the Sensation of a Lump in the Throat: Causes and Concerns - Otolaryngology

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The sensation of having a lump in the throat, often referred to as "globus sensation," can be a perplexing and distressing experience. It is characterized by the feeling of a foreign body or tightness in the throat, even when there is no physical obstruction. This sensation can be accompanied by discomfort in other areas, such as the back or shoulders, as you described, particularly near the right shoulder blade.

There are several potential causes for this sensation, and understanding them can help alleviate concerns. One common cause is related to stress and anxiety. Emotional distress can lead to muscle tension in the throat and neck area, which can create the sensation of a lump. This is often exacerbated by swallowing, as the act of swallowing can trigger the muscles in the throat to contract, leading to discomfort.

Another possibility is gastroesophageal reflux disease (GERD), where stomach acid flows back into the esophagus, causing irritation. This can lead to symptoms such as heartburn, regurgitation, and the sensation of a lump in the throat. The pain you experience in your back, particularly near the shoulder blade, could be referred pain from the esophagus or related to muscle tension from discomfort in the throat.

Infections such as pharyngitis or laryngitis can also cause a lump sensation, although these conditions typically present with additional symptoms like pain, swelling, or redness in the throat. Since you mentioned that you do not experience pain or discomfort when swallowing, it seems less likely that an acute infection is the primary cause. However, chronic conditions like chronic pharyngitis could still be a consideration.

It’s also important to consider the role of esophageal motility disorders, where the muscles of the esophagus do not function properly, leading to difficulty in swallowing and the sensation of something being stuck. These conditions can sometimes be diagnosed through specialized tests, such as esophageal manometry.

Given that you have already consulted a physician and undergone X-rays, which showed normal results, it’s reassuring that there are no immediate structural issues. The pain you experience when swallowing saliva or when experiencing gas could indicate that your symptoms are related to gastrointestinal issues rather than a primary throat problem.

If your symptoms persist or worsen, it may be beneficial to follow up with a gastroenterologist for further evaluation. They might recommend additional tests, such as an upper endoscopy, to examine the esophagus and stomach more closely. Additionally, lifestyle modifications, such as dietary changes, stress management techniques, and possibly medications to reduce stomach acid, may provide relief.

In summary, the sensation of a lump in the throat can arise from various causes, including stress, GERD, muscle tension, or esophageal motility disorders. Since you have already seen a doctor and received some initial treatment, it would be wise to monitor your symptoms and seek further evaluation if they do not improve. Remember that addressing underlying stress and anxiety can also play a significant role in alleviating these sensations.