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The neck region is full of a number of important anatomical structures that traverse it and any discomfort in the area for a significant amount of time should not ignored but looked at immediately. Painful throbbing in the neck along with a feeling like someone is squeezing the throat is a cause for concern. This could be caused by a number of different causes all of which require an urgent visit to the doctor for a thorough investigation.

Possible causes

Infectious Mononucleosis: Commonly known as glandular fever, this is generally associated with a persistent low grade fever and also multiple lymph node enlargements. These lymph nodes can be acutely painful if they are inflamed and enlarged. The cause of this type of infection is viral in origin, specifically the Epstein-Barr virus. It is a common viral infection and most adults in the world are exposed to it during their lifetime and develop immunity to it.

A rash which keeps on reappearing after a short duration is also one of the symptoms that is associated with this disease.

The symptoms can come up later in life as well due to the immune system being compromised, so a deeper cause should also be looked into.

Cervical Lymphadenitis: This is more commonly seen in children although is not uncommon in older individuals either. It is caused by a persistent source of infection from the areas which drain into the areas lymph nodes. This includes the teeth, gums, and ears as well as the tonsils.

All these areas should be examined and a source of infection should be identified if present.

Thyroiditis: Choking and pulsating sensations can be seen in thyroiditis. This is an inflammation of the thyroid gland due to an underlying infection. As expected, an abnormality in the thyroid gland will be accompanied with hormonal changes. There can be rapid weight loss or weight gain depending upon the hormone levels.

Fatigue is commonly associated with this disease. A high pulse rate as well as chronic low grade fever may be seen in patients suffering from this disease.

Other causes: It is common for doctors to do an X-ray of the area to rule out any unnatural looking growths or lumps in the area which could be neoplastic in nature.

Investigations

Certain investigations will have to be carried out to narrow down the possible diagnoses and these include blood tests, CT scans and thyroid function tests. Atypical lymphocytosis and a mono spot test positive will be conclusive for infectious mononucleosis while Cervical lymphadenitis will be associated with an elevated level of polymorphonuclear monocytes.

Clinical judgment and examination however is invaluable in these cases and it is not uncommon for the tests to not return anything spectacularly positive.

Treatment

The final treatment will be based on the confirmation of the diagnosis and the results of the investigations. However, a course of antibiotics and anti-inflammatory drugs will almost certainly be included. Thyroiditis has been found to be self-limiting in most cases and so only symptomatic treatment will be necessary. In rare cases hormonal therapy may have to be given until the gland function returns to normal.

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