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Neck Pain When I Swallow

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Neck Pain When Swallowing

Speech and swallowing difficulty due to cervical spine instability

Neck pain when swallowing typically occurs directly over the vertebral column in the middle cervical spinal region. When discussing this symptom, we are not talking about throat pain of any kind or pain that is felt in the esophagus. Instead, we are discussing true neck pain in the dorsal anatomy that is caused by swallowing food, drink or simply saliva. Swallowing is something we must do countless times each day. When pain is elicited each time they swallow, patients find themselves in distressing positions with constant symptomatic activity. In most cases, patients will have neck pain that is ever-present, caused by movement or other activities besides swallowing. In essence, swallowing makes already present pain worse. Pain that is experienced only when swallowing is extremely rare.

This treatise examines why swallowing can cause or exacerbate neck pain. We will detail the causes of swallowing-related neck pain, as well as provide some tips for relieving the symptoms.

Research On Cervical Instability And Prolotherapy

Caring Medical has published dozens of papers on Prolotherapy injections as a treatment in difficult to treat musculoskeletal disorders. We are going to refer to two of these studies as they relate to cervical instability and a myriad of related symptoms including the problems of swallowing difficulties or cervicogenic dysphagia.

In our own research, our Caring Medical research team published a comprehensive review of the problems related to weakened damaged cervical neck ligaments.

This is what we wrote: To date, there is no consensus on the diagnosis of cervical spine instability or on traditional treatments that relieve chronic neck instability issues like those mentioned above. In such cases, patients often seek out alternative treatments for pain and symptom relief. Prolotherapy is one such treatment that is intended for acute and chronic musculoskeletal injuries, including those causing chronic neck pain related to underlying joint instability and ligament laxity. While these symptom classifications should be obvious signs of a patient in distress, the cause of the problems is not so obvious. Further and unfortunately, there is often no correlation between the hypermobility or subluxation of the vertebrae, clinical signs or symptoms, or neurological signs or symptoms. Sometimes there are no symptoms at all which further broadens the already very wide spectrum of possible diagnoses for cervical instability.

Salivary Gland Cancer Symptoms

Salivary glands make saliva and release it into the mouth. There are three major salivary glands:

  • Sublingual glands
  • Submandibular glands

Symptoms for this type of cancer may include:

  • Painless lump in your ear, cheek, jaw, lip or inside of the mouth
  • Fluid draining from your ear
  • Trouble swallowing or opening mouth wide
  • Numbness or weakness in your face
  • Persistent pain in your face

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Searching For Clues When Surgery And Treatment Fail To Correct Swallowing Difficulties

We have seen many patients with the degenerative cervical spinal disease who can no longer tolerate continued high dosage narcotic painkillers or the anxiety or depression trip after trip to specialist after specialist is causing them. One clue that we may be able to help these people with their challenges including swallowing difficulties is if you put them in a cervical collar, do they get relief? If the answer is yes, then the collar is providing the missing cervical neck instability.

We do see people with advanced degenerative cervical disc disease who have or had significant bone spur formation. Many of these patients have had surgery to remove the bone spurs, yet their swallowing difficulties remained. If it was not the bone spurs pressing on the esophagus, what could it be? Why do these people still have swallowing difficulties after surgery?

Infection Of The Virus Or Sinus

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A virus such as cold, influenza or flu is the common cause of painful swallowing. Infections with the sinus may also be the fault. Due to inflammatory tonsils, coughing and sinus irritation, your neck pain is probably caused. There are several other symptoms, like stuffy or runny nose, cough, headache, or fever, if you have an infection with virus and sinuses. The usual and common treatment for this kind of infections are rest and OTC medicines although the doctor you consult may in some cases give you steroids or antibiotics.

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What Treatments Are Available

A variety of treatments are available, including medication, surgery, needle procedures, and radiation. First-line treatment is usually medication. When medications fail to control pain or cause intolerable side effects, a neurosurgeon may be consulted to discuss other procedures.


Over-the-counter drugs such as aspirin and ibuprofen are not effective against neuralgia pain.

Anticonvulsants, such as carbamazepine , gabapentin , are used to control pain. If the drug begins to lose effectiveness, the doctor may increase the dose or switch to another type. Side effects may include drowsiness, unsteadiness, nausea, skin rash, and blood disorders. Therefore, patients are monitored with periodic blood tests to ensure that the drug levels remain safe. Multiple drug therapy may be necessary to control pain .

Some people manage the pain trigger by applying a liquid xylocaine to the tonsil area and temporarily numbing it so they can eat and swallow.


Needle procedures


Cold Flu Or Sinus Infection

A sore throat that causes painful swallowing often signals that youâre getting one of these common illnesses. It can start a day before other symptoms like a runny nose and cough.

If it’s a cold, you’ll need to wait it out by sipping fluids and getting plenty of rest. If it might be the flu, which feels much worse and is a lot more serious than a cold, you need to see a doctor.

With a sinus infection, constantly trying to clear your throat of drainage can cause irritation and painful swallowing until the infection clears.

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What Are The Causes

Many believe that the protective sheath of the nerve deteriorates, sending abnormal messages. Like static in a telephone line, these abnormalities disrupt the normal signal of the nerve and cause pain. Most often the damage is from a blood vessel compressing the nerve. Other causes include aging, multiple sclerosis, and nearby tumors.

Swallowing Difficulties: A Problem Of Autonomic Nervous System Dysfunction

Neck, Throat and Back Pain HELPED! Dr. Rahim Chiropractic

Swallowing difficulty may also be due to autonomic nervous system dysfunction that may be caused by Barré-Lieou Syndrome, also known as a posterior cervical sympathetic syndrome and cervicocranial syndrome. This can be a severely debilitating condition in which the autonomic nervous system of the head and neck area is not working correctly. In almost all patients we see, there is a link between cervical spine instability and the onset of Barré-Lieou Syndrome.

Swallowing is a very complex process that involves the mouth, throat, and esophagus. Many nerves and muscles affect the correct functioning of these parts, and while part of the process of swallowing is under voluntary control, much of it is involuntary. Cervical spine instability can affect both voluntary and involuntary responses.

  • Another clue linking the cervical ligaments to swallowing difficulties.

MRI of the neck shows bulging discs at c5-c6 causing a narrowing of the subarachnoid space. The space between the arachnoid membrane and pia mater contains the cerebrospinal fluid and large blood vessels that supply the brain and spinal cord. The person in this MRI had neck pain, headaches, swallowing difficulties, sinusitis, balancing issues that were related to cervical spine instability.

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Other Causes Of Neck Pain

There are numerous other medical conditions unrelated to cancer that cause pain in your neck, such as:

  • Strained muscles. Overuse, poor posture at work, or an awkward sleeping position can strain your neck muscles and cause discomfort.
  • Cervical spondylitis. When the spinal disks in your neck experience wear and tear, which generally occurs as you age, you may experience pain or stiffness in your neck.
  • Herniated discs. When the soft interior of a spinal disk protrudes through a tear in the tougher exterior, its called a slipped disc.

Other common causes of neck pain include:

Swallowing Difficulties: Tmj Involvement With Cervical Instability

In the Journal of Oral and Maxillofacial Surgery: The Official Journal of the American Association of Oral and Maxillofacial Surgeons, doctors looked at oral stage dysphagia with potential effects on function and patient well-being.

To examine the effects of function in TMJ patients, the doctors looked at 178 TMJ/TMD temporomandibular joint dysfunction patients.

  • Of the 178 TMD participants, 99% reported at least one symptom or sign of oral stage dysphagia.
  • Individuals presenting with
  • subluxation of the jaw ,
  • degenerative joint disorder ,
  • and myofascial pain disorder reported oral stage dysphagia most frequently.

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Summary And Contact Us Can We Help You How Do I Know If Im A Good Candidate

We hope you found this article informative and it helped answer many of the questions you may have surrounding Cervical disc disease and difficulty swallowing. Just like you, we want to make sure you are a good fit for our clinic prior to accepting your case. While our mission is to help as many people with chronic pain as we can, sadly, we cannot accept all cases. We have a multi-step process so our team can really get to know you and your case to ensure that it sounds like you are a good fit for the unique testing and treatments that we offer here.


This article was updated January 24, 2022

Treatment For Painful Swallowing

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Treatment for painful swallowing can vary depending on the cause of the pain. Your doctor will likely prescribe antibiotics to treat infections of the throat, tonsils, or esophagus. Your doctor may give you a mouthwash that can numb your throat while you take oral antibiotics.

This numbing agent helps to block any pain you may feel when swallowing the pill. For severe pain, a throat spray can help numb the pain. Your doctor may also prescribe anti-inflammatory medications to reduce inflammation in the esophagus, throat, or tonsils.

If you frequently experience painful swallowing due to recurring tonsillitis or if your tonsillitis doesnt respond to medication, your doctor may recommend surgery to remove your tonsils.

This surgery is called a tonsillectomy. Its an outpatient procedure, which means you can go home the same day as the surgery. You and your doctor can discuss your risks and determine whether a tonsillectomy is appropriate for your condition.

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Brain Fog Breathing And Swallowing Difficulty Dizziness Tinnitus

Brads story will resonate with many of you. He will describe the same symptoms and combination of symptoms that many of our patients suffer with when they first see us.

Brads story is unique, it may not be typical of the patients we see. Brad with treated with Prolotherapy injections and neck curve correction techniques. Not everyone will achieve these results as the results of treatment will vary.

We specifically want to highlight his case because he has some unusual strange sensations in his ear and breathing difficulties because of his problem with his contracting diaphragm.

Patient symptom list:

  • Ringing in the ears and a sensation in his ears of hot wax. He also reported it was as if spiders were crawling in his ears.
  • Severe dizziness. The patient describes that he would be in a car and then out of nowhere he would get dizziness and it would feel like the car was flipping end over end.
  • Contracting diaphragm
  • Patients description at 1:32: I would just be sitting or standing there, doesnt matter which, and all of a sudden I couldnt breathe. Finally, I would take a big gasp of air, and finally, I would be able to breathe.
  • Swallowing difficulties: The saliva in his mouth would build up and it was as if he was drowning. This would cause panic attacks.
  • The patient also reported when he turned his head to the right, he would lose control of all his muscles and he would drop.
  • There Is A Problem With The Chewing Muscles Contributing To Problems In Your Cervical Spine And Your Entire Posture

    Swallowing difficulties are hard to manage because in some patient cases, possibly yours, you have to continuously peel the onion, to get to the true root cause of the patients problem. Swallowing difficulties may not be a primary complaint of a patient, but one of the many complaints that seemingly have no answer. Here we are examining whether the muscles of the jaw are negatively impacting your cervical spine and if your swallowing difficulties, indeed many problems you are suffering from, may be from this connection.

    In the European Journal of Orthodontics, doctors in Japan made a connection:

    • In this study, the doctors compared the mandibular stress distribution and displacement of the cervical spine. In simple terms, how TMJ instability and hypermobility of the jaw negatively affected the cervical spine.
    • What did they find? imbalance between the right and left masticatory muscles antagonistically act on the displacement of the cervical spine, i.e. the morphological and functional characteristics in patients with mandibular lateral displacement may play a compensatory role in posture control.

    What? The TMJ altered your posture by stressing your cervical spine? Isnt posture a problem of swallowing difficulties? Isnt posture a problem of everything?

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    There Is No Doubt That Tmj Patients Suffer From Swallowing Difficulties But Do They Have Cervical Instability As Well And Is This Making Swallowing More Challenging

    In many patients, we see primary problems related to neck pain and cervical instability see problems of TMJ. In many patients that we see with problems of TMJ, we see cervical neck pain. Surprisingly, despite the research suggesting the connection, many patients were not made aware that their jaw pain could be a problem originating in the neck.

    In the medical journal Clinical Oral Investigations, oral surgeons in Belgium made a connection.

    They conducted a study looking for possible correlations between clinical signs of temporomandibular disorders and cervical spine disorders.

    • Thirty-one consecutive patients with symptoms of TMD and 30 controls underwent a standardized clinical examination of the masticatory system, evaluating the range of motion of the mandible, temporomandibular joint function, and pain of the TMJ and masticatory muscles.
    • Afterward, subjects were referred for clinical examination of the cervical spine, evaluating segmental limitations, tender points upon palpation of the muscles, hyperalgesia, and hypermobility.
    • The results indicated that segmental limitations and tender points are significantly more present in patients with TMJ than the control subjects

    Swallowing Difficulties Caused By The Odontoid Process Of The Axis Because Of C1/2 Instability

    How to manage sore throat with pain while swallowing? – Dr. Sriram Nathan

    A December 2019 paper from the New York Chiropractic & Physiotherapy Centre, New York Medical Group, Hong Kong, China has published in the journal Clinical Medicine Insights Case Reports. The paper was titled: Unusual Cause of Dysphagia in a Patient With Cervical Spondylosis. What was the unusual cause? Cervical spine instability. Here is the unusual case presented:

    Given that causes of dysphagia differ from patient to patient, individualized treatment plans tailored toward patients specific conditions are needed. Here we present a case of an elderly woman with upper neck stiffness and dysphagia who sought chiropractic treatment. Radiographic findings suggested cervical spondylosis with a vertical atlantoaxial subluxation. Following 20 sessions of chiropractic treatment, the patient experienced complete relief from neck problems and difficulty in swallowing.

    Rhythmic swallowing movements are controlled by a central pattern-generating circuit of the brain stem. In this case, the brain stem could have been compressed by the odontoid process of the axis due to C1/2 instability.

    Cervicogenic dysphagia is a cervical cause of difficulty in swallowing. Cervical complaints in the context of dysphagia are mostly underestimated. A high degree of clinical suspicion is pivotal in timely intervention.

    In this case, results may have been achieved because the c1/c2 vertebrae were adjusted back into alignment.

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    Treating Cervical Spine Instability Is Treating Swallowing Difficulties

    In this video, DMX imaging displays Prolotherapy results in before and after treatment images. This patients treatment had problems of a pinched nerve in the cervical spine resolved. Prolotherapy is discussed below. Prolotherapy is a regenerative medicine injection treatment that utilizes dextrose, a simple sugar as a proliferant to rebuild soft tissue structures.

    This video demonstrates the alleviation of cervical disc herniation and the patients related symptoms.

    • In this video, we are using a Digital Motion X-Ray to illustrate a complete resolution of a pinched nerve in the neck and accompanying symptoms of cervical radiculopathy.
    • A before digital motion x-ray at 0:11
    • At 0:18 the DMX reveals completely closed neural foramina and a partially closed neural foramina
    • At 0:34 DMX three months later after this patient had received two Prolotherapy treatments
    • At 0:46 the previously completely closed neural foramina are now opening more, releasing pressure on the nerve
    • At 1:00 another DMX two months later and after this patient had received four Prolotherapy treatments
    • At 1:14 the previously completely closed neural foramina are now opening normally during motion

    What Are The Symptoms

    Patients describe an attack as a burning or jabbing pain, or as an electrical shock that may last a few seconds or minutes. Swallowing, chewing, talking, coughing, yawning or laughing can trigger an attack. Some people describe the feeling of a sharp object lodged in the throat. The pain usually has the following features:

    The pain usually has the following features:

  • Affects one side of the throat
  • Can last several days or weeks, followed by a remission for months or years
  • Occurs more frequently over time and may become disabling
  • About 10% of patients also have potentially life-threatening episodes of heart irregularities caused by involvement of the nearby vagus nerve, such as:

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