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The complaint of a lump sensation in the throat is very common. Most commonly, lump sensations are harmless while visible lumps in the throat should not be taken lightly. An exam of the neck and throat is extremely important to rule out serious problems.

The complaint of a lumpy sensation in the throat is very common. Most commonly, lump sensations are harmless while visible lumps in the throat should not be taken lightly. An exam of the neck and throat is extremely important to rule out serious problems. Visible lumps in the throat are not common. 
 
The sensation of a lump in the throat will often cause a lot of anxiety, although anxiety may be the culprit in the first place. However, there are many other possible causes of this annoying disorder. Patients are naturally worried and frequently fear that the lump sensation may be cancer. Fortunately, throat cancer is extremely uncommon. The bad thing about throat cancer, as well as most other cancers in their initial stage, is that it rarely shows any symptoms.
 
You should know that it is an ENT surgeon who should look into the problem and differentiate a benign from a malignant cause. [1]

The following are the possible causes of lump in the throat. 

Cricopharyngeal spasm – a self-limiting disorder that resolves on its own. It occurs when the cricopharyngeus muscle (also known as the upper esophageal sphincter) starts to spasm instead of contract and relax.  It is the most common cause of a lump throat sensation. These spasms are often made worse by stress and anxiety. [2]

Additional symptoms that would prove Cricopharyngeal spasms are:

  • It feels like a golf or a tennis ball is stuck in the throat.
  • The lump comes and goes depending on the day.
  • Symptoms are usually gone in the mornings and present later in the day.
  • Stress aggravates the symptoms.
  • Swallowing saliva is hard while eating is not a problem
  • Improvement occurs several weeks or a few months after, but almost immediately if the person knows what the problem is. 
  • Warm fluids comfort the throat. 
  • When stress lets up, the symptoms improve. 
Gastroesophageal reflux disease, or GERD, is the recurring movement of stomach acid from the stomach back up into the esophagus. It causes heartburn, regurgitation, chest sensations and pain. If the stomach contents reflux up to the level of the larynx, the disorder is called Laryngopharyngeal reflux (LPR or 'silent reflux'). LPR is very likely to cause symptoms such as chronic throat clearing, throat phlegm, changes in the voice and the notorious lump in the throat sensation. [3]
 
Thyroid disorders. The thyroid is a small but crucial gland situated below the skin and muscles at the front of the neck, just at the spot where a bow tie would go. This gland regulates the production of many hormones and controls metabolism and growth. An underactive thyroid gland, a disorder called hypothyroidism, would cause a sensation of a lump in the throat. [4]
 
General enlargement, nodules, and inflammation of the thyroid gland can be caused by both hypothyroidism and hyperthyroidism. These nodules can cause a feeling of a lump in the throat. Diagnosis usually rests on physical examination, blood tests, a needle biopsy and possibly an ultrasound examination. 
 
A lump in the throat is very common for people who have no physical problems but are under a lot of emotional stress and who are unable to express their feelings.
 
People who have psychological problems like generalized anxiety disorder (GAD), depression, and panic attacks often experience a lump in the throat sensation. [5
 
Generalized anxiety disorder can be defined as chronic and exaggerated worry and tension with constant anticipation of a disaster and excessive worry about health, money, family, or work. The cause is often hard to find. The most common symptoms of GAD are anxiety, trouble concentrating, irritability, depression, difficulties with sleeping, lightheadedness, racing and pounding heartbeat, muscle tension and aches, problems swallowing, lump in the throat feeling, sweating, and nausea.
 
Patients who have arthritis in the neck, also known as Cervical Spondylitis, may feel a lump in the throat due to increased muscle tension in the neck and around the larynx. [6]
 
Also, medications, antihypertensives such as diuretics and ACE inhibitors as well as antimuscarinics used in the treatment of irritable bowel, urinary problems, and psychiatric conditions can have a drying effect on the throat and contribute to the lump sensation.

Postnasal drip and excess mucus from the nose and sinuses can accumulate in the back of your throat and this can give you a sensation of a lump in the throat. 

Not so frequent conditions such as laryngitis, pharyngitis, and certain tongue disorders may contain throat lump in their symptoms list.  
 
Laryngitis is an inflammation of the larynx (voice box) that can be viral or bacterial in origin. Its most common symptoms include hoarseness, loss of voice, constant need to cough, sore throat, difficulty swallowing and lump in throat feeling, although the lump feeling may also be felt as a tingling sensation in the back of the throat. [7]
 
Pharyngitis is an inflammation of the pharynx that can be viral or bacterial. Its main symptoms are similar to those of a cold – a runny nose, fever, red throat, headache and of course lump in the throat. [8]
 
Tongue disorders that could be blamed for your lump sensation are glossitis, oral thrush, and tongue cancer. [9]
 
Emotional explanations for the throat lump sensation should not be accepted until other causes have been ruled out.

So, when should you call your doctor? 

It’s important to know that a sensation of a lump in your throat or globus sensation isn’t dangerous, and most of all, it doesn’t cause additional complications. That means seeing a doctor is often unnecessary. However, if you develop other symptoms, such as difficulty swallowing, call your doctor as soon as possible, and make an appointment with an ear, nose, and throat (ENT) specialist.