Throat Foreign Body Sensation and Its Systemic Symptoms

Systemic symptoms following the sensation of a foreign body in the throat?

Hello Doctor: Since the beginning of last year, I have had a sensation of a foreign body in my throat after choking while swallowing and speaking.
My throat muscles always feel tight, my jaw feels retracted, and the muscles around my right shoulder blade feel tense, affecting my ability to lift my right arm and bend over.
I also have a tight sensation in the muscles beside my esophagus in the right chest cavity, along with pain under my right rib, and swallowing feels strange (although I can still swallow, it feels different from before).
Initially, I thought it was just a temporary issue that would resolve in a few days or an abnormal sensation caused by pressure from choking.
After it didn’t improve, I went to my usual chiropractor for adjustments, but there was still no improvement.
I began to suspect that there might be something wrong in my throat and went to a large hospital for X-rays, CT scans, endoscopy, colonoscopy, and blood tests, but all results came back normal.
The only abnormality was a lower platelet count and eosinophil count in my blood tests.
I then sought various alternative therapies (acupuncture, cupping, herbal medicine), but I felt that things were getting more chaotic.
What started as localized symptoms evolved into a lack of coordination in my entire body, and now I am hesitant to seek further treatment, but the discomfort persists.
I have several questions that I would like to ask the doctor:
1.
Before the choking incident, I had long-term gastric bloating and nasal allergies, and I had been regularly seeing the same massage therapist for adjustments, which provided some improvement, but I felt it was not a complete cure.
I later realized that sometimes my own stress or nervousness in group settings could also contribute to my symptoms, so I consulted a psychiatrist about a year and a half ago.
I took medication intermittently and felt better after finishing, but I stopped seeing the doctor until my anxiety and emotional issues resurfaced, leading to three or four visits, with intervals of no more than three weeks.
I want to ask if the throat issues that developed later could be due to the adjustments made by the chiropractor disrupting my musculoskeletal alignment? Or could it be a side effect of not continuously taking the autonomic nervous system medication?
2.
After the choking incident and finding no abnormalities, I went back to the psychiatrist for medication, but after a week of taking it, I felt that the sensation of a foreign body in my throat and other symptoms had not improved, so I stopped going.
At that time, I was anxious and turned to alternative therapies, spending nearly six months on herbal medicine, cupping, and acupuncture.
Not only did the sensation of a foreign body in my throat not improve, but the tightness in the fascia in my right chest cavity and under my right rib gradually spread: from the right lower side to the left lower side, then to the left upper side (during this time, I felt a severe pressure on my heart), and eventually, my entire back became tense (bending over felt very tight), and my gastrointestinal health deteriorated (due to alternative therapies and sometimes anxiety-induced gastrointestinal spasms).
I had to seek treatment from a traditional Chinese medicine orthopedic specialist for a while.
After several sessions, he said my bones were aligned, but my muscle condition still did not improve.
Recently, I feel that the tightness in my back is caused by an imbalance in the muscles (fascia) of my internal organs.
I found that autonomic nervous system disorders can have various symptoms, so I would like to ask the doctor if there are any psychiatric medications or methods that can help adjust the abnormal pulling and spasms of the internal organs?
3.
If the imbalanced muscles in my body need to recover, should treatment follow the direction of pain and tightness or go against it? If I want to restore my body to its condition before the choking incident, should I resolve the symptoms (tightness and pressure in the fascia) in the order they appeared, or will continuous treatment eventually bring me back to the starting point? For example, if symptoms range from 1 to 10, and my symptoms originally were at position 1 but have moved to position 5, will treatment allow the symptoms to progress to 10 and then return to 1? Or should I treat from 5 back to 1?

Haohao, 20~29 year old female. Ask Date: 2018/01/22

Dr. Wu Enliang reply Psychiatry

It seems that your life is indeed troubled by these physical sensations, and it can be very frustrating to have seen many doctors and undergone various treatments without resolution.
Our brain's response to stress can lead to increased sensitivity in the body.
It is recommended to consistently take medications for the autonomic nervous system for a period of time, generally at least six months, and to engage in some relaxation training or psychological therapy.
Regarding the third question, it is not very clear; I suggest discussing it in detail with a trusted psychiatrist after your appointment.

Reply Date: 2018/01/22

More Info

The sensation of a foreign body in the throat, often referred to as "globus sensation," can be a perplexing and distressing experience. It is characterized by the feeling of something being stuck in the throat, even when there is no actual obstruction. This sensation can be accompanied by various systemic symptoms, including muscle tightness, discomfort in the chest, and even psychological symptoms such as anxiety.

Understanding the Symptoms
1. Physical Symptoms: The tightness in the throat and the sensation of a foreign body can stem from several causes. One common reason is muscle tension, which can be exacerbated by stress or anxiety. The throat is surrounded by muscles that can become tense, leading to discomfort and the sensation of something being lodged. Additionally, if you have a history of gastroesophageal reflux disease (GERD) or allergies, these conditions can contribute to throat irritation and the sensation of a lump.

2. Systemic Symptoms: The systemic symptoms you describe, such as tightness in the shoulder and chest, and discomfort radiating to the right arm, may indicate a broader issue related to muscle tension or even anxiety. Chronic muscle tension can lead to a phenomenon known as myofascial pain syndrome, where tightness in one area can cause pain and discomfort in other areas of the body.

3. Psychological Factors: Anxiety and stress can significantly impact physical sensations. The body’s stress response can lead to muscle tension, which may exacerbate the feeling of a foreign body in the throat. Moreover, anxiety can manifest physically, causing symptoms such as palpitations, muscle tightness, and gastrointestinal disturbances.

Addressing Your Concerns
1. Impact of Chiropractic Adjustments: While chiropractic adjustments can help with musculoskeletal issues, they may not directly address the sensation of a foreign body in the throat. If the adjustments have not alleviated your symptoms, it is possible that the underlying issue is not purely structural but may involve muscle tension or psychological factors.

2. Medication and Treatment: If you have been prescribed medication for anxiety or stress, it is essential to follow up with your healthcare provider regarding its effectiveness. Some medications can take time to show results, and discontinuing them prematurely may lead to a resurgence of symptoms. Cognitive-behavioral therapy (CBT) is another effective treatment for anxiety that can help address the underlying psychological factors contributing to your symptoms.

3. Muscle Recovery: When it comes to muscle recovery and addressing tightness, it is generally more effective to work on the areas of tension rather than trying to reverse the symptoms in a specific order. Techniques such as physical therapy, stretching, and relaxation exercises can help alleviate muscle tightness and improve overall function. It is crucial to listen to your body and work with a healthcare professional who can guide you through appropriate rehabilitation exercises.

Recommendations
- Consult a Specialist: Given the complexity of your symptoms, it may be beneficial to consult with a multidisciplinary team, including an ENT specialist, a neurologist, and a mental health professional. This approach can help ensure that all potential causes of your symptoms are thoroughly evaluated.

- Stress Management: Incorporate stress management techniques into your daily routine. Practices such as mindfulness, yoga, and deep breathing exercises can help reduce muscle tension and improve your overall sense of well-being.

- Physical Therapy: Consider engaging in physical therapy focused on the neck and shoulder areas. A physical therapist can provide targeted exercises to relieve tension and improve muscle coordination.

- Follow-Up Care: Regular follow-ups with your healthcare providers are essential to monitor your symptoms and adjust treatment plans as necessary. Keeping an open line of communication can help you feel more in control of your health journey.

In conclusion, the sensation of a foreign body in the throat, combined with systemic symptoms, can be multifaceted, involving physical, psychological, and possibly neurological components. A comprehensive approach that includes medical evaluation, psychological support, and physical rehabilitation may provide the best pathway to relief.

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