Why do I feel like I have a lump in the middle of my chest?

October 2, 2025 •

5 min read

The sensation of a lump in the throat or chest, medically known as globus sensation, is a frequent complaint, yet in most cases, no physical obstruction is found. This feeling, often described as a “ball” or “wad of phlegm,” can be a symptom of various conditions, from anxiety to acid reflux, rather than a solid mass. Understanding these possible causes can help demystify the unsettling feeling and guide you toward appropriate relief.

Quick Summary

This sensation can stem from various causes, including acid reflux (GERD), anxiety, muscle spasms in the esophagus, or inflammation of chest wall cartilage (costochondritis). It's crucial to understand the distinct symptoms to differentiate between common, benign conditions and more serious issues that warrant medical evaluation.

Key Points

Globus Sensation: A common cause of a lump-like feeling is globus sensation, where no physical blockage exists, often linked to acid reflux or anxiety.
GERD as a Culprit: Stomach acid irritating the esophagus can trigger muscle tension that feels like a lump, often accompanied by heartburn and throat irritation.
Anxiety's Role: Stress and anxiety can cause physical symptoms like muscular tension in the throat and chest, resulting in the sensation of a lump.
Inflammation and Pain: Costochondritis, an inflammation of chest cartilage, can cause sharp or pressure-like chest pain that can be mistaken for a lump.
When to See a Doctor: Seek immediate medical care if the feeling is accompanied by severe pain, difficulty breathing, fever, or pain radiating to other areas.
Diagnosis is Key: A doctor can perform a physical exam and other tests, such as imaging or endoscopy, to accurately diagnose the cause and rule out serious conditions.

Common causes of a lump-like chest sensation

Experiencing a phantom lump or tightness in the middle of your chest can be distressing, but it's important to know that many common conditions are responsible. Pinpointing the exact cause often depends on accompanying symptoms, lifestyle factors, and the nature of the feeling.

Gastroesophageal reflux disease (GERD)

GERD is one of the most frequent causes of a lump-in-the-throat or chest sensation, known as globus pharyngeus or globus sensation. When stomach acid flows back up into the esophagus, the irritation and inflammation can cause the muscles at the top of the esophagus to tighten. This can result in a sensation of a foreign object being stuck, even though there is no physical blockage. Other symptoms often include heartburn, a sore throat, or a chronic cough, which may worsen after eating or when lying down. Managing GERD with diet changes, lifestyle adjustments, and antacid medications often resolves the globus sensation.

Anxiety and stress

Psychological factors, particularly anxiety and stress, are well-documented triggers for the globus sensation. The body’s "fight or flight" response can cause increased muscle tension throughout the body, including the muscles in the throat and chest. This muscle clenching creates the feeling of a lump or tightness. This is especially common during periods of high stress or intense emotional situations. Interestingly, for many, the sensation may temporarily improve when they are eating or drinking, only to return afterward.

Esophageal spasms

Sometimes, the muscles of the esophagus can experience uncoordinated contractions or spasms. This can lead to chest pain, difficulty swallowing, or the feeling that something is stuck. These spasms can be brought on by acid reflux, eating or drinking very hot or very cold foods, or stress. In cases where the spasm occurs in the cricopharyngeal muscle at the top of the esophagus, the feeling is often described as a "wad of phlegm" or "golf ball" sensation that can't be swallowed.

Costochondritis

This condition involves the inflammation of the cartilage that connects a rib to the breastbone (sternum). The pain from costochondritis is often sharp and can be felt in the middle of the chest, sometimes mimicking a heart attack. The pain may worsen with deep breaths, coughing, or movement. While it is an inflammatory condition, the swelling and pain can sometimes be misinterpreted as a physical lump or internal pressure.

Benign growths and other issues

While less common, some non-cancerous physical growths can also cause a feeling of pressure or a mass. These include benign tumors like lipomas (fatty tissue) or cysts, which can grow on or under the skin. A rare condition called Xiphoid syndrome, which involves the inflammation of the xiphoid process (the cartilage tip of the sternum), can also create a localized, painful lump. These issues are typically diagnosed with a physical exam and imaging tests.

Comparison of potential causes


Cause	Symptom Characteristics	Associated Symptoms	Triggers	When to Seek Help
GERD / Acid Reflux	Sensation of a lump or tightness in the throat/chest; not painful.	Heartburn, sore throat, sour taste, chronic cough.	Eating, especially large meals or spicy foods; lying down.	If symptoms are persistent despite lifestyle changes or if they are severe.
Anxiety / Stress	Vague, non-painful lump sensation; can come and go.	Rapid heart rate, sweating, shortness of breath, dizziness.	Periods of high stress, public speaking, strong emotions.	If anxiety is unmanageable or if you experience severe symptoms like chest pain.
Esophageal Spasms	Squeezing, crushing, or lump-like pain in the chest.	Difficulty swallowing, food feeling stuck, regurgitation.	Very hot/cold food, emotional stress.	If severe chest pain or difficulty swallowing occurs.
Costochondritis	Sharp, stabbing, or pressure-like pain in the chest wall.	Pain worsens with deep breathing, coughing, or movement.	Strenuous exercise, injury, respiratory illness.	If you suspect a heart attack or the pain is severe and doesn't improve.

When to see a doctor

Although many causes for a lump feeling in the chest are not life-threatening, it is important to consult a healthcare professional for an accurate diagnosis, especially if the sensation is persistent or accompanied by other worrying symptoms. While the internet offers general information, only a doctor can rule out serious conditions. You should seek immediate medical care if the lump sensation is combined with:

Severe chest pain or pressure
Difficulty breathing or shortness of breath
Fever, chills, or a rapid heart rate
Pain that radiates to your arm, neck, or jaw
Unexplained weight loss

Diagnostic process

To determine the cause, your doctor will likely begin with a physical examination and take a detailed medical history. This may involve palpating the area of concern and asking about your symptoms, lifestyle, and potential triggers. Depending on these findings, further tests may be ordered to exclude more serious issues. These can include:

Imaging: A chest X-ray, CT scan, or MRI can provide a clearer picture of the bones, soft tissues, and organs within the chest cavity. This helps identify issues like inflammation, benign growths, or structural changes.
Endoscopy: This procedure involves inserting a thin, flexible tube with a camera down your throat to examine the esophagus and stomach lining. It can help diagnose GERD or identify any physical abnormalities.
Heart tests: If heart-related causes are suspected, tests like an electrocardiogram (EKG) or stress test may be performed, though anxiety is a much more common cause of chest discomfort in otherwise healthy individuals.

Treatment options

Treatment for the lump sensation depends entirely on the underlying cause. For GERD, antacids or other medications may be prescribed, along with dietary changes. For anxiety, stress management techniques, therapy, or medication can be highly effective. In cases of costochondritis, rest, anti-inflammatory medications, and gentle stretching are often recommended. If a benign growth is identified, a doctor may choose to monitor it or remove it surgically if it causes discomfort. In many cases, simply receiving a clear diagnosis that the cause is not serious, such as with globus sensation or costochondritis, can significantly reduce anxiety and help alleviate the symptoms.

Conclusion

The unsettling feeling of a lump in the middle of your chest is a symptom with a wide range of potential causes. While conditions like GERD, anxiety, and esophageal spasms are common culprits, it is crucial to consult a doctor to rule out more serious issues. By paying attention to the context of your symptoms and seeking professional guidance, you can find the correct diagnosis and effective treatment. For more information on health conditions, visit the National Institutes of Health website.

Managing stress and anxiety-related symptoms

For those experiencing globus or chest tightness related to stress, incorporating mindfulness and relaxation techniques can provide relief. Deep breathing exercises, meditation, and yoga have been shown to help calm the nervous system and reduce muscle tension. Regular, moderate exercise is also a powerful tool for managing anxiety and releasing tension. In cases where anxiety is persistent, seeking support from a mental health professional can provide valuable strategies and resources.

Frequently Asked Questions

Yes, anxiety is a common cause of a lump-like feeling in the chest or throat, known as globus sensation. This is due to muscle tension and the body's fight-or-flight response, which can cause muscles in the chest and throat to tighten. The sensation is not caused by an actual physical mass.

Globus sensation is the medical term for the persistent or intermittent feeling of having a lump or foreign body stuck in your throat when no physical obstruction is present. It is a benign condition often associated with acid reflux, stress, or muscle tension.

Yes, Gastroesophageal Reflux Disease (GERD) is a very common cause. Stomach acid backing up into the esophagus can irritate the lining and cause the muscles to tighten, creating the sensation of a lump. Managing acid reflux can often resolve the symptom.

While many causes are benign, you should seek immediate medical attention if the lump sensation is accompanied by severe chest pain or pressure, difficulty breathing, a rapid heart rate, fever, or radiating pain. These symptoms can indicate a more serious condition.

A feeling of heaviness or pressure can be a symptom of heart problems like angina, but it is also a common symptom of anxiety. The sensation caused by conditions like globus is typically not painful and does not interfere with swallowing, unlike more serious issues. A doctor's evaluation is crucial to distinguish the cause.

Yes. A physical lump is an actual mass that a doctor can feel or see on an imaging test. A lump sensation is a feeling that there is something there, but it is not a physical object. Many benign conditions cause the sensation, but a doctor can determine if a physical lump is present and what it is.

Costochondritis is an inflammation of the cartilage connecting the ribs to the breastbone. It causes sharp, localized chest pain that can be mistaken for a lump or internal pressure due to the inflammation. The pain often worsens with deep breathing or movement.