Knowing Stress Sore Throat Symptoms and Treatments

Healthful Vitality | 08/29/2021 | By NP Team | Knowing Stress Sore Throat Symptoms and Treatments

Have you ever had a lump or ‘ball in the throat’ sensation in your throat? Or do you have a consistent itching/scratch sensation in your throat? Besides these are you been under stress for a long span of time? Then you might also be suffering from a stress sore throat. Let us have a brief discussion on stress sore throat symptoms, its management and treatment options.

What is Stress sore throat?

Stress sore throat medically known as Globus Hystericus or Globus Pharyngeus is the sensation of a ball or lump in the throat that is worsened by stress. It is a widely reported symptom. For example, a study from the USA reports that 12.5% of otherwise healthy people had stress sore throat. [1] It is one of the oldest noted diseases dating 2500 years back to the time of Hippocrates. [2]

How stress can ever cause a sore throat?

The exact pathophysiology of a stress sore throat is unknown. However, studies on this area provide us with some relevant clues for the onset of its symptoms. Let us have a quick go through them:

Stress Response Effect

A sore throat can be a result of physiological variations in our bodies induced by Cortisol, the stress hormone for coping with stress. Indeed, stress and strong emotions can present with respiratory symptoms, such as shortness of breath and rapid breathing because the airway between the nose and the lungs constricts. [3] This can present as the sensation of a sore throat or the feeling of a lump in your throat. 

Altered sensory perception

Stress and anxiety can alter the sensory perceptions leading to a stress sore throat. [4] In addition, long-standing stress sore throat can also result in increased anxiety and stress which further worsens the symptoms.

Stress Induced Acid Reflux

Gastro-oesophageal reflux patients who are chronically anxious and exposed to prolonged stress are also vulnerable to stress sore throats. They may perceive low-intensity oesophageal stimuli as painful reflux symptoms. The acidic gastric fluid passing the upper oesophageal sphincter causes minor throat injury. This injury presents as sore throat or lump in the throat sensation. [5]

Psychological Problems

Psychological problems such as low mood, emotional arousal, anxiety, etc. are found in patients with a lump in throat sensation. Several studies have reported increased numbers of stressful life events preceding symptom onset, suggesting that life stress might be a cofactor in the onset of emotional stress sore throat symptoms and its exacerbation. [6] A recent study in Covid-19 patients showed that sore throat was one of the symptoms significantly associated with higher IES-R, DASS stress subscale, DASS anxiety subscale, and DASS depression subscale scores. [7]

In another study in patients with similar symptoms, 95.5% said that sore throat occurred with strong emotion, and many volunteered that it disappeared with crying. Thus it is also said to be a physical indication of suppressed emotions. [8] This study also proves the importance of expressing emotions for a better mental health.

What are the Stress Sore Throat Symptoms?

A sore throat can be manifested in many diseases related to the respiratory and digestive systems. The question is how we can differentiate a stress sore throat from other throat irritations. If your sore throat has the following traits, then it is most likely that you are having a stress sore throat. [6] [9]

Exercises for relieving stress sore throat

These exercises focus on the relaxation of muscles in the area of the throat and allow free movement of laryngeal cartilages. While doing these exercises care should be taken not to strain too much at a faster pace. The stress sore throat relieving exercises are; [10] [11]

Treatments for Stress Sore Throat

Normally stress sore throat is not an alarming medical condition. Besides that, the likelihood of long-term symptom persistence and lack of highly beneficial medications are to be considered. Therefore, the treatment for its management is most importantly focused on proper explanation and reassurance. [12] 

Furthermore, modes of treatment include anti-reflux therapy, speech and language therapy, anti-depressants, and cognitive-behavioral therapy. [6] [13] Let us go through a little detail on treatment options.

Explanation and Reassurance

It is explained to the patients that the disease is not due to any underlying ailments but a manifestation of stress and anxiety. Reassurance and support are to be provided regarding the stress building factors. Relieving stress lessens stress sore throat. The relief from sore throat reduces further anxieties.

Speech and language therapy

Speech therapy and relaxation techniques, including neck and shoulder exercises, general relaxation techniques, voice exercises and voice hygiene to relieve vocal tract tension, are successfully been implemented to treat patients with persistent stress sore throat symptoms. [14] Researchers suggest significant improvement in stress sore throat patients who were provided with speech therapy. [15]

Cognitive Behavioural Therapy (CBT)

Cognitive Behavioural Therapy is psychological counselling aiming for a healthy thought process and thus assuring better mental health. It helps relieve stress and in turn the stress sore throat. CBT is a promising treatment option for patients with recurring stress sore throat symptoms.[16]

Anti-reflux therapy

It includes treatment for stress-induced acid reflux. Decreasing frequencies of acid reflux decrease throat injuries reliving stress sore throat. Proton Pump Inhibitor drugs are used for treating acid reflux disorders.

Antidepressant medications

For those with uncontrolled stress, anxiety and depression disorders, antidepressant medications may be needed. Alleviating psychological disorders can in effect decrease stress sore throat symptoms thus in both ways increasing quality of life.

The above-discussed exercises and enlisted treatment options should be adopted under the consultation of a qualified health professional. Any self-treatment efforts may lead to adverse effects. The main approach towards the treatment is targeting the management of underlying psychological crisis rather than the sore throat itself.

Takeaway

Long-standing stress can cause stress sore throat. The main symptom of emotional stress sore throat is the ‘lump in the throat’ or itching sensation occurring without any other underlying diseases. Various relieving exercises and treatment options are available. These measures are focusing on stress management and reassurance can alleviate anxiety and thereby the symptoms itself.

(Related Article: Coping Strategies for Your Stress Control)

References:

1. Drossman DA, Li Z, Andruzzi E, et al. U.S. householder survey of functional gastrointestinal disorders. prevalence, sociodemography, and health impact. Dig Dis Sci 1993; 38:1569–80. Available at: https://www.ncbi.nlm.nih.gov/pubmed/8359066

2. Harar RP, Kumar S, Saeed MA, Gatland DJ. Management of globus pharyngeus: review of 699 cases. J Laryngol Otol. 2004; 118(7): 522–7. doi: 10.1258/0022215041615092.

3. American Psychological Association. Stress effects on the body November 1, 2018. Available at: https://www.apa.org/topics/stress/body

4. Thompson WG, Heaton KW. Heartburn and globus in apparently healthy people. Can Med Assoc J. 1982; 126(1):46-48. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1862803/?page=1

5. Bradley LA, Richter JE, Pulliam TJ, et al. The relationship between stress and symptoms of gastroesophageal reflux: the influence of psychological factors. Am J Gastroenterol. 1993; 88(1):11-19. Available at: https://pubmed.ncbi.nlm.nih.gov/8420248/

6. Lee BE, Kim GH. Globus pharyngeus: A review of its etiology, diagnosis and treatment. World Journal Gastroenterology 2012; 18(20): 2462-2471. Available at: https://www.wjgnet.com/1007-9327/full/v18/i20/2462.htm

7. Wang C, Pan R, Wan X, et al. Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China. Int J Environ Res Public Health. 2020; 17(5):1729. Published 2020 Mar 6. doi:10.3390/ijerph17051729. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084952/

Related Article: Here Are Some Sources of External Stressors

8. Thompson WG, Heaton KW. Heartburn and globus in apparently healthy people. Can Med Assoc J. 1982; 126(1):46-48. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1862803/?page=1

9. Deary IJ, Wilson JA, Harris MB, et al. Globus pharyngis: development of a symptom assessment scale. J Psychosom Res 1995;39:203–13. 10.1016/0022-3999(94)00104-D. Available at: https://www.ncbi.nlm.nih.gov/pubmed/7595878

10. NHS. Globus Sensation. Patient Leaflets by Directors Team 1st August 2018 Reference Number: HEY-208/2018 Departments: ENT. Available at: https://www.hey.nhs.uk/patient-leaflet/globus-sensation/

11. Best Exercises for Globus Sensation By WebMD Editorial Contributors Medically Reviewed by Dan Brennan, MD on December 13, 2020. Available at: https://www.webmd.com/a-to-z-guides/best-exercises-globus-sensation.

12. Galmiche JP, Clouse RE, Bálint A, Cook IJ, Kahrilas PJ, Paterson WG, Smout AJ. Functional esophageal disorders. Gastroenterology. 2006; 130:1459–1465.. Available at: https://www.ncbi.nlm.nih.gov/pubmed/16678559

13. Galmich. Karkos PD, Wilson JA. The diagnosis and management of globus pharyngeus: our perspective from the United Kingdom. Curr Opin Otolaryngol Head Neck Surg. 2008; 16:521–524. Available at: https://www.ncbi.nlm.nih.gov/pubmed/19005323

14. Wareing M, Elias A, Mitchell D. Management of globus sensation by the speech therapist. Logoped Phoniatr Vocol. 1997; 22:39–42.

15. Burns P, O’Neill JP. The diagnosis and management of globus: a perspective from Ireland. Curr Opin Otolaryngol Head Neck Surg. 2008; 16(6):503-506. doi:10.1097/MOO.0b013e3283169258]. Available at: https://www.ncbi.nlm.nih.gov/pubmed/19005320

16.  Khalil HS, Bridger MW, Hilton-Pierce M, Vincent J. The use of speech therapy in the treatment of globus pharyngeus patients. A randomised controlled trial. Rev Laryngol Otol Rhinol (Bord). 2003; 124(3):187-190. Available at: https://pubmed.ncbi.nlm.nih.gov/14725135/