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Neck discomfort when eating or drinking is quite common and can be caused by a strained muscle or an underlying illness. Swallowing difficulties, also known as dysphagia, can affect the mouth, throat, and oesophagus, causing pain and difficulty swallowing. This can be caused by a variety of factors, including neck muscle strain, neck instability, nerve compression, acid reflux, and bone spurs. Cervical disc disease has been linked to swallowing difficulties, and patients often present with primary complaints of neck pain or neck instability. Furthermore, certain medications can affect swallowing by causing mucosal dryness and problems with chewing. It is important to seek medical attention for recurring neck pain when swallowing to ensure accurate diagnosis and treatment.
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What You'll Learn
Neck pain and swallowing difficulties
Swallowing difficulties can be caused by disorders, diseases, or conditions impacting the muscles or nerves involved in swallowing. This includes the vagus nerve, which is involved in all three phases of swallowing. Compression or interruption of the vagus nerve signals due to neck instability can lead to swallowing difficulties.
Dysphagia can be classified into three types: oral, oropharyngeal, and esophageal dysphagia. Oral dysphagia occurs when there is an issue with the mouth, such as with the jaw, teeth, or tongue, which work together to tear food into smaller pieces. Oropharyngeal dysphagia involves problems transferring food from the mouth to the throat, while esophageal dysphagia is related to the esophagus itself.
Several conditions can cause dysphagia, including neurological diseases like Parkinson's disease, amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), and muscular dystrophy. Other causes include laryngopharyngeal reflux (LPR), gastroesophageal reflux (GERD), dry mouth, oral and dental health issues, and side effects of certain medications.
If you experience neck pain and swallowing difficulties, it is important to seek medical attention to determine the underlying cause and receive appropriate treatment. A range of tests can be performed to evaluate the structures in the head and neck involved in swallowing, including X-rays, endoscopies, and laryngoscopies. Treatment options may include conservative care treatments, exercises, and dietary modifications.
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Cervical spine disorders
The cervical spine, or neck, consists of the first seven vertebrae in the spine. It supports the weight of the head and allows for a wide range of head motions. The cervical spine is surrounded by muscles, nerves, tendons, and ligaments. The intervertebral discs between the vertebrae are "shock-absorbing". The spinal cord runs through the centre of the spine and sends and receives messages from the brain.
Cervical spondylosis is a common cervical spine disorder caused by degeneration of the bones and discs in the neck. It can lead to herniated discs and bone spurs. Bone spurs can pinch the spinal cord and nerve roots, causing tingling, numbness, and weakness in the arms, hands, legs, or feet. Cervical spondylosis can also result in a narrowing of the spinal canal.
Other cervical spine disorders include cervical herniated disc, degenerative disc disease, and cervical spinal stenosis. Cervical herniated disc occurs when the discs between the vertebrae rupture, protrude, or bulge out. Degenerative disc disease involves the breakdown of discs between the vertebrae. Cervical spinal stenosis is the narrowing of the spinal canal around the spinal cord.
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Degenerative disorders
Cervical instability in the neck has been linked to swallowing difficulties, diagnosed as cervicogenic dysphagia. This is caused by weakened, torn, or damaged ligaments in the neck. Cervical instability has also been linked to cervical spine nerve compression, which can cause difficulties in swallowing, esophageal spasms, and acid reflux.
Medications can also affect swallowing. For instance, antipsychotic medication can impact swallowing through its anticholinergic effects on the salivary glands and esophagus, as well as through the production of tardive dyskinesia, causing lingual and upper esophageal hyperkinesias. Antihypertensives can also impact swallowing by causing mucosal dryness and dehydration.
In addition, degenerative disorders of the esophagus can lead to dysphagia. For example, achalasia is a rare disorder where the muscles at the bottom of the esophagus do not relax, preventing food from entering the stomach. Cricopharyngeal spasms are another example, where abnormal contractions occur when the muscle at the top of the esophagus squeezes too much, creating the sensation of something being stuck in the throat.
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Swallowing muscle exercises
Neck problems, including cervical spine disorders, whiplash-associated disorders, and post-concussion syndrome, can cause swallowing difficulties, medically termed dysphagia. Dysphagia can also be caused by certain medications, or by conditions such as Parkinson's disease, achalasia, cricopharyngeal spasms, muscular dystrophy, and myasthenia gravis.
If you are experiencing dysphagia, it is important to consult a medical professional, such as a physical therapist, occupational therapist, or speech-language pathologist, who can prescribe specific swallowing exercises to address your particular condition. These exercises can improve muscle strength and coordination, thereby improving your swallowing ability.
- Tongue-strengthening exercises: These exercises can help improve tongue strength and mobility, making it easier to manipulate food inside your mouth and move it into your pharynx.
- Super-supraglottic swallow: Inhale and hold your breath, bear down as if having a bowel movement, and swallow while continuing to hold your breath.
- Gargle and yawn: Pretend to gargle while holding your tongue back as far as possible, then pretend to yawn while continuing to hold your tongue back.
- Dry swallow: Squeeze all your swallowing muscles as tightly as you can, imagining that you are swallowing a vitamin without water.
- Saliva swallow: Gather saliva on your tongue, keep your lips pressed together, and swallow the saliva all at once as if swallowing a grape or a pill.
- Straw exercise: Place a straw in your mouth and suck on it, creating enough suction to pick up a piece of paper and carry it over to a cup.
These exercises can be practised at home, but it is important to first consult a medical professional to ensure that you are performing the exercises correctly and to rule out any serious underlying conditions.
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Head and neck disorders
Dysphagia, or difficulty swallowing, is a common condition that can affect the mouth, throat, and oesophagus, causing pain or discomfort when swallowing. This condition can be caused by a variety of factors, including underlying illnesses, neck disorders, or issues with the muscles or nerves involved in swallowing.
Neck disorders, such as cervical disc disease or instability, have been linked to swallowing difficulties. Cervical instability can lead to nerve compression, oesophageal spasms, and acid reflux, all of which can contribute to dysphagia. Additionally, conditions like tendinitis of the longus colli muscle, paravertebral calcification, and prevertebral abscess can cause both neck pain and painful swallowing, known as odynophagia.
Medications can also play a role in swallowing difficulties. Anticholinergic medications, for example, can cause side effects such as mucosal dryness, problems with bolus manipulation, chewing, and swallowing. Antipsychotic medications can affect swallowing by impacting the salivary glands and oesophagus, and the production of tardive dyskinesia, leading to lingual and upper oesophageal hyperkinesias.
Swallowing disorders may also be related to neurological diseases, such as Parkinson's disease, multiple sclerosis (MS), and muscular dystrophy. These conditions can impact the coordination and strength of the muscles involved in swallowing, including those in the neck, jaw, and tongue.
To diagnose and treat swallowing difficulties, a multidisciplinary approach is often necessary. Speech-language pathologists, radiologists, gastroenterologists, neurologists, and other specialists may be involved. Diagnostic tests can include modified barium swallow studies, endoscopies, and laryngoscopies. Treatment options vary and can include conservative care treatments, exercises, electrical stimulation, and dietary modifications.
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Frequently asked questions
Dysphagia is a swallowing disorder that affects the mouth, throat, and oesophagus, causing difficulty or pain while swallowing.
Key symptoms include sharp or dull pain while swallowing food or liquids, difficulty initiating the swallowing process, headaches, dizziness, hearing problems, severe muscle spasms in the neck, ear filling, and skipped names.
There are many possible causes of dysphagia, including neck muscle strain, underlying illnesses, nerve compression, acid reflux, and medication side effects.
