What Causes Pain When Swallowing and How to Alleviate It

Swallowing is an essential bodily process that allows the mouth to move substances, such as food or liquids, to the stomach through the pharynx (throat) and esophagus (a muscular, hollow tube that connects the throat to the stomach).

Sometimes, it can hurt while swallowing food or liquids. This can result in sensations of squeezing or burning that may cause pain, tenderness, or discomfort in the mouth, throat, and esophagus. Pain during swallowing is medically referred to as odynophagia, which is caused by different underlying factors.

If it hurts to swallow, this could indicate that you are experiencing an infection, illness, or irritation to the nerves and muscles of your mouth, throat, or esophagus. While some cases of swallowing pain can be relieved at home, other cases will require medical care and treatment.

Pain during swallowing can be acute (short-term) or chronic (long-term). There are home remedies, medical treatments, and lifestyle changes that can help prevent and manage symptoms for relief.

When it hurts to swallow, you may experience strong sensations of burning or squeezing in areas of the body as high as your neck or as low as your breastbone. Other symptoms may include chest pain, the feeling of food stuck inside the throat, and pressure or heaviness in the neck or upper chest while consuming food.

Depending on the underlying cause, symptoms of painful swallowing can last for days, weeks, or months.

There are several underlying causes that can make it hurt to swallow. These include certain infections or health conditions of the mouth, throat, or esophagus, as well as other oral and eating problems.

Throat Infections

Throat infections such as viral pharyngitis (sore throat) and bacterial strep throat can cause pain when swallowing. Pharyngitis causes pain, scratchiness, or discomfort in the throat. Strep throat is caused by a type of bacteria called group A Streptococcus. Symptoms include pain when swallowing, swollen neck glands, fever, chills, and a red, sore throat that may have white patches.

Infections like the common cold and flu can also result in a sore throat, making it hurt to swallow.

Viruses

Viruses such as cytomegalovirus (CMV) and human immunodeficiency virus (HIV) can lead to symptoms such as sore throat, which makes it hurt to swallow. CMV is related to viruses that cause herpes simplex virus and mononucleosis.

Primarily spread through skin-to-skin contact, herpes simplex virus (HSV) is a common infection that causes painful ulcers or blisters in the oral or genital area. Symptoms can also include sore throat and swollen glands, which may lead to painful swallowing.

Mononucleosis, or mono, is a viral infection that results in symptoms such as sore throat, fatigue, fever, and swollen lymph glands. HIV is a virus that attacks the body’s immune system, causing symptoms such as sore throat, fever, chills, muscle aches, and joint pain.

Esophagal Disorders

Various esophageal disorders can lead to swallowing that hurts. These include:

Gastroesophageal reflux disease (GERD): GERD is a chronic gastrointestinal disease that causes acid in your stomach to travel back up to the esophagus, resulting in symptoms like sore throat, heartburn, nausea, and the feeling of food stuck behind the breastbone.
Esophagitis: Stomach fluid flows back into the esophagus, causing the lining of the esophagus to become inflamed, swollen, or irritated. It can cause chest pain, difficulty swallowing, and a hoarse or sore throat. Risk factors include drinking alcohol, smoking, and taking certain medications or supplements such as doxycycline, vitamin C, potassium tablets, or Fosamax (alendronate) without enough water.
Achalasia: This swallowing condition occurs when the nerves in the esophagus deteriorate, causing the muscles of the esophagus to stop working. This prevents the valve at the bottom of the esophagus from opening. Symptoms include pressure in the chest after eating, coughing or choking on food, and difficulty swallowing.
Ulcers: Ulcers, or open sores, can occur on the mouth, esophagus, or back of the throat.
Esophageal spasms: These abnormal contractions of the esophageal muscles can be painful and may cause food to get stuck in the esophagus or stomach liquid to come back up.

Mouth and Dental Problems

Several mouth and tooth problems can make swallowing painful. These include gum disease (gingivitis), oral thrush (yeast infection of the mouth), and a tooth infection or abscess (pocket of pus). These conditions can all lead to pain in the mouth or teeth that makes it painful and difficult to swallow.

Food Stuck In the Throat

Sometimes, it hurts to swallow because food gets stuck in your throat. Small or large bits of food can become lodged in the throat or esophagus, causing pain or an uncomfortable sensation while swallowing.

Cancer

Some types of cancer, including esophageal and oral cancers, cause pain when swallowing. Esophageal cancer presents with symptoms such as hoarseness, chest pain, and trouble swallowing. Oral cavity (mouth) and oropharyngeal (throat) cancers lead to symptoms such as jaw swelling or pain, difficulty chewing or swallowing, sore throat, and pain in the mouth that doesn’t go away.

If swallowing continues to hurt or feel painful, or if symptoms don’t improve after a few days, see a healthcare provider. If your symptoms worsen or you experience increased difficulty swallowing or breathing, dehydration, chills or fever, or abdominal pain, seek medical help immediately.

You should also see a healthcare professional as soon as possible if you experience any of these additional symptoms:

Bloody or black stools
Blood in saliva or phlegm (mucus)
Dizziness or shortness of breath
Unexplained weight loss
Cough
Joint swelling and pain
Rash
Heartburn
Nausea or vomiting
Sour taste in the mouth

A healthcare provider can determine what is causing your pain during swallowing. Some diagnostic tests they may use include:

Esophagogastroduodenoscopy (EGD): Also known as an upper endoscopy, an EGD is a nonsurgical procedure that inserts an endoscope (a long, thin tube) down the throat into the body to examine the upper gastrointestinal (GI) tract, which includes the mouth, back of throat, stomach, esophagus, and duodenum (the first part of the small intestine). A biopsy, or tissue sample, can also be taken with the endoscope for an accurate diagnosis.X-rays: X-rays are a form of electromagnetic radiation that capture internal images of bones, tissues, and organs in the body. When diagnosing swallowing pain, the provider may take X-rays of your chest and neck to rule out or confirm certain health conditions.Barium swallow: Also called an esophagogram, a barium swallow is an imaging test that detects problems in your upper GI tract. First, you’ll consume a chalky-tasting liquid containing barium (a silver-white metallic compound), which coats the internal tissues and organs to make them easier to see on an X-ray. Next, a fluoroscopy (a specialized type of X-ray) is taken to show internal organs moving in real time.Throat culture: A throat culture utilizes a throat swab to detect infections and group A Streptococcus bacteria (which diagnoses strep throat).Esophageal tests: The provider will measure pressure and acid levels in the esophagus.HIV blood test: The provider will take a blood sample to test for HIV.

When it hurts to swallow, several treatments can help provide relief and reduce pain. These include home remedies, lifestyle and dietary supports, and medical treatments.

Home Remedies

Home treatments and lifestyle and dietary changes that can help ease painful swallowing include:

Eat and chew your food slowly and mindfullyConsume soft or pureed foods or liquidsSuck on ice or frozen foods such as popsicles to relieve painGargle with salt waterDrink warm beveragesAvoid extremely hot or cold foodsGet plenty of rest

Viruses are a common cause of painful swallowing. Most viruses will resolve on their own without antibiotics within a week of rest and self-care remedies. Speak to your healthcare provider about over-the-counter pain relievers, such as Advil (ibuprofen) or Tylenol (acetaminophen), that may help relieve symptoms.

Medical Treatments

Some causes of swallowing pain may require medical treatment, such as prescription medications or surgery. These may include:

Antibiotics: These may be prescribed if you have a bacterial infection, such as strep throat.Muscle-relaxing medications: These may be prescribed for certain health conditions, such as esophageal spasms or other disorders.Proton pump inhibitors (PPIs): PPIs decrease the amount of stomach acid, which could reduce the effect of acid-reflux conditions like GERD.H2 blockers: Similar to PPIs, these lower the amount of acid released in the stomach, which can help treat GERD.Surgery: Surgery may be needed to treat certain health conditions that lead to pain while swallowing, such as mouth and throat cancers.

How to Prevent Painful Swallowing

There are several self-care remedies and lifestyle changes you can implement to prevent and reduce recurrences of painful swallowing. Try the following:

Wash your hands frequently to keep germs at bay
Avoid close contact with people who have sore throats, upper respiratory infections, or colds
Reduce exposure to smoking and second-hand smoke
Reduce consumption of alcohol
Use a humidifier or cool mist vaporizer to add more moisture to the air, especially if the air in your home is dry

Swallowing is an essential process for moving food and liquids through the upper GI tract. When it hurts to swallow, you may feel burning and squeezing sensations while swallowing along with discomfort, pressure, or pain in the neck or chest while eating. Bacterial infections, viruses, esophageal disorders, and cancers of the mouth and throat can cause pain when swallowing.

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