Pain in the muscles of the throat

Sore throat muscles are a complex, variable symptom that is not specific, i.e. does not indicate a specific disease. Complaints of sore throat, in the muscles of the larynx are considered to be among 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 actions.

The part of the body that we are accustomed to calling the throat is in fact a rather complex anatomical and multifunctional structure consisting of the larynx and pharynx. The upper respiratory system itself is the pharynx, larynx, as well as the oral, nasal cavity and trachea. The pharynx is where 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 the anterior part of the thyroid cartilage (thyroarytenoid)
• transverse arytenoid muscle, which pulls and brings together the arytenoid cartilages
• posterior cricoarytenoid muscle, which rotates the cartilage and changes the position of the vocal processes
• cricothyroid muscle, tensor of 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 Sore Throat Muscles

The main causes of pain in the throat muscles relate to either traumatic injury or motor muscle disorders. Other conditions, diseases that provoke a pain symptom can also be considered causative factors, but the pain in the throat is more likely to be reflected, secondary. In addition, there are myopathies of infectious etiology (helminthiasis, tuberculosis), which are accompanied by a painful symptom in the larynx, but such cases are extremely rare in clinical practice.

The most common causes of sore throat muscles are:

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Movement disorders

• Such conditions in the throat are caused either by severe overexertion or, on the contrary, by 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 (weakening of muscles) and those caused by impaired innervation - neurogenic. Also, disorders can be partial - paresis or full - paralysis.
• Cortical (central) palsy can be caused 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 usually 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 infringement of the glottis. The cause may be functional, but the spasm may also be provoked by hypocalcemia against the background of 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, causing severe muscle spasm and, accordingly, a pain symptom, a feeling of lack of air. Hysterical spasm of the laryngeal muscles is often mistakenly diagnosed as bronchospasm, bronchial asthma or laryngospasm, and standard treatment with hormonal drugs or bronchodilators does not give results.
• Functional dysphonia (non-organic), 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 vocal cords. Chronic tension in the muscles of the larynx, neck and face is accompanied by hypertonicity of the abdominal press, activation of the vascular system.
• Spastic dysphonic disorder is an overstrain of the muscles of the larynx, pharynx and a violation of the coordination of the internal and external throat and respiratory muscles. The cause of such dysfunction is stress, mental trauma, and less often viral diseases (flu).
• Hysterical aphonia (complete loss of voice). The cause is the patient's unstable nervous and mental system, the impact of a stressful situation. In addition to the loss of voice and moderate pain in the throat muscles, the person falls into a depressive state, apathy.
• Functional aphonia, 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 formation (voice) is disrupted.

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 laryngeal stenosis.

Drug intoxications

Drug intoxications accompanied by damage to the motor neurons of the internal laryngeal muscles. The cause is drug intoxication with synthetic drugs, most often antimalarial drugs

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.

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Symptoms of sore throat muscles

Muscle dysfunction of the larynx is primarily manifested in changes in voice parameters. The first symptoms of pain in the throat muscles are an obvious, or rather audible change in the timbre, volume and sonority of the vocal apparatus. In addition, any throat disease is accompanied by a violation of the respiratory function, caused by the weakness of the affected muscles.

Some typical symptoms of sore throat muscles depending on the underlying cause are:

• 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, and tissue systems, 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, acute respiratory viral infections, measles, whooping cough. Symptoms are painful sensations in the muscle tissue of the larynx, irritation, dryness, unproductive cough, subfebrile temperature, swelling of the mucous membrane of the throat.
• All dysphonias are characterized by either a 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 they are aching, pulling. The specificity of throat pain is a "scratching", dry sensation, loss of vocal capabilities, which are often signs of serious ENT diseases, so alarming symptoms require timely diagnosis.

Diagnosis of sore throat muscles

The doctor's diagnostic actions may be difficult, since most often patients seek help when the disease of the throat muscles is already either in an advanced state and is accompanied by side symptoms, or goes into a latent chronic form. In addition, the vocal apparatus - muscles and ligaments are 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 contracts, which is extremely difficult to do due to pain.

The diagnostic stages may be as follows:

• Interview with the patient and collection of anamnesis.
• External examination of the body.
• Visual examination of external signs of the disease - tension in the neck muscles, possible swelling, lymph nodes (palpation).
• Throat x-ray.
• Laryngoscopy.
• Pharyngoscopy.
• If necessary, a biopsy is prescribed.

A more detailed description of the methods used to diagnose pain in the throat muscles:

• Inspection.
• An external examination of the neck and larynx is carried out.
• The larynx is palpated, mainly the cartilages - thyroid, cricoid - to determine elasticity, the presence or absence of a characteristic crunch. A normal larynx does not hurt during palpation, is amenable to passive movement, its muscles are not tense.
• Palpation of the lymph nodes is performed (deep and posterior cervical, submandibular, pretracheal, prelaryngeal, paratracheal, as well as those located close to the subclavian fossa). The norm is that the lymph nodes should not be palpable, this indicates that they are not enlarged and there is no inflammatory process.
• Laryngoscopy.
• Examination using a laryngeal mirror. The larynx is examined in two stages - during inhalation and during vocal production (the sounds "i" and "e").
• Indirect hypopharyngoscopy is an examination of the back wall of the larynx using a mirror.
• Culture for streptococcus, diphtheria and other pathogenic microorganisms.
• Complete blood count, biochemical analysis may be prescribed.
• If mononucleosis is suspected, which often manifests itself as pain in the muscles of the larynx, a monodrop 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 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.

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Treatment for 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 treat it at home, you just need to give your vocal cords some rest, keep quiet, do not overwork your larynx, do not irritate it with spicy, sour food.

If the symptoms indicate a more serious condition, the pain in the throat muscles does not subside for several days, you cannot do without medical recommendations. As a rule, therapeutic prescriptions concern topical drugs - sprays, aerosols, as well as physiotherapy procedures. In general, standard treatment for a sore throat can be medicinal, detoxifying or surgical. 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, etc.).

The most common treatments for muscular sore throat are:

• Neutralization of the provoking factor in functional movement disorders, dysphonia. It is necessary to exclude the possibility of overstraining the ligaments and muscles, adhere to a gentle regimen, and observe silence.
• Muscle hypertonicity is relieved by warm compresses on the neck area and physiotherapeutic procedures (UHF, electrophoresis).
• If laryngitis or pharyngitis is detected, appropriate therapy is carried out.
• Special exercises for restoring and strengthening the functions of ligaments give good results.
• More serious inflammatory diseases are treated with antibiotics that correspond to the identified type of pathogenic microorganism.
• Chronic disorders of the throat muscles caused by scars and tumor processes are treated surgically.
• Threatening symptoms - bilateral paralysis of the larynx, stenosis of 3-1 degree is treated urgently with the help of tracheotomy.

It should be noted that the throat muscles most often suffer from conditions that do not require antibacterial therapy or surgery; in 85-90% of cases, treatment consists of warming up the overstrained muscles, irrigating the ligaments, and rest. The voice with such a complex is restored after 2-4 days.

Prevention of sore throat muscles

Based on statistical data, most throat muscle diseases are caused by vocal strain. Accordingly, prevention of throat muscle pain should concern the rules for using such a valuable resource. Tips for preventing pain in the larynx muscles caused by other serious diseases fit into the standard scheme:

• Regular medical check-ups, including consultation and examination by an ENT doctor.
• Adherence to the rules of a healthy lifestyle – physical activity, strengthening overall 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, obviously, the vocal apparatus is used most by people whose profession is connected with performances, speeches. They are the ones who most often suffer from functional dysphonia and the recommendations offered 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 the throat muscles in good shape is daily vocal exercises, similar to vocal warm-ups. There are many methods of articulation and breathing exercises that help strengthen the muscle tissue and ligaments of the larynx.
• You can't overstrain your voice for a long time. There are certain standards: lecturers and teachers speak 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 the throat muscle are very closely connected with the general condition of the body, especially with the condition of the nervous system. Therefore, in order for the pain in the throat muscles to be familiar only by hearsay, it is necessary to strengthen the entire body as a whole, alternate periods of work and rest, and protect the nervous system.
• The throat is closely connected with the nasopharynx and respiratory system, respectively, their condition can affect the muscles of the larynx. Breathing exercises, sanitation of the nasopharynx will help to avoid painful muscle sensations.
• The functions of the throat can be impaired by the environment, especially dry, smoky air. The air should be humidified, this applies to rooms with an air conditioning system and in the winter, when the heating season begins.

Sore throat muscles are 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-medication, following the old proverb: "A wise man will rather avoid an illness than later look for a healer and choose a medicine."