Cricopharyngeal Spasm – With a Lump in the Throat Sensation


Information for Patients with a Lump in the Throat Sensation

Article
By James P. Thomas, MD
January 2003

Causes of a Cricopharyngeal Spasm

This syndrome results from a spasm in the cricopharyngeus muscle. It is a self limiting disorder that will resolve on its own. The symptoms are so characteristic that as soon as a patient tells me they have a lump in the throat, I can usually describe all of their symptoms to them.

Symptoms of a Cricopharyngeal Spasm

  • Lump in the throat sensation.
  • Feels like a golf ball, tennis ball … is stuck in my throat.
  • Feels like my tie is too tight.
  • Feels like I am being strangled.
  • My throat feels swollen.
  • The symptoms can be mimicked by pushing on the cartilage in the neck just below the Adams apple.
  • The lump comes and goes depending on the day.
  • Symptoms are usually best in the AM and worse later in the day.
  • Stress aggravates the symptoms.
  • Saliva is difficult to swallow yet food is easy to swallow.
  • Eating, in fact, often makes the tightness go away for a time.
  • The symptoms are similar to getting choked up at a wedding or a funeral.

Why Did I Get a Cricopharyngeal Spasm?

Physiology 101
There are two valves in the esophagus or swallowing tube. They are normally contracted and they relax when you swallow so that food can pass through them going to the stomach. They then squeeze closed again to prevent regurgitation of the stomach contents. If the normal contraction becomes a spasm, like a charlie horse of the calf muscle, these symptoms start. Stress often makes these spasms much worse. Many people have experienced neck tightness when stressed and this is similar. Even if not caused by stress, stress will make the spasm much worse.

A Management Program

An exam of the neck and throat is extemely important to eliminate serious problems. In fact, it enters most peoples minds that a lump in the throat might be a cancer. In practice, real lumps in the throat, such as a cancer, are not felt. It is one of the reasons that a cancer can get so big before it is discovered. It probably is fortunate that we don’t have great sensation in the throat as we would then feel every particle of food, with every meal as it travels down the throat. So lacking great sensation in the throat, problems are a little mysterious there.

Unfortunately, many physicians are not familiar with how symptomatic a cricopharyngeal spasm can be and I often see patients who have been extensively tested with Barium swallows, esophageal endoscopies, pH testing, CT scans, xrays, MRI scans and they all come back normal or possibly with some finding that is completely unrelated to the lump in the throat sensation. Really, just a good exam of the throat, voice box and neck is all that is necessary and it is sufficient as well.

You Should Know the Following

  • Just knowing the tightness is not a sign of cancer frequently helps relieve the discomfort.
  • You will get better. Often improvement is over several weeks or even a few months, but occurs once one knows what the problem is.
  • Warm fluids should comfort the throat. Consider a cup of warm tea when the lump is bothersome.
  • If stress lets up, the symptoms improve. Think about what stress might be making this lump worse.
  • Muscle relaxants, such as valium, would be a good treatment, except for their addictive properties.

Medication

I sometimes dispense several valium (perhaps 4) as a test to prove the symptoms are from muscle spasms. I recommend taking one of the Valium on a weekend, when being alert is not important. When the lump occurs, one takes the Valium. Within an hour, there should be significant improvement in the lump sensation. If the symptoms improve after taking the muscle relaxant, then the symptoms are reasonably from a muscle spasm. Again, the knowledge that a muscle relaxant makes a lump disappear can help confirm that the cause of the lump is from a muscle and not an actual lump. I have also tried injections with a local anesthetic, often with good, but temporary results. It does help to confirm in the patients mind, there is the possibility of relief.If a local anesthetic injections helps, I have with inconsistent results injected botulinum toxin into the cricopharyngeus muscle, sometimes with prolonged relief.

Benefits of managing cricopharyngeal spasm: The symptoms go away.

Source: www.voicedoctor.net



2 Comments

  1. If “un-healed”, could this develop to muscle-spasm around the Adams apple as well?

  2. Hello, I found your website as one of the only fairly comprehensive ones outlining this condition, and thought I would report what caused my two brief episodes of this.

    First let me say I don’t take any drugs, except for Ibuprofen once a month when I’m on my period. I’m healthy and have no known illnesses / allergies / disabilities. I’m female and 25. I smoke cigarettes.

    The first time I experienced cricopharyngeal spasm was after a friend offered me a few puffs of weed (I hadn’t smoked any in years prior). After around an hour, I felt nauseous and the cricopharyngeal spasm came on. It got notably better within a few hours, and I fell asleep when the urge to belch up air to relieve the clot in my throat had subsided enough to allow sleep. At that time I had no idea what it was. It was gone completely when I woke up.

    The second time, I got it months and months later, after taking Clarinase to ease nasal congestion when I was down with the cold, that was also when I googled it to find out what it was. I experienced a slight feeling of nausea from it, though the cricopharyngeal spasm was really the worst symptom. It lasted much longer than it did when I took the weed, and only went away around 24 hours after I’d taken the pill. (Note I’ve taken Vicks decongestant tablets before when down with the cold, and never experienced anything like it). I had not taken any other drug at the time.

    I found out this symptom is a fairly known side-effect of smoking weed, and does happen sometimes, but I haven’t thus found it associated with the use of Clarinase (no such mention was made in the little leaflet that came with my pills, and no known side-effects of these pills sound even only related to cricopharyngeal spasm)

    As a layman, I’m also kind of curious as to which active substance in Clarinase could have caused the cricopharyngeal spasm in the first place? I’m now scared of taking another Clarinase pill for fear of it happening again. Thought I’d shoot this out there, who knows, maybe it’s of some help.

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