Lump in the throat (globus sensation)

Lump in the throat: information, causes and treatment

Globus sensation

A lump or tight feeling in the throat is common. It is often harmless, but it can be uncomfortable or worrying. This page explains possible causes, the assessment an ENT specialist may offer and steps that may help.

What is globus sensation?

Globus is the feeling that something is present in the throat even though no obstruction can be seen. It is often felt around the voice box and may be described as mucus, pressure, irritation or burning. It is usually benign, but persistent or changing symptoms should be assessed.

Common non-serious causes

1. Muscle tension: prolonged tension in the throat and neck muscles can produce a tight or lumpy feeling.
2. Mucus or throat sensitivity: excess mucus or increased awareness of normal mucus can cause discomfort.
3. Stress and anxiety: psychological tension can intensify physical sensations in the throat.

What may help?

• Assessment and reassurance: an examination by an ENT specialist can help exclude visible abnormalities. Symptoms often improve once a serious cause has been ruled out.
• Managing stress: relaxation exercises or support from a psychologist may help when stress is an important factor.
• Speech and language therapy: exercises can help relax the throat and neck muscles and improve voice use.

Medical conditions that can cause similar symptoms

Although globus is often harmless, possible physical causes include:

• Throat or laryngeal disease: serious disease is uncommon, but the risk is higher with warning symptoms and in people who smoke or drink a large amount of alcohol.
• Sinus inflammation or post-nasal drainage: mucus can irritate the throat.
• Reflux: stomach contents reaching the oesophagus or throat can cause irritation.
• An enlarged thyroid gland: swelling in the neck can sometimes create pressure.
• Chronic throat irritation: smoking, reflux and other irritants may contribute.

Assessment

Depending on the symptoms, the ENT specialist may perform:

• Examination of the mouth and throat and palpation of the neck.
• Flexible nasendoscopy: a thin flexible camera is passed through the nose to inspect the throat and voice box.
• Imaging: an X-ray or scan is only needed in selected cases.
• Allergy assessment when the history suggests an allergic cause.
• Speech and language assessment if voice use or muscle tension may be contributing.

Summary

Globus sensation is commonly related to muscle tension, mucus, reflux or stress and often improves. Treatment depends on the likely cause and may include reassurance, lifestyle measures, reflux management or speech and language therapy.

Seek prompt medical advice if the sensation is accompanied by progressive difficulty swallowing, pain on swallowing, unexplained weight loss, a neck lump, persistent hoarseness, coughing up blood or breathing difficulty.