Why does it hurt to swallow on one side of the throat and what to do?

With most viral or bacterial throat conditions, it hurts to swallow, and most often the pain is bilateral. However, sometimes it hurts to swallow on one side of the throat, and it is not always due to inflammation from acute respiratory viral infections, tonsillitis (sore throat), pharyngitis or laryngitis.

Causes of the sore throat on one side

The anatomical name for the throat is pharynx (pharynx), which consists of three sections: the nasopharynx (nasopharyngs), oropharynx (oropharyngs, mesopharynx), and larynx (pars laryngea, hypopharynx). The hypopharynx is the lowest part of the pharynx, which is part of both the upper respiratory tract and the gastrointestinal tract. Connecting the pharynx to the trachea larynx (larynx) is part of the respiratory system; the larynx contains the vocal cords, which are folds of its mucous membrane.

Read:

• Causes of sore throat
• Laryngeal pain
• Sore throat when swallowing
• Pain in the tonsils

Among the causes of unilateral (one-sided) pain in the throat, larynx, or pharynx felt when swallowing, experts note:

• foreign bodies of the pharynx (most often when eating fish, its bones get stuck in the hypopharynx, causing damage to the mucous membrane;
• pharyngeal abscess, which can form during a purulent sore throat (tonsillitis). Depending on its localization, it hurts to swallow on the right or left side;
• formation after acute bacterial tonsillitis paratonsillar abscess, in which it hurts to swallow and the lymph node on one side is enlarged and when palpated also causes a feeling of pain (usually it is one of the parotid lymph nodes);
• purulent complication of acute bacterial tonsillitis or periodontal inflammation - lateral parapharyngeal (oropharyngeal) abscess;
• Laryngeal polyps (which in many cases form on the vocal folds);
• Upper respiratory tract involvement by obligate oral mucosal bacteria of the genus Actinomyces - actinomycosis of the pharynx or larynx;
• unilateral inflammation of the salivary gland (particularly the submandibular gland) - sialadenitis. Secondary infection of the salivary glands can be caused by tonsillitis with involvement of nearby lymph nodes;
• Malignant tumors of the pharynx. And neoplasms that usually result in unilateral symptoms are squamous cell laryngeal cancer, lymphomas, oropharyngeal carcinoma (squamous cell cancer of the oropharynx), and carcinoma of the parotid salivary gland.

Risk factors

Risk factors for a one-sided sore throat when swallowing may include rarer causes that can cause it. For example, when your throat is swollen on one side and it hurts to swallow, the cause may be related to acid reflux: the "backward passage" of stomach acid through the esophagus - allowing it to enter the larynx gastroesophageal reflux disease (GERD). And, according to gastroenterologists, the likelihood of one-sided irritation of the pharyngeal mucosa lining with gastric acid reflux is higher in people who tend to sleep on one side.

Unilateral swelling of the palatine tonsils, when the tonsil is swollen on one side and it hurts to swallow, can be a symptom of a cyst of the palatine tonsil (retention, epidermoid, lymphoepithelial).

If the ear hurts and it hurts to swallow on one side, the presence of neuralgia of the laryngeal nerve (nervus glossopharyngeus), which has a pharyngeal plexus, cannot be ruled out. Note that this is irradiating pain in the ear (reflected otalgia).

A similar clinical picture - with unilateral pain in the pharynx that occurs during swallowing and radiates to the ear and temporomandibular joint - is also observed in the rather rare Needle syndrome - stylo-lingual syndrome or stylalgia. This syndrome is caused by an anomaly - giant styloid process of the temporal bone (processus styloideus ossis temporalis).

Pathogenesis

The mechanism of development of unilateral pain in the throat when swallowing is determined by the causative disease. For example, in case of laryngeal neuralgia it is nerve damage or compression of its roots.

In the case of stylo-lingual syndrome, the pathogenesis is due to the fact that the styloid process of the temporal bone - if abnormally long - can reach the lower part of the glans (palatine tonsil), pass through the pharyngeal constrictor muscle (m. Constrictor pharyngis superior) and irritate the palatine nerve plexus of the lingual nerve.

To date, there are several theories of the biological function of pain, but the generally accepted ideas are related to the response of primary afferent nociceptors (specific pain receptors), their contact with second-order pain transmission neurons in the spinal cord, which transmit impulses to the brainstem reticular formation, thalamus, somatosensory cortex, and limbic system.

The pathogenesis of reflected (irradiating) pain is explained by the activity of sympathetic nerves, peripheral branching of primary afferent nociceptors, as well as hyperactivity of neurons of the dorsal horn of the spinal cord with convergence and interpretation of afferent (sensory) signals from different organs as coming from the same dermatome (skin area innervated by nerve fibers of the sensory root of a particular spinal nerve).

Diagnostics of the sore throat on one side

Read more about diagnostic methods:

• Laryngoscopy
• Pharyngoscopy
• Pharyngeal examination
• X-rays of the larynx and pharynx
• Functional examination of the larynx

Differential diagnosis is designed to correctly determine the etiology of unilateral pain in the throat, larynx, or pharynx felt on swallowing.

Treatment of the sore throat on one side

When it hurts to swallow on one side of the throat, there is sore throat treatment and treatment of the underlying condition. Read:

• Tonsillitis: treatment
• Treatment of a paratonsillar abscess
• Neuralgia pills
• Laryngeal Cancer - Treatment
• Gastroesophageal reflux disease (GERD) - Treatment

Laryngeal polyps, palatine tonsil cysts and anomalies of the styloid process of the temporal bone are treated surgically.