Needle poking feeling in throat treatment

Written by Dr.Bayat
Associate Professor of Orthopedic expert,Brigham Hostpital
 

Needle poking or stabbing feeling in the throat can be due to many reasons but the most important and important one is Glossopharyngeal neuralgia (GPN) it’s a rare condition which can cause sharp, stabbing, or shooting pain which feels like needle poking in the throat area near the tonsils, the back of the tongue or the middle ear, some other causes can be allergies, Stomach acid return or GERD, Pharyngitis, Otitis media, Cervical discopathy and many more.

This pain takes place along the pathway of the glossopharyngeal nerve, which is present deep in the neck. It serves the back of the tongue, throat and the parotid gland, the middle ear and the eustachian tube in human body.

If you want to read about needle poking feeling in throat treatment then keep reading it’s explained all below from causes to symptoms to treatment.

 

 

General idea about needle poking feeling

Such painful episodes of needle poking feeling are mostly intermittent, lasting from a few seconds to a few minutes but the pain might occur several times in a day. In some other cases it might even not come back for several weeks to months. Certain activities in particular may trigger these painful episodes, including following:

  • Drinking cold drinks
  • Chewing food
  • Swallowing
  • Sneezing or coughing
  • Sometimes clearing the throat
  • Touching the gums even

Sometimes people with this problem try to avoid eating, drinking or chewing because they fear that these activities might trigger a painful attack and if continued over time, this can result in weight loss which is not a good thing .

 

What are the causes for this needle poking feeling the throat?

Needle poking feeling in throat can be due to   following reasons which include :

  • Glossopharyngeal neuralgia
  • Allergies
  • Stomach acid return or GERD
  • Pharyngitis
  • Otitis media
  • Cervical discopathy
  • Cervical muscle spasms
  • Thyroiditis
  • Pharynx disorders
  • Vocal cord tumors
  • Lymphadenopathy
  • peptic ulcers

 

  • Glossopharyngeal neuralgia

This is a disorder which is rare but can cause annoying pain and needle poking in the throat. Glossopharyngeal neuralgia is such a disorder where there is problem in function of the ninth pair of nerves in the brain, the lingual-pharyngeal nerve or the glossopharyngeal nerve. In human body we have 12 pair of nerves that emerges from brain and each of them has its own function.

The ninth one is mostly  responsible for sensation and muscle movements near throat. There is nothing worrisome  in this disorder and it almost always resolves completely and spontaneously without any long lasting adverse effects just the consideration must be made about accompanying heart problems so for that doctor should be consulted.

As we know the pharyngeal nerve and the Vagus nerve are anatomically close to each other, in some rare cases the development of glossopharyngeal neuralgia can simultaneously stimulate the Vagus nerve leading to heart issues.

Generally, only one side of the head and neck is affected by GPN as the glossopharyngeal nerve has several branches, including the tympanic branch that receives sensory information  from the middle ear and mastoid muscle, there is another important branch that is the carotid sinus nerve that innervates the carotid body and carotid sinus.

Such painful attacks can result in life-threatening symptoms, like fainting , slow heartbeat or arrhythmia.

 

  • Cervical discopathy

Cervical discopathy is a type of problem which can provoke lots of different pain and discomfort ranging from dull pain in neck to sharp shooting pain to fingertips. Pain in this disorder can be felt in throat and has needle like characteristics poking one , but unlike glossopharyngeal neuralgia lasts longer and wouldn’t resolves completely on its own needs intervention.

 

  • Thyroiditis

Inflammation of thyroid gland is called thyroiditis can be painful in many cases .The characteristic of thyroiditis pain is that it exacerbates or gets really bad by swallowing and drinking. Pain in this issue can start suddenly but unlike glossopharyngeal neuralgia wouldn’t resolve spontaneously on its own.

 

What are the choices for Needle poking feeling in throat treatment?

If this poking feeling is due to GNP then in most cases, anticonvulsant drugs are the first line of treatment. If this drug therapy is not effective or if a patient has side effects from this treatment  surgery is considered. First line Medications include:

  • Anticonvulsants: some anticonvulsants like Carbamazepine, oxcarbazepine, phenytoin, gabapentin, pregabalin, and other antiseizure medications are often prescribed for it and are effective .
  • Antidepressants: Amitriptyline and other antidepressant drugs are sometimes prescribed for use along with anticonvulsants to treat individuals who become depressed as the debilitating pain can cause depression in some.
  • Anesthetics: Local anesthetics can be injected to block the nerve or applied topically to areas where pain occurs in some cases .
  • Interventional therapies: In few cases medical therapy fails to control the pain properly and instead additional treatment may be needed. Interventional therapies include :
  1. Nerve block
  2. Lingual pharyngeal nerve neurolysis

The first one  that is nerve block is reversible but the neurolysis is irreversible. The pharyngeal lingual nerve is called as the ninth nerve as it emerges from the brain. This nerve, along side with many other nerves like the Vagus nerve, the Accessory nerve, and internal jugular vein, exit from a hole in the floor and base of the skull known as the jugular foramen and then enters the lateral surface of the neck from the right and left. People  who are not completely relieved from the pain by nerve block are then considered for option of nerve neurolysis.

An specialist like anesthesiologist can perform lingual-throat neurolysis in two ways that are:

  • Lingual pharyngeal neurolysis: with the help of radio frequency waves or the lingual pharyngeal neurolysis with the help of some drugs.

 It is typically  recommended to use a combination of drug therapy in addition to the interventional therapy in the process of treatment of severe and sudden attacks of glossopharyngeal neuralgia. The combination of these therapies almost always gets better results.

  • Surgery: Surgery is the last resort several surgical procedures can be options in alleviating the pain associated with GPN among them the most common one is microvascular decompression as explained below. If a tumour is found compressing the nerve or in case if Eagle syndrome is diagnosed i.e. elongated styloid compressing the nerve , then a different type of surgery may be chosen.
  • Microvascular decompression surgery : This procedure is  most common surgical technique for treating this and it's  performed under the affect of general anesthesia. The surgeon makes an incision and  small opening in the bone behind the ear on the side of the head where pain takes place . Then the doctor will use a microscope or an endoscope to view the nerve and search for any blood vessels compressing the nerve. Then the nerve and artery are separated and a small permanent sponge will be placed between the nerve and the artery which is compressing the nerve. After this procedure is performed, the surgeon will replace the bone that's is causing issue and close the incision. Microvascular decompression is the type of surgery which has the highest initial and long-term success rate. It is said to be effective in about 90% of cases and shows a lower rate of pain recurrence. However, if a patient cannot have microvascular decompression surgery due to any other medical condition, a less invasive procedure can be performed.

 

 How is it diagnosed?

Doctor will take proper history as it’s very helping. The location of the pain is very important in the diagnosis of glossopharyngeal neuroglia  since in other conditions, like trigeminal neuralgia, can produce similar symptoms. There is no single particular diagnostic test which can confirm that GPN is present or not . An ear, nose and throat specialist will perform an examination or we can say physical exam to rule out other disorders. The doctor may stimulate certain areas, like the tonsils or the back of the tongue, to see if pain occurs or not. The doctor might ask whether certain activities, like talking or chewing, swallowing trigger any pain or   not. An MRI i.e. magnetic resonance imaging or a  CT (computed tomography) scan  can be ordered to determine whether any tumor or blood vessel is compressing the nerves and causing pain or not.

 

Take away

What one feels in the throat is very hard to understand by the doctor if not described properly or if not  given  as detailed as possible.

When  person visits the physician he must try his best to explain the feeling as if present in one side or both side of the throat. If any experience of discomfort in the stomach is felt or if patient is on new medication, he shouldn't forget to tell the doctor about them.

Finding the exact cause of throat pain may become so difficult in some cases and may require lots of exams and imaging for diagnosis.

 

Written by Dr.Bayat
Associate Professor of Orthopedic expert,Brigham Hostpital

 

References

  • Blumenfeld A, Nikolskaya G. Glossopharyngeal neuralgia. Curr Pain Headache Rep. 

  • Grimm K, Fritsche E. [Reduction of Breasts ... Hans Schaller and the first mammoplasty in 1561. Contribution to history of medicine]. Handchir Mikrochir Plast Chir.

  • Simmonds M, 1913 Über lymphatische Herde in der Schilddrüse.

  • Blumenfeld: Neuroanatomy through clinical cases, 2nd Ed.

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Phone: +1(647)303 0740

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