A burning sensation in the back of the throat is a common complaint that signals irritation or inflammation of the tissues lining the pharynx. This discomfort, often described as a fiery or scratchy feeling, is the body’s response to an irritant or a developing health issue. Understanding the source of this irritation is the first step toward finding relief and determining whether the symptom indicates a more serious underlying problem.
Gastroesophageal Reflux and Stomach Acid
One of the most frequent causes of chronic throat burning is the backward flow of stomach contents, known as gastroesophageal reflux. The stomach lining is designed to withstand digestive acid, but the throat and voice box tissues are far more sensitive to this caustic material. When the lower esophageal sphincter fails to close properly, stomach acid can splash up into the esophagus.
If this acid travels up into the throat and voice box, the condition is called Laryngopharyngeal Reflux (LPR), sometimes referred to as “silent reflux.” Unlike classic Gastroesophageal Reflux Disease (GERD), which often causes heartburn, LPR may present solely as throat irritation, a persistent cough, or a feeling of a lump. This burning sensation is often worse after eating, when lying down, or upon waking, as gravity no longer helps keep the stomach contents down. Certain dietary choices, such as high-fat foods, spicy dishes, caffeine, and alcohol, can relax the sphincter muscle or increase acid production, triggering a burning episode. Avoiding these triggers is a primary way to manage the chronic irritation caused by acid exposure.
Infections and Inflammatory Conditions
A burning throat can result from pharyngitis, or inflammation of the throat tissues, often due to the body’s immune response to a pathogen. The majority of these cases are caused by common viral infections, such as the cold, flu, or COVID-19. In these instances, the burning is typically accompanied by symptoms like a cough, runny nose, and general malaise.
Bacterial infections, most notably Strep throat caused by Group A Streptococcus, also lead to severe pharyngitis. Bacterial pharyngitis tends to be more abrupt in onset and often presents with a higher fever, swollen tonsils, and white patches of pus, but typically without a cough or cold symptoms. Post-nasal drip is another common inflammatory trigger for persistent burning. Excess mucus from allergies or a sinus infection runs down the back of the pharynx, irritating the sensitive mucosal lining. This drainage forces frequent throat clearing, which compounds the local irritation and contributes to the burning feeling.
Environmental Factors and Lifestyle Irritants
Environmental factors can directly irritate the pharyngeal mucosa, causing a burning sensation. Dry air, particularly in heated indoor spaces during winter or from sleeping with the mouth open, is a common culprit. When the air lacks moisture, the throat’s protective mucosal layer becomes dehydrated, leading to a dry, scratchy, and inflamed feeling.
Chemical irritants from lifestyle habits, such as cigarette smoke and e-cigarette vapor, also assault the throat tissues. Tobacco smoke contains thousands of chemicals and particulate matter that trigger an inflammatory response, leading to a chronic burning sensation. Vaping aerosols contain volatile organic compounds and aldehydes that also act as chemical irritants, impairing the throat’s natural defense mechanisms. Exposure to occupational irritants, such as strong cleaning fumes, dust, or chemical vapors like chlorine or ammonia, can also cause acute respiratory tract irritation, resulting in a sudden and intense burning in the back of the throat.
Urgent Symptoms and When to Seek Care
While a burning throat is often a temporary symptom of a common cold or mild irritation, certain accompanying signs suggest a more serious condition requiring prompt medical evaluation. Seek professional care if the burning sensation persists longer than two weeks without improvement, or if it is accompanied by concerning systemic symptoms.
Immediate medical attention is necessary if you experience severe difficulty breathing or swallowing (dysphagia), as this can indicate dangerous swelling of the airway. Other red flag symptoms should prompt a visit to a primary care physician or an ear, nose, and throat specialist:
- A high fever that does not respond to over-the-counter medication.
- Persistent blood in your saliva or mucus.
- A noticeable lump in the neck or throat.
- Unexplained weight loss.
- Significant voice changes, such as hoarseness lasting more than ten days.
- Unusual drooling, especially in a child.