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Pain in the throat muscles – this is a complex, variable symptom that is not specific, that is, indicating a specific disease. Complaints about pain in the throat and in the muscles of the larynx are considered one of the most common in medical practice, however, in order to determine their cause, it is necessary to clarify the nature of the symptom and carry out certain diagnostic steps.
That part of the body that we are used to calling the throat is actually a rather complex anatomical and multifunctional structure, consisting of larynx – larynx and pharynx – pharynx. The upper respiratory system itself is the pharynx, larynx, as well as the oral, nasal cavities and trachea. In the pharynx, the respiratory and digestive tracts connect and cross, and the larynx directly forms the human voice with the help of the vocal cords, and plays a secondary role in breathing. The throat is a whole complex of muscles:
- muscles that relax the vocal cords (narrowing of the glottis)
- muscle located in front of the thyroid cartilage (thyroarytenoid)
- transverse arytenoid muscle, which stretches and brings together the arytenoid cartilages
- posterior cricoarytenoid muscle, which rotates the cartilage and changes the position of the vocal processes
- cricothyroid muscle, which tenses the vocal cords
In addition, the functions of the larynx depend on the surrounding neck muscles; any tension in them provokes reflex hypertonicity in the throat. Thus, no matter what types of muscle tissue are damaged – be it constrictors, dilators, neck muscle tissue or those that change the tension of the ligaments, pain in the throat muscles occurs.
Causes of pain in the throat muscles
The main causes of pain in the throat muscles relate to either traumatic injury or motor muscle disorders. Other conditions and diseases that provoke a pain symptom can also be considered causative factors, but a sore throat is more likely to be reflected, secondary. In addition, there are myopathies of infectious etiology (helminthiases, tuberculosis), which are accompanied by pain in the larynx, but such cases are extremely rare in clinical practice.
The most common causes of sore throat muscles are:
Movement disorders
- Such conditions in the throat are caused either by severe overstrain, or, on the contrary, by a weakening of muscle tone. Most often, motor dysfunctions are diagnosed in children suffering from rickets, spasmophilia, whooping cough and other serious diseases. Motor causes of pain in the throat muscles are divided into myopathic (muscle weakening) and those caused by impaired innervation – neurogenic. Also, disorders can be partial – paresis or complete – paralysis.
- Cortical (central) paralysis can be triggered by head trauma, cerebral hemorrhage, even minor sclerosis. Cortical disorder is diagnosed mainly in adults, often combined with damage to the soft palate, and is mostly bilateral.
- Peripheral paralysis and paresis of the laryngeal muscles are caused by neurogenic factors – damage to nerve endings, pathways in the chest, neck due to tumor processes, abscesses or injuries. Peripheral motor disorders of the throat are usually unilateral.
- Laryngospasm is a significant muscular restriction of the glottis. The reason may be functional, but the spasm can also be triggered by hypocalcemia due to vitamin D deficiency (in children under 3 years of age).
- Functional central paralysis is caused by a mental disorder when the relationship between the functions of inhibition and excitation in the brain is disrupted. Most often, hysterical paralysis is diagnosed, which provokes severe muscle spasms and, accordingly, pain symptoms, a feeling of lack of air. Hysterical spasm of the laryngeal muscles is often misdiagnosed as bronchospasm, bronchial asthma or laryngospasm, and standard treatment with hormonal drugs or bronchodilators does not produce results.
- Functional dysphonia (inorganic), which, in addition to pain in the throat muscles, is characterized by complete loss of voice or hoarseness, change in timbre, weakening of sonority. Dysphonia can be spastic, hypo and hypertonic and occur in both chronic and acute forms. Hypertonic dysphonia is considered the most painful, when a person talks for a long time in a noisy environment, straining the ligaments. Chronic tension in the muscles of the larynx, neck and face is accompanied by hypertonicity of the abdominal press and activation of the vascular system.
- Spasmodic dysphonic disorder – overstrain of the muscles of the larynx, pharynx and impaired coordination of the internal and external throat and respiratory muscles. The reason for this dysfunction is stress, mental trauma, and less commonly, viral diseases (flu).
- Hysterical aphonia (complete absence of voice). The reason is the patient’s labile nervous and mental system, exposure to a stressful situation. In addition to the loss of voice and moderate soreness in the throat muscles, a person falls into a depressive state and apathy.
- Aphonia of a functional nature, developing as a consequence of chronic laryngitis. An inflamed throat needs rest; if a person continues to strain the ligaments and muscles of the larynx, the mechanism of sound (voice) formation occurs.
Inflammatory pathologies of the throat
- Acute or chronic laryngitis.
- Stenosing laryngotracheobronchitis.
- Chondroperichondritis is an inflammatory process in the cartilaginous tissue of the larynx, which also involves muscle tissue. The purulent and fibrous form is considered especially painful.
- Endogenous or exogenous acute stenosis of the larynx.
Drug intoxication
Drug intoxication accompanied by damage to motor neurons of the internal laryngeal muscles. The reason is drug intoxication with synthetic drugs, most often antimalarials.
In order to find out the true causes of pain in the throat muscles, an accurate description of the symptoms is required, which helps to specify the direction of diagnostic actions.
Symptoms of pain in the throat muscles
Muscular dysfunction of the larynx primarily manifests itself in changes in voice parameters. The first symptoms of pain in the throat muscles are an obvious, or rather audible, change in timbre, volume and sonority of the vocal apparatus. In addition, any throat disease is accompanied by impaired respiratory function due to weakness of the affected muscles.
Some typical symptoms of sore throat muscles depending on the underlying cause:
- Laryngeal paralysis – painful sensations in the muscles of the throat, neck, weak, hoarse or hoarse voice, difficulty breathing.
- Chondroperichondritis is a painful area in the larynx, neck, pain in the throat muscles, enlarged lymph nodes, swelling of the skin at the site of cartilage damage, difficulty breathing. The acute form of the disease can cause suffocation.
- Laryngeal stenosis is a compensatory mobilization of the respiratory, hemodynamic, tissue system, most often in the form of shortness of breath, tachycardia, tissue hypoxia and, accordingly, pain in the throat muscles.
- Laryngitis, which is most often a consequence of influenza, ARVI, measles, whooping cough. Symptoms are pain in the muscle tissue of the larynx, soreness, dryness, unproductive cough, low-grade fever, swelling of the mucous membrane of the throat.
- All dysphonia is characterized by either weakening of the voice or aphonia, that is, its complete absence. Apart from problems with the vocal apparatus, there are usually no other clinical symptoms if dysphonia is diagnosed as functional.
As a rule, muscle pain is not characterized by high intensity; rather, it is aching and pulling. The specificity of throat pain is a “scratching”, dry sensation, loss of vocal abilities, which are often signs of serious ENT diseases, so alarming symptoms require timely diagnosis.
Diagnosis of pain in the throat muscles
The diagnostic actions of a doctor can be difficult, since most often patients seek help when the disease of the throat muscles is either in an advanced state and is accompanied by side symptoms, or becomes a latent chronic form. In addition, the vocal apparatus – muscles and ligaments – is very difficult to evaluate in principle, even at rest. The most accurate diagnosis of pain in the throat muscles is when the larynx is functioning, that is, the muscle tissue is contracting, which is extremely difficult to do due to soreness.
Diagnostic steps may be as follows:
- Conversation with the patient and collection of anamnesis.
- External examination of the body.
- Visual inspection of external signs of the disease – tension in the neck muscles, possible swelling, lymph nodes (palpation).
- X-ray of the throat.
- Laryngoscopy
- Pharyngoscopy.
- If necessary, a biopsy is prescribed.
A more detailed description of the methods that the diagnosis of pain in the throat muscles involves:
- Inspection.
- An external examination of the condition of the neck and larynx is carried out.
- Palpation of the larynx is carried out, mainly of the cartilage – thyroid, cricoid, to determine elasticity, the presence or absence of a characteristic crunch. A normal larynx does not hurt upon palpation, is amenable to passive movement, and its muscles are not tense.
- Lymph nodes are palpated (deep and posterior cervical, submandibular, pretracheal, prelaryngeal, paratracheal, and also those located close to the subclavian fossae). Normal – the lymph nodes should not be palpable, this indicates that they are not enlarged and there is no inflammatory process.
- Laryngoscopy
- Inspection using a laryngeal speculum. The larynx is examined in two stages – during inspiration and during voice production (sounds “i” and “e”).
- Indirect hypopharyngoscopy – examination of the posterior wall of the larynx using a mirror.
- Culture for streptococcus, diphtheria and other pathogenic microorganisms.
- General blood test, biochemical analysis may be prescribed.
- If mononucleosis is suspected, which often manifests itself as pain in the muscles of the larynx, a single-drop test is prescribed.
In addition, diagnosis of diseases of the throat muscles may require consultation with related specialists – endocrinologist, pulmonologist, neurologist, psychiatrist. Pain in the muscles of the larynx can be felt as a spasm or a lump and have a purely psychogenic cause; for this it is necessary to exclude or confirm hysteria and other borderline conditions from the field of neurology and psychiatry.
Treatment of sore throat muscles
The doctor decides how to treat pain in the throat muscles. Of course, if the discomfort is caused by a single case of vocal strain, you can be treated at home, you just need to rest the cords for a while, keep quiet, do not overwork the larynx, and do not irritate it with spicy or sour foods.
If the symptoms indicate a more serious condition, pain in the throat muscles does not subside for several days, medical advice cannot be avoided. As a rule, therapeutic prescriptions concern topical preparations – sprays, aerosols, as well as physiotherapeutic procedures. In general, standard treatment for a sore throat can be medication, detoxification, or surgery. Unlike pain symptoms in other organs, ENT therapy is almost always aimed at neutralizing the identified cause of pain, and only then can it be symptomatic (relief of pain, cough, and so on).
The most common treatments for sore throat muscles are:
- Neutralization of the provoking factor in functional movement disorders, dysphonia. You should exclude the possibility of overstraining ligaments and muscles, adhere to a gentle regimen, and remain silent.
- Muscle hypertonicity is relieved with warm compresses on the neck area and physiotherapeutic procedures (UHF, electrophoresis).
- If laryngitis or pharyngitis is detected, appropriate therapy is carried out.
- Special exercises to restore and strengthen the functions of the ligaments give good results.
- More serious inflammatory diseases are treated with antibiotics corresponding to the identified type of pathogenic microorganism.
- Chronic disorders of the throat muscles caused by scars and tumor processes are treated surgically.
- Threatening symptoms are bilateral laryngeal paralysis, grade 3-1 stenosis is urgently treated with tracheotomy.
It should be noted that the throat muscles most often suffer from conditions that do not require antibiotic therapy or surgery; in 85-90% of cases, treatment consists of warming up the overstrained muscles, irrigating the ligaments and rest. With this complex, the voice is restored after 2-4 days.
Preventing pain in the throat muscles
If we take statistical data as a basis, then most diseases of the throat muscles are caused by vocal strain. Accordingly, the prevention of pain in the throat muscles should concern the rules for using such a valuable resource. Tips for preventing pain in the muscles of the larynx caused by other serious diseases fit into the standard scheme:
- Regular medical examinations, including consultation and examination by an ENT doctor.
- Compliance with the rules of a healthy lifestyle – physical activity, strengthening general muscle tone, balanced nutrition, giving up bad habits, especially smoking.
- Avoiding hypothermia and viral diseases.
Every day a person pronounces from 3000 to 7000 words; it is obvious that the people whose profession is related to speaking and making speeches use the vocal apparatus the most. They are the ones who most often suffer from functional dysphonia and the proposed recommendations will be most useful to them:
Prevention of pain in the throat muscles due to occupational diseases of the vocal apparatus:
- The best way to keep your throat muscles toned is through daily vocal exercises, similar to the chants of vocalists. There are many methods of articulation and breathing exercises that help strengthen the muscle tissue and ligaments of the larynx.
- You should not overexert your voice for a long time. There are certain standards: lecturers and teachers speak for no more than 4 hours in a row, vocalists and actors – up to 3 hours.
- Before a long performance, you need to “warm up” your ligaments and muscles and drink a warm drink.
- The vocal apparatus and throat muscles are very closely related to the general condition of the body, especially to the condition of the nervous system. Therefore, in order for pain in the throat muscles to be familiar only by hearsay, you need to strengthen the entire body as a whole, alternate periods of work and rest, and take care of the nervous system.
- The throat is closely connected with the nasopharynx and respiratory system, and accordingly, their condition can affect the muscles of the larynx. Breathing exercises and sanitization of the nasopharynx will help avoid muscle pain.
- The functions of the throat may be impaired by the environment, especially dry, smoky air. The air should be humidified, this applies to rooms with air conditioning and the winter period, when the heating season begins.
Pain in the throat muscles is most often not a serious pathology, but it is better to prevent it in advance and, at the first alarming symptoms, contact a specialist without self-medicating, following the old proverb: “A wise person would rather avoid an illness than later seek a healer and choose a medicine.”