A familiar picture: a person sits down at the table, takes the first spoonful — and freezes: they can swallow, but they don't want to. A sore throat when swallowing is one of the most common complaints that brings people to the pharmacy and to the doctor, and in most cases it resolves on its own. Let's look at what lies behind it and what to watch for.
Why Swallowing Hurts: How Sore Throat Pain Works
The throat is not a single organ but several sections, and "sore throat" means pain in any part of the throat. Most often it is caused by irritation or inflammation. Inflammation of the posterior pharyngeal wall is called pharyngitis, and sore throat is its main symptom. If the tonsils are predominantly inflamed, it is called tonsillitis.
What happens inside: pain is a consequence of irritation or inflammation, which is why it intensifies at the moment of swallowing.
Common Causes of Sore Throat When Swallowing
The most common cause is acute viral pharyngitis: it accounts for about 80% of cases. In another 20–30% of cases, even a virology laboratory cannot determine which virus caused the pain. Less often, bacteria are to blame — for example, streptococcal pharyngitis: in children it causes 37% of sore throat cases.
- viral infections — colds and flu;
- laryngitis, tonsillitis, infectious mononucleosis;
- streptococcal pharyngitis and other bacterial infections;
- irritation from smoke, including from smoking;
- stomach acid in reflux and allergy.
Other causes include injuries and tumors.
Acute and Very Severe Pain When Swallowing: What It May Mean
With streptococcal pharyngitis, the pain can be severe and persist for quite a long time. It is recognized by a set of symptoms and confirmed with a rapid test.
Severe pain by itself does not indicate a catastrophe. But there are conditions in which it is combined with dangerous signs: epiglottitis (inflammation of the epiglottis) and retropharyngeal abscess. An ordinary sore throat without active treatment lasts from two to seven days — if it lasts longer, a conversation with a doctor should not be delayed.
Painful to Swallow but the Throat Doesn't Hurt: Possible Causes
It can be different: the throat looks calm, but swallowing is painful or difficult. This condition is called dysphagia (swallowing disorder). Some people cannot swallow liquids, others cannot swallow solid food or even saliva, and then eating becomes difficult.
What happens inside: the cause may not be in the throat but in the esophagus or the nervous system. Among the conditions that lead to swallowing disorders are esophageal problems, including gastroesophageal reflux disease, stroke, head and spinal cord injuries, nervous system diseases such as Parkinson's disease and cerebral palsy, and tumors of the head, neck, and esophagus. In older adults, swallowing disorders are more common.
To determine the cause, various examinations are used — from bedside swallowing assessment to barium X-ray and endoscopy of the upper digestive tract.
Pain When Swallowing and Accompanying Symptoms
Pain when swallowing may be accompanied by: a dry and scratchy throat, redness of the posterior wall of the mouth, bad breath, a mild cough, and enlarged lymph nodes in the neck. In children the picture is the same, but high fever and lethargy are added.
When Pain When Swallowing Requires a Doctor's Examination
See a doctor if the child is under 5 years old, if the pain does not improve within a week, if the throat hurts often, and also if there is a sensation of a lump in the mouth or neck or a mouth ulcer persists for more than three weeks.
Seek help without delay in case of very high fever, chills, signs of dehydration (the person urinates less often, urine is dark and has a strong odor), and weakened immunity — for example, due to diabetes or chemotherapy.
A sore throat by itself is not a reason to call an ambulance. Call 103 or 112 if the person has difficulty breathing or cannot swallow, if saliva is flowing (a sign that swallowing is not possible), if a high-pitched whistling sound is heard on inspiration (stridor), and also if the symptoms are severe and rapidly worsening.
This material is for reference: it helps you get your bearings and avoid panicking prematurely, but it does not replace a doctor's consultation — an examination and conversation are still needed.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer