I was diagnosed with ES and Hyoid Syndrome in October 2025. Prior to this diagnosis, I have had 2 episodes of extremely painful esophageal spasms. The pain is comparable to having a heart attack. Has anyone also had esophageal spasms with a diagnosis of ES and or Hyoid Syndrome?
There have been a few discussions which might be interesting for you to read:
Pill Induced Esophagitis? - General - Living with Eagle
Symptoms for 2 decades, suddenly severe, pending diagnosis - General - Living with Eagle
There’s an old post so you probably wouldn’t get any answers, but there’s mentions of throat spasms by @eddieh here:
My Story - crazy symptoms ..questions - General - Living with Eagle
But it seems that the vagus nerve is involved with oesophageal spasms, and that nerve is commonly involved with ES, so it could be causing yours:
The vagus nerve is the primary nerve involved in esophageal spasms. It plays a crucial role in the regulation of the parasympathetic nervous system, which promotes rest, relaxation, and digestion. The vagus nerve is responsible for transmitting signals between the brain and the body’s major organs, including the esophagus. Disruptions in the vagus nerve’s function can lead to irregular muscle contractions in the esophagus, resulting in spasms. Conditions such as gastroesophageal reflux disease (GERD) and autoimmune disorders can disrupt the vagus nerve’s function, contributing to esophageal spasms.
Thank you so much for your reply! I have had my esophagus stretched twice because of esophageal spasms. My gastroenterologist stated they are not sure what causes them. A second note is that I had a mild stroke on July 27, 2024 which affected my left arm only but my arm was back to normal within 2 days. My heart doctor put me on diltiazem (cardizem) and I mentioned I have had esophageal spasms the cardiologist said diltiazem would help control the esophageal spasms. I haven’t had another since taking diltiazem. I have recently gone through physical therapy for pain in left shoulder. Another different question. How do I change my profile? I filled it out in August 2025 when I had not been diagnosed with ES. IN October 2025 I saw an ENT who is board-certified otolaryngologist. When I shared with him my symptoms, he said he didn’t think I had Eagle Syndrome possibly had Hyoid Syndrome. He ordered a CT scan with contrast of my neck. I went back to him a week later and he said CT scan show that I had both Eagle Syndrome and Hyoid Syndrome. Specifically, I have elongation of right styloid process and calcification of left stylohyoid ligament. He gave me a shot of triamcinolone (kenalog) on my left side of neck. I noticed no difference after shot. Since having my stroke, I am wondering if having ES played a role in causing it. Further tests, however, revealed I have two blockages, one is a 70% blockage in one artery, and a stent was put in it. However, I still have a 40% blockage in the Widowmaker artery! A stent won’t be put in it until blockage is 70%. I feel like a walking time bomb! So now knowing I have ES, I can’t help but wonder how much ES has played in my heart situation! Thank your help!! I feel so lucky to have “happened” upon this “Living with Eagle” forum. I am learning so much! I apologize for such a long post!! Thank you again!!
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@geppard - Welcome to our forum! We’re glad you found us, too, & that we can help you.
I’ve never heard of diltiazem/cardizem but I’m glad if it’s helped stop your esophageal spasms.
I’m not sure the diagnosis this doctor gave you is accurate. Eagle Syndrome is defined as 1) elongation of the styloid process(es), 2) calcification of the stylohyoid ligament(s) or 3) a combination of 1 & 2. Some doctors actually diagnose ES as “calcification of the stylohyoid ligaments” not as styloid process elongation.
Hyoid Bone Syndrome is typically caused by elongation of the greater horn(s) of the hyoid bone not calcification of the stylohyoid ligament(s).
You pose a valid concern as an elongated styloid or calcified stylohyoid ligament can make contact with the common or internal/external carotid artery(ies) which can irritate or puncture the artery causing a clot to form & thus posing a stroke risk. This is very rare, but it can happen. Sometimes the contact between the carotid artery & styloid/s-h ligament calcification is intermittent i.e. it only happens when your head is in specific positions (looking up or down, left or right…). Since most scans are done w/ the head in a neutral position, it can appear there is no contact between the bony tissue & the carotid.
Getting a dynamic (head turned in different directions) CTA (CT w/ contrast given during the arterial phase of the heartbeat) can better diagnose whether or not your styloid/calcified s-h ligament are contacting your carotids.
Besides the vagus nerve, an elongated styloid can also negatively affect the spinal accessory nerve. That nerve runs through the sternocleidomastoid muscle (SCM) in your neck & into your shoulder. Shoulder pain is a very common symptom of ES & may not resolve with PT. I hope yours did though.
The other thing I need to mention is that the vagus nerve plays a significant role in our bodies besides innervating the esophagus. It affects heart rate, blood pressure, breathing, voice, body temperature, gastrointestinal function, anxiety levels & even bladder & bowel function to some degree. It’s the largest & most extensive of our cranial nerves. You may have read that information in one of the links @Jules sent you.
To edit your profile, click on your avatar in the upper right corner of this page. Yours is a purple circle w/ a white G in it. A drop down menu will show up w/ symbols on the right side. Click on the symbol that looks like a head sitting above shoulders. Then click on Preferences. That should take you to a place where you can update your profile information.
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Goodness, you have been through the mill with the stroke & cardiac issues…it does sound like it might be worth trying to get a CTA/CTV as @Isaiah_40_31 suggests to ensure there’s no compression of your carotid artery particularly…
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Thank you so much for your reply!! I am learning so much!! I have an upcoming appointment with my cardiologist, and will print off the information and take with me. Thank you again!
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I’ve been reading with interest this discussion on extremely painful esophageal spasms, because I get them too. The pain is so gripping, and doesn’t let go very easily… So if it’s true the vagus nerve plays a part in the spasms, along with also affecting heart rate, blood pressure, breathing, body temp, gastrointestinal function, anxiety levels and even bladder & bowel function, then…maybe the vagus nerve is compressed or irritated in my case, as Dr. Middleton supposes. I deal with all the things you listed, except voice problems (unless not always feeling very talkative falls under voice problems!
).
One other symptom is tingling/electric shocks in my lips that comes and goes. Is that related too??
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My voice is hoarse as well. I can get up with voice sounding normal, then sit down and work at computer, do dishes, just different activities, then go to say something and my hoarseness has returned. Sometimes so bad I can hardly get any words out.
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One more unusual item concerning the esophageal spasms I have had. The *very painful" spasm starts, then I eventually throw up, at which time the spasm stops. The first one I had, the pain was so bad I thought I was having a heart attack. After a few minutes of the pain not letting up, we called the ambulance. As the ambulance was coming up our driveway, I threw up. Pain then immediately stopped. What triggered it was my eating one bite of cold grits. The second time esophageal spasms hit we were eating in a Chinese restaurant. I took a bite of rice from my plate and the rice had become cold. Same thing happened as the first time. Severe pain started, ( another patron in restaurant had called 911) and after EMT arrived, I threw up into a trash can, pain went away. This was in June 2024, then in July 27, 2024, I had a mild stroke which affected my left arm. Fast forward, heart doctor prescribed diltiazem for heart palpitations and he said it will also help with the esophageal spasms. I have not had another esophageal spasms while taking diltiazem.
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That sounds like it could be Trigeminal Neuralgia, or possibly Facial nerve neuralgia; both nerves can be affected by the styloids.
I laughed at not feeling very talkative 
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@geppard - The vocal symptoms you’ve described are exactly what an unhappy vagus nerve can cause.
The description of your esophageal spasms & what stopped them sounds miserable & the thing that resolved them - miserable. As I said previously, I’m really glad the medication your cardiologist prescribed has made such a difference.
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