Tonsil Pain: Causes, Treatments, and Concerns

Tonsillar pain or tonsil pain?

Hello Doctor, last Wednesday I experienced a sharp pain on the left tonsil, and on Sunday my throat suddenly felt very tight, making it hard to breathe.
By Monday, the sharp pain appeared on the right side as well, so now both sides have this sharp sensation.
On Tuesday, I visited the ENT department at Zhongxiao Hospital, and the doctor said I have excessive phlegm, which is causing the tightness in my throat, but my throat appears normal.
On Wednesday, I went to National Taiwan University Hospital, where the doctor also examined my throat and said it looks normal.
He performed a thyroid ultrasound, which came back normal.
However, he noted blood streaks on the soft palate near the tonsils and on the throat wall.
I requested a nasal endoscopy, but the doctor said it wasn't necessary since my throat and tonsils looked normal.
Later that Wednesday evening, I visited a nearby clinic, where the doctor said the sharp pain is due to tonsil stones, and the tightness in my airway could be related to gas.
He cleaned both sides for me.
I have had tonsil stones for the past two years, primarily on the right side, which usually only feels uncomfortable but has never caused sharp pain.
After the cleaning, the sharp pain on the left side has resolved, but the right side still has a sharp and uncomfortable sensation when eating or drinking, which comes and goes.
I wonder why I only felt discomfort before and now have sharp pain.
Additionally, I felt cold twice this week.

1.
Is the sharp pain on the right side due to incomplete removal of the stones? The right tonsil is larger, but I have never experienced sharp pain from the stones before, only discomfort.
Why is there sharp pain this time?
2.
Can excessive phlegm really cause airway tightness and discomfort? I do not have any cold symptoms, and my throat does not hurt.

3.
The clinic doctor always uses a squeezing tool to force the stones out, which is very painful and causes bleeding.
Won't this injure the tonsils? I read online that stone removal is usually done with suction.
The doctor said the stones are hidden and that there are rarely stones on the left side.
What symptoms indicate that someone has had tonsillitis more than six times a year? Is it related to colds?

Wenwen, 40~49 year old female. Ask Date: 2018/01/05

Dr. Zheng Jueyi reply Otolaryngology

Hello, if the tingling sensation has been examined by multiple physicians and no tumors were found, it is commonly associated with chronic inflammation.
The feeling of excessive phlegm may also be a result of chronic inflammation, potentially related to chronic tonsillitis or irritation from gastroesophageal reflux.
In addition to local treatment and medication management from your physician, it is advisable to incorporate regular routines and reduce the intake of sugary and spicy foods to gradually improve the condition.
Wishing you safety and health.
Sincerely, Dr.
Jue-Yi Cheng, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2018/01/05

More Info

Tonsil pain can be a frustrating and concerning issue, especially when it is accompanied by other symptoms such as difficulty breathing or a sensation of tightness in the throat. Based on your description, it seems you have been experiencing a series of events that have led to discomfort in your tonsils, particularly with the presence of tonsil stones (tonsilloliths). Let's break down your concerns and provide some clarity on the situation.

1. Tonsil Stones and Pain: Tonsil stones are calcified debris that can form in the crevices of the tonsils. They are often composed of food particles, dead cells, and bacteria. While many people with tonsil stones may not experience pain, some can develop discomfort or a sharp pain, especially if the stones become larger or if they irritate the surrounding tissue. The fact that you have had a history of tonsil stones, particularly on the right side, could explain the recent onset of pain. The pain you are experiencing could be due to inflammation or irritation caused by the stones, or it could be a result of the stones themselves pressing against sensitive areas of the tonsil.

2. Phlegm and Respiratory Discomfort: You mentioned that a doctor indicated that excess phlegm could be causing a feeling of tightness in your throat. While phlegm itself does not directly cause the airway to constrict, it can lead to a sensation of tightness or discomfort, especially if it is thick or if you are experiencing post-nasal drip. This can occur even in the absence of cold symptoms, as allergies or irritants in the environment can lead to increased mucus production. If you are not experiencing other cold symptoms, it is possible that your body is reacting to something in your environment, leading to increased mucus and subsequent throat tightness.

3. Tonsil Cleaning Procedures: The method of cleaning tonsil stones can vary. While some practitioners may use a tool to manually extract the stones, which can be painful and may cause bleeding, others may use suction devices or other less invasive methods. If you are experiencing significant pain and bleeding during these procedures, it is worth discussing with your healthcare provider to explore alternative methods that may be less traumatic to the tonsils. Repeated trauma to the tonsils can lead to inflammation and may exacerbate your symptoms.

4. Symptoms of Tonsil Inflammation: You asked about what constitutes frequent tonsil inflammation. Generally, if you experience tonsillitis (inflammation of the tonsils) more than six times a year, it may be considered chronic. Symptoms of tonsillitis can include sore throat, difficulty swallowing, swollen tonsils, and sometimes fever. If you find that you are frequently experiencing symptoms that resemble tonsillitis, it may be worth discussing with an ENT specialist whether a more comprehensive treatment plan or even a tonsillectomy (removal of the tonsils) might be appropriate.

In conclusion, your symptoms of tonsil pain, the sensation of tightness in your throat, and the presence of tonsil stones are interconnected. It is essential to continue working with your healthcare providers to monitor your symptoms and explore treatment options that can alleviate your discomfort. If you find that your symptoms persist or worsen, seeking a second opinion or further evaluation from an ENT specialist may provide additional insights and treatment options.

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