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Why Does it Hurt To Swallow?

There are times when even swallowing a glass of water can hurt. Pain in the throat when you swallow is pretty common and it can have many causes. For most people, it’s just a sore throat that’s making it hard to swallow; for others, more ominous problems could be the cause.

Medically known as odynophagia, pain, when you swallow isn’t usually an isolated finding. You will experience other signs and symptoms of an infection or disease if you experience pain when swallowing. Some of the common symptoms you can find are:

  • Fever
  • Runny nose
  • Constant scratchy pain in the throat
  • Hoarseness of the voice
  • Sneezing
  • Coughing
  • Acid reflux
  • Difficulty in breathing

All of these symptoms come with specific conditions; figuring out what the actual problem is and sort it out, will make swallowing smooth and pain-free for you again.

What Causes Painful Swallowing?

Here are some of the most common causes of painful swallowing1,2:

#1: Sore throat

Sore throats, especially when severe, are notorious for making your daily life miserable. Even though an infected sore throat usually stays for only a few days, these days can be anything but comfortable.

If you have a sore throat, you could experience symptoms of the flu, fever, and a constant prickly or scratchy pain in the throat. Swallowing anything may become painful. Sometimes you may even notice the lymph nodes in your necks swell up.

There can be many causes of a sore throat but most commonly it is a viral infection. Viral sore throats don’t normally require medical treatment and can go away on their own. After a few days, you may find temporary pain relief by sucking on a lozenge, using throat sprays and rinses. Swallowing might also become less painful this way.

Painful swallowing could also be a sign of a bacterial infection.3 Bacterial sore throats can be more painful, severe, and last longer than viral sore throats. You will most likely need medical intervention to get completely cured.

#2: Chronic cough

There are many conditions which can cause you to cough for prolonged periods. At the top of the list is bronchitis, an inflammation of the tubes that lead to your lungs. When you have a chronic cough, swallowing can become difficult.

Cough suppressants can help but it’s a good idea to check in with your pharmacist to find the exact cause of the cough. In most cases, you will need appropriate medication to treat the problem.

#3: Acid reflux disease

Acid reflux disease is more common in older people. This occurs when the acid from your stomach is refluxed back to your oesophagus, all the way to your throat. A sore throat is a common effect of this problem and this can eventually make swallowing difficult.

The proper treatment of acid reflux disease involves taking antacids, proton pump inhibitors and even sometimes surgery.

#4: Tonsillitis and Abscesses

The tonsils are two masses of lymph tissues situated behind your tongue. They can become infected by bacteria (usually in childhood) and this can cause them to become red, tender and swollen. Swollen, inflamed tonsils are known as tonsillitis and this can cause pain while swallowing as well.

Similarly, deep-rooted infection in one or both tonsils can cause an abscess to form. The abscess can swell and make swallowing difficult.

Antibiotics and draining the pus from the abscess will help make these painful symptoms go away.

#6: Thyroid swelling

The thyroid gland can enlarge if it becomes infected or if you have a problem with your thyroid hormones. When the gland enlarges, it’s called a goitre. Goitres can also put pressure on the throat and make swallowing uncomfortable or even painful.

If your thyroid swelling is very large, you may require surgery to get relief. However, if the swelling is small, simple thyroid medications may help.

#7: Trauma

Any throat injury, even from something as trivial as drinking a hot beverage or eating something hard and sharp can cause pain when you swallow. In most cases, this type of injury will heal on its own.

Simple pain killers may help to give you some comfort.

#8: Tumours

Tumours of the neck and throat region can also enlarge and physically make it hard to swallow.

How is Painful Swallowing Diagnosed?

Many times the cause of the pain, when you swallow, is fairly obvious. A sore throat, common cold or tonsillitis are easily visible and you won’t need extensive lab tests to reach a diagnosis.

However, when the cause is unclear, your doctor may recommend any of the following diagnostic investigations:

  • A complete blood count to rule out infections
  • Thyroid function tests to check your thyroid hormone levels
  • A Barium meal, a technique that makes use of X-rays to see visible structural or anatomical problems in your oesophagus
  • MRI and CT scans for a complete look at the anatomy of your throat
  • Sputum and throat swab cultures to check for the cause of an infection

How is Painful Swallowing Treated?

Depending upon the cause of your painful swallowing, your pharmacist or doctor will recommend specific treatment options for you. If all you have is a sore throat, using pain relievers like lozenges, honey, throat rinse and gargles will make you feel much better.

If your condition is something more severe than a throat infection, you will need to have a full examination and investigations done before treatment can begin.

In any case, painful swallowing should never be taken lightly; if you have this symptom, visit your pharmacist or contact your GP as soon as possible.


  1. Why Does it Hurt to Swallow? WebMD. Available at: https://www.webmd.com/cold-and-flu/painful-swallowing-causes#1
  2. Pain when swallowing. Available at: https://www.medicalnewstoday.com/articles/322301.php
  3. Centor, Robert M., et al. "Sore throat: streptococcal or not?" Patient Care, vol. 21, no. 18, 15 Nov. 1987, p. 28+. Accessed 11 Mar. 2020

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