Q. I feel something in the back of throat with no pain and inflammation. Why?

Answered by
Dr. Muhammad Zohaib Siddiq
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Mar 24, 2020

Hello doctor,

I have had a feeling like something had been at the back of my left side of the throat for a few days. I do not know what it is? Tonsils are not inflamed, throat a bit dry, and does not hurt to swallow.



Welcome to

One of the reasons for your symptoms is anxiety which you told. Globus hystericus is a feeling of something like a lump in throat which cannot be swallowed, or swallowed and reappears.

Tonsils usually are asymptomatic unless very large and obstruct throat are inflamed causing severe pain. If your throat is red, or you run a fever then chances of inflammation are more. Alternatively, you may send a picture of your throat so that I may see any visible inflammation or tonsils.

Thank you doctor,

I have attached the file.



Welcome back to

There are small tonsils on both sides but do not seem to be inflamed. Symptoms seem to be anxiety-related. Avoid anxiety.

Other cause can be dryness of throat as you told which leads to straining of throat muscles which causes feeling something. Do saline gargles. It will soothe your throat. Sometimes postnasal drip and acid reflux may cause this symptom. If you have a nasal allergy, take anti-allergic.

Hi doctor,

Thank you so much for your help. I really appreciate it.



Welcome back to

You are welcome. Keep in touch for further doubts.

Thank you doctor,

May I ask one more question?

I have a TMJ problem. It is clicking and all. The dentist told me I might live with it and all as there is no point of surgery and causes complications.

I think I have vertigo as I am always lack of balance every time. I move my head position or even look at the mobile or any device for a bit. I am not sure if it is in need of glasses or it is just vertigo?

I do not know if this is a cause of anxiety, but I have had like a pain in the back of my left side of the head and the front of the head between the eyebrows. I am always worried I am going to faint or fall over. Is there anything I can do for this?

I took my bloods out and all are fine. Folic acid and vitamin B12 were very low. I am getting worried as I am 23 years old. I do not know what it is all connected too.



Welcome back to,

First coming to your vertigo. When you move your head it causes vertigo, correct? There are many causes of vertigo most common in this scenario is benign paroxysmal positional vertigo (BPPV), which leads to vertigo or dizziness while moving the head. It is caused by inner ear disorder in which a fluid called endolymph is either reduced in volume or there are some precipitations in it called the otolith. Thus when one moves the head, it causes movement of endolymph which causes vertigo. In case of otolith, movement of these small stone-like precipitates causes vertigo.

Diagnosis is made by a maneuver called Dix Hallpike maneuver, in which the doctor moves your head in certain direction to diagnose.

In case of otoliths, doctor performs a maneuver called Epleys maneuver which settles these stones at a position where these cannot move and thus vertigo subsides.

Other causes of vertigo are certain medicines, low blood pressure, low blood sugar levels, and rarely infection or inflammation of the inner ear called labirynthitis. But vertigo in these conditions is not necessarily during the movement of the head.

Yes, focussing or accommodation problem of eyes can lead to vertigo. You may have to consult ophthalmologist to diagnose vision problems.

For folic acid and B12, you have to take meats and vitamin supplements. Strict vegetarian diet leads to vitamin B12 deficiency. Also, an autoimmune disorder which destroys receptors that absorb vitamin B12 can cause B12 deficiency. It leads to anemia called pernicious anemia. CBC (complete blood count), in case of pernicious anemia will show anemia and large red blood cells size. Hope yours is normal.

Regarding TMJ, clicking sensations only usually do not cause harm. If there is pain, stiffness or swelling, then you may have to take anti-inflammatory medicines to cool it down. Osteoarthritis of TMJ (temporomandibular joint) is very common. Diagnosed by MRI (magnetic resonance imaging) of TMJs.

Above all symptoms may also be due to stress and anxiety. Treatment of anxiety is to do deep breathing exercises and meditation, proper sleep, and avoidance of anger. Next step involves medicines but I recommend help yourself to help yourself as primary strategy for anxiety and depression management.

Thank you doctor,

This has helped me calm down a bit. And for the pain at the back of the head? On the right-hand side? Is it tension?



Welcome back to

Most common cause of headache is a tension headache, which is due to tension in muscles of head. Another common cause is Migraine. These two types are totally benign.

When to worry about headache? When headache is associated with vomiting, blurring of vision, weakness in body, slurring of speech, etc.

For tension-type headache, relaxation exercises, head massage and simple painkillers such as Acetaminophen with or without muscle relaxants such as Orphenadrine citrate are all that are required.

Same treatment is also helpful for migraines. Also, avoidance of triggers of migraine is essential. Triggers include (but not limited to):

1. Cheese.

2. Chocolate.

3. Caffeine.

4. Skipping meals.

5. Inadequate sleep.

6. Stress.

I hope this helps.

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