallowing symptoms include:

• Changing eating habits, such as eating soft foods and avoiding foods that are very hot or very cold
• Not smoking, which can irritate the throat
• Using over-the-counter (OTC) lozenges or throat sprays
• Using a local anesthetic containing lidocaine (spray or oral solution) to numb the throat
• Pain management with Tylenol (acetaminophen) or NSAIDs

Eating Tips for Painful Swallowing

Changes you can make to your diet and habits to make eating with painful swallowing easier include:

• Choose soft/moist foods and foods that are easier to chew and swallow.
• Finely chop, mince, blend, or puree foods to soften them.
• Have beverages with your meal and sip as you eat to moisten your mouth and help the food go down.
• Use a straw if your mouth is irritated.
• Add moisture to foods by using sauces, gravies, etc., or dipping foods into warm drinks or soup.
• Avoid or soften crunchy, dry, or abrasive foods, such as chips, cookies, nuts, etc.
• Avoid foods that sting or irritate your mouth or throat. This may include salty or spicy foods, acidic foods like fruit/vegetable juice or vinegar, extremely hot or cold food and drinks, and alcohol.

If painful swallowing is causing you to eat less and lose weight, try these tactics:

• Eat smaller, more frequent meals.
• Add foods that are higher in protein or fats.
• Drink smoothies, milkshakes, or supplement drinks.

Complications Associated With Painful Swallowing

In addition to complications from the cause of the painful swallowing, ongoing pain while swallowing can lead to:

• Lack of adequate food and fluid intake
• Unintentional weight loss
• Reduced physical wellness and quality of life

Are There Tests to Diagnose the Cause of Painful Swallowing?

If you are experiencing painful swallowing, a healthcare provider will first do a physical examination and ask some questions about your symptoms and medical history. They may ask about the following:

• The nature of the pain (is it constant, does it come and go, is it getting worse, etc.)
• How the pain feels (sore throat, feeling like there is a lump in your throat, etc.)
• How it affects swallowing (pain when swallowing liquids, solids, or both)
• The circumstances surrounding the pain (such as have you swallowed or inhaled any irritating substances)
• Any other symptoms you may have
• Other health problems you have
• Any medications you take

If your healthcare provider feels it’s necessary, they may run tests such as:

• Tests for strep throat: A rapid antigen test is common, or a throat culture may be performed.
• HIV testing: This tests for the human immunodeficiency virus.
• Endoscopy: A flexible tube with a light and camera is used to look inside the body and sometimes remove tissue (biopsy) to analyze in the lab.
• Barium swallow and upper gastrointestinal (GI) series: A drink containing barium is swallowed then X-rays are performed.
• Chest or neck X-ray
• Esophageal pH monitoring: This test measures acid in the esophagus.
• Esophageal manometry : This test measures pressure in the esophagus.
• Esophagogastroduodenoscopy (EGD): An endoscope is used to examine the lining of the esophagus, stomach, and first part of the small intestine.

When to See a Healthcare Provider Painful Swallowing

Contact a healthcare provider if your painful swallowing is prolonged, is bothering you, or is accompanied by:

• Blood in your stools (or your stools appear black or tarry)
• Shortness of breath
• Wheezing
• Light-headedness
• Weight loss
• Fever
• Chills
• Abdominal pain
• Cough
• Nausea or vomiting
• Heartburn
• Sour taste in the mouth

Can Painful Swallowing Be a Sign of Cancer?

• Dysphagia (difficulty swallowing)
• Indigestion or heartburn that doesn’t go away
• Unexplained weight loss
• Pain in the throat or behind the breastbone

These symptoms can be caused by many more common conditions than esophageal cancer. If you have any of these symptoms, see a healthcare provider to have them checked.

Other symptoms of esophageal cancer include:

• Food coming back up
• Hoarseness
• A cough that won’t go away
• Coughing up blood
• Dark (almost black) stool (uncommon)

Summary

Painful swallowing is a symptom that can have many different causes, including infection, medical conditions such as GERD (gastroesophageal reflux disease), and damage from objects stuck in the throat.

Painful swallowing can be felt anywhere from the neck to the breastbone. It may feel like pain, discomfort, burning, or a squeezing sensation.

Painful swallowing is a common symptom of many different conditions. See a healthcare provider if you are experiencing unexplained painful swallowing or if the pain while swallowing isn’t going away or is accompanied by other symptoms.

Treating the underlying cause is the most important way to treat painful swallowing. Symptoms can be relieved by changing eating habits, using lozenges or numbing sprays/oral solutions, or taking pain medication such as NSAIDs.

Frequently Asked Questions

Is painful swallowing a sign of COVID-19?

Yes. A sore throat and/or painful swallowing can be a symptom of COVID-19. As with other COVID symptoms, if you are experiencing a sore throat and/or painful swallowing, it’s a good idea to take a COVID test.

How can I ease the pain from swallowing with a sore throat?

Changing what and how you eat can help, such as eating softer foods and chewing thoroughly. You can take pain relievers such as Advil or Motrin (ibuprofen). Throat lozenges may help, and there are both prescription and over-the-counter numbing sprays and oral solutions which may provide temporary relief. Be careful eating when using numbing agents as these products can increase the risk of choking, and you may not feel that something is too hot or cold. Numbing agents can also have side effects. Check with a healthcare provider or pharmacist before using them.

Is painful swallowing a medical condition?

Painful swallowing is not a condition in and of itself, but a symptom that can be caused by a number of different medical conditions. The medical term for painful swallowing is odynophagia.

17 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. Nicklaus Children’s Hospital. Painful swallowing.
2. Queensland Health. Painful eating and swallowing.
3. Mount Sinai. Painful swallowing.
4. Centers for Disease Control and Prevention. Stroke signs and symptoms.
5. University of Florida Health. Painful swallowing.
6. Nemours KidsHealth. Cytomegalovirus (CMV).
7. The Oral Cancer Foundation. Candida infection.
8. Nemours KidsHealth. Tonsillitis.
9. Nemours TeensHealth. Peritonsillar abscess.
10. Nemours KidsHealth. What is an ear infection?
11. Cedars-Sinai. Esophagitis.
12. Cedars-Sinai. Nutcracker esophagus.
13. American Academy of Family Physicians. Ulcers.
14. healthdirect. Laryngitis.
15. MyHealth Alberta. Swallowed object in throat or esophagus: care instructions.
16. Piersiala K, Kakabas L, Bruckova A, Starkhammar M, Cardell LO. Acute odynophagia: a new symptom of COVID‐19 during the SARS‐CoV‐2 Omicron variant wave in Sweden. J Intern Med. 2022;292(1):154-161. doi:10.1111/joim.13470
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By Heather Jones
Heather M. Jones is a freelance writer with a strong focus on health, parenting, disability, and feminism.