Pain When Swallowing: Causes, Relief and Treatment

There are many causes of pain while swallowing. In most cases, it’s related to illness or infection. A sore throat is usually a symptom of the common cold or strep throat. Your throat might also hurt when you swallow “wrong” or have difficulty swallowing a pill.

Throat pain can be accompanied by pain in the surrounding areas, including the mouth or the esophagus. The severity and exact location of the pain depends on the cause.

If you aren’t sure what’s causing pain l when you swallow, or you suspect it’s linked to an infection or illness, contact your healthcare provider. 

Why it Hurts to Swallow: 8 Potential Causes

Here are eight potential reasons why it might hurt to swallow:

1. Cold, Flu, and Sinus Infections

A sore throat is one of the first symptoms of many respiratory illnesses. It usually lasts about a day and eases up once additional symptoms develop. 

Home remedies for a sore throat are the best option if the pain is related to the common cold or flu.

2. Strep Throat

Strep throat is another common cause of painful swallowing. Strep is a bacterial infection that is most often alleviated with antibiotics. 

A sore throat caused by strep is usually accompanied by: 

• Fever
• Fatigue
• Swollen glands
• White spots on the throat 
• Vomiting (in young children)

Healthcare providers use rapid strep tests and sometimes throat culture to diagnose this infection.

3. Herpes Simplex Virus or CMV

Both of these are viral infections. Painful mouth sores are a common symptom of the herpes simplex virus. 

In many cases, these sores cause pain when swallowing. The sores usually ease within a few days. However, if this is the first time you’ve developed sores or you have HIV or are immunocompromised, contact your healthcare provider.

In some cases, other symptoms accompany mouth sores during an outbreak. These include: 

• Fever
• Nausea
• Muscle aches
• Vomiting 

4. Tonsillitis

Tonsillitis is an infection and inflammation of the tonsils, which are located at the back of the throat. It’s usually caused by a virus or bacterial infection.

A sore throat from tonsillitis is often accompanied by other symptoms, including:

• Swelling
• Bad breath
• Fever
• Tender jaw or neck
• White or yellow spots in the throat (especially with strep)

Your doctor might recommend tonsil removal if tonsillitis reoccurs. 

5. Oral Thrush

Oral thrush is a yeast infection that often occurs in babies, as well as people with HIV and diabetes. It can also be a side effect of taking steroids or certain antibiotics.

Thrush is usually accompanied by other symptoms, including:

• Loss of taste
• Dry, cracked skin at the corners of the mouth
• Cottony feeling in the mouth

Healthcare providers usually prescribe antifungal medicationto treat thrush.

6. Swallowing Pills or Food

Struggling to swallow a pill or bite of food smoothly can irritate your throat. If you often struggle to swallow pills, try to use capsules that have a smooth outer surface. 

It also helps to consume at least a half cup of water when taking a pill and to sit up straight for at least 10 minutes or more after you’ve swallowed it.

It’s common for people taking certain medications like doxycycline, potassium supplements, and nonsteroidal anti-inflammatory drugs (NSAIDs) to occasionally struggle with swallowing and/or experience sore throats. 

7. GERD

GERD stands for gastroesophageal reflux disease. It’s may be accompanied by other symptoms like:

• Heartburn
• Trouble swallowing
• Hoarse voice
• Vomiting
• Difficulty swallowing
• Gagging
• Acidic taste in the mouth

Painful swallowing occurs because acid damages the esophagus. Dietary changes and prescription medications can alleviate GERD.

8. Some Cancers and Cancer Treatments

Painful swallowing can be a symptom of cancer or a side effect of cancer treatment. If you’ve had a sore throat or difficulty swallowing for a week or more, speak to your doctor. 

Symptoms That May Occur With Painful Swallowing

Symptoms that often occur in conjunction with a sore throat or as a result of swallowing pain include:

• Earaches
• Gagging and choking
• Appetite loss
• Nasal and chest congestion
• Swollen glands

Home Remedies for Throat Pain Relief

If your swallowing pain is mild or has just begun, you can try a home remedy to relieve discomfort. Some of the most effective and commonly used treatment for throat pain include:

Over-the-Counter (OTC) Anti-inflammatory Medications

OTC anti-inflammatory pain relief medications reduce swelling and ease pain throughout the body. 

However, these medications can increase the risk of bleeding and other side effects if you have certain medical conditions or take daily medications. Check with your healthcare provider to determine whether or not it is safe to take OTC anti-inflammatory medications. 

Antacids

Acid reflux, commonly known as heartburn, can make it painful to swallow. Using an OTC antacid eases this discomfort.

Throat Sprays

OTC throat sprays numb the throat, which can make it easier to swallow.

Saltwater Gargling

Saltwater reduces inflammation and offers mild pain relief. Unlike the OTC medications listed above, you can gargle saltwater several times a day.

Warm Beverages

Sipping hot tea or water is a great at-home remedies for throat pain. You can add a lemon slice for extra flavor.

Hot Shower or Steam

Breathing in warm steam eases throat pain. Steam also eases nose and chest congestion that might accompany a sore throat, particularly if you have a cold. Taking a hot shower also relaxes sore muscles and reduces chills.

Avoid Certain Foods and Other Substances

Things like alcohol, tobacco, and spicy and cold foods can exacerbate throat pain. You should avoid these things if you experience pain when swallowing. 

When to See a Doctor 

Pain when swallowing isn’t always cause for concern. 

In many cases, throat pain eases as the cold or other illness improves. If you’ve swallowed wrong or if coughing hurts your throat, it’ll likely feel better in a day or two.

In some cases, you’ll need prescription medication to resolve throat pain. This is especially true with strep throat and other bacterial illnesses.

No matter what you think the cause of your difficulty swallowing is, you’ll want to see a healthcare provider if you:

• Don’t have other symptoms or an obvious cause
• Experience pain that lasts more than a week or intensifies
• Notice painful white spots on your throat 
• Have a swollen throat
• Have difficulty breathing
• Drool
• Have problems opening your mouth
• Experience swollen lymph nodes that don’t ease after a few days

Diagnosing the Cause of Painful Swallowing

Your healthcare provider mayuse several tools to diagnose painful swallowing. These include:

Throat Culture

A throat culture is the removal of cells from the back of the throat. Your doctor may use a long swab to get a sample and culture it to determine if any organisms are present.

Blood Test

Your doctor might take a blood sample to determine your white blood cell count. This can help determine if you have a bacterial infection.

CT Scan

A CT scan uses a machine to create an image of your throat. This allows your doctor to look for abnormalities, including abscesses or umors, in your throat.

Barium Swallow

This is a special type of X-ray that allows a doctor to view your throat and esophagus internally. It helps evaluate your swallowing function. You’ll drink a special liquid beforehand to make it easy to view the path that food takes from your mouth to your stomach.

Treatment Options  

Allopathic treatment options vary based on the cause. Often, healthcare providers prescribe antibiotics because swallowing pain is related to a bacterial infection such as strep throat.

Your doctor might prescribe an antifungal medication if you’ve developed a yeast infection that affects swallowing.

If you experience recurring tonsillitis, your doctor may recommend tonsil removal. This helps prevent sore throats related to tonsil inflammation.