Cricopharyngeal Spasm

Cricopharyngeal spasms occur when your cricopharyngeal muscle (in your throat) tightens more than it should. These spasms are harmless. But they can cause uncomfortable symptoms. You might feel like you’re choking, even though you’re not. Treatments include medications and physical therapy.

What Is a Cricopharyngeal Spasm?

Cricopharyngeal (CRY-coe-fare-en-gee-uhl) spasms are throat spasms. Your cricopharyngeal muscle — sometimes called the cricopharyngeus or upper esophageal sphincter (UES) — sits at the top part of your esophagus (food pipe). This muscle contracts to open and close your esophagus, allowing food and liquid to pass through. In people with cricopharyngeal spasm, this muscle contracts too much and/or too tightly. When this happens, you can still swallow but your throat feels uncomfortable.

Cricopharyngeal spasms can affect people of all ages, even children. They may be related to other issues, like acid reflux, inflammatory diseases or neurological conditions.

Other names for cricopharyngeal spasms include cricopharyngeal achalasia and cricopharyngeal dysfunction.

Symptoms and Causes

What are the symptoms of cricopharyngeal spasms?

Cricopharyngeal spasm symptoms can range from mild to severe. They may include:

• Choking or strangling sensations
• Feeling like there’s a lump in your throat that you can’t clear
• Pressure on the area just below your Adam’s apple

These symptoms usually go away when you’re eating or drinking. They can also worsen when you’re stressed. Even though many people with cricopharyngeal spasm feel restriction in their throats, they can still swallow normally.

What causes cricopharyngeal spasms?

Cricopharyngeal spasms occur when your upper esophageal sphincter tightens more than it should. They’re more common in people with:

• Acid reflux or GERD
• Anxiety disorders
• Inflammation
• Neurological conditions (like stroke, myositis and muscular dystrophy)
• Stress

Complications of cricopharyngeal spasms

Leaving cricopharyngeal spasms untreated for a long time can cause something called Zenker’s diverticulum (a type of esophageal diverticulum). The condition causes a pouch in the back of your throat where food and saliva collect, making it harder to swallow.

Diagnosis and Tests

How are cricopharyngeal spasms diagnosed?

Your healthcare provider will do a physical examination and ask about your symptoms. They’ll also review your health history to see if you have any conditions that could contribute to cricopharyngeal spasm.

What tests will be done to diagnose cricopharyngeal spasms?

If your provider thinks you might have cricopharyngeal spasms, they’ll do an upper endoscopy. During this outpatient procedure, they’ll insert a thin tube with a tiny camera down your throat. This allows them to see your esophagus in greater detail.

They might run additional tests, which could include:

• Esophageal manometry test. This test shows how the muscles in your esophagus operate when you swallow.
• Barium swallow test. Your provider will ask you to drink a barium liquid that coats your digestive tract. Then, they’ll take X-rays to examine your esophagus.

Management and Treatment

How are cricopharyngeal spasms treated?

Management depends on the cause and severity of your symptoms. Cricopharyngeal spasm treatments include:

• Acid reflux medications. If cricopharyngeal spasm is related to acid reflux, GERD or similar conditions, your healthcare provider may prescribe medications like H2 blockers or proton pump inhibitors.
• Botox injections. This temporarily weakens the affected muscles, helping them relax.
• Counseling. If stress is a contributing factor, counseling can help. Managing your anxiety can reduce — and in some cases eliminate — cricopharyngeal spasm symptoms.
• Muscle relaxants. These prescription medications can help calm stress that triggers cricopharyngeal spasms.
• Physical therapy. Exercises for cricopharyngeal spasms can help ease your symptoms. A physical therapist can show you how to relax the affected muscles.

Rarely, some people need surgery. During this procedure, your surgeon makes incisions (cuts) in your cricopharyngeal muscle. This keeps it from contracting too much.

Managing cricopharyngeal spasm symptoms at home

In addition to medical treatments, there are also ways to get relief from cricopharyngeal spasm symptoms on your own:

• Drink warm beverages to help relax your throat muscles.
• Eat smaller meals throughout the day. This helps your throat muscles stay relaxed for longer.
• Gently massage your neck and throat.
• Keep track of factors that make your symptoms worse, then avoid them.
• Practice mindfulness, meditation or other relaxation techniques.
• Take supplements to reduce cricopharyngeal spasms. Magnesium may be particularly helpful.

Outlook / Prognosis

What can I expect if I have cricopharyngeal spasms?

Most of the time, cricopharyngeal spasms go away on their own. You may experience flare-ups during times of stress, but learning to manage your symptoms can help improve your quality of life.

How long cricopharyngeal spasms last

In most cases, people with cricopharyngeal spasms notice improvement in about three weeks. But everyone is unique, and this timeline can vary.

Sometimes, just being aware of the issue can help. Once you have a diagnosis to explain your symptoms, you might become less anxious and experience symptoms less often.

Prevention

Can cricopharyngeal spasms be prevented?

You can’t always prevent cricopharyngeal spasms. But treating the underlying cause — like acid reflux, neurological issues or inflammatory conditions — can help reduce your risk. Additionally, managing stress can be key in easing your symptoms.

Living With

When should I see my healthcare provider?

If you’ve had symptoms lasting longer than three weeks, call your healthcare provider. They may run some tests to rule out other, more serious conditions.

Additional Common Questions

What’s the difference between cricopharyngeal spasms and esophageal spasms?

Cricopharyngeal spasms and esophageal spasms both affect your esophagus. Some symptoms overlap, but there are key differences:

A note from Wockr

Cricopharyngeal spasms aren’t dangerous. But they can be painful. Flare-ups may induce panic, especially if you feel like you’re choking. Treatment can help ease your symptoms. But sometimes, awareness and a basic understanding of your condition can help. When you know what triggers your symptoms, it can lessen the anxiety you might experience during flare-ups. If you think you have cricopharyngeal spasms, talk to your healthcare provider. They can help figure out the cause and come up with an appropriate treatment plan.