Sore Throat (Pharyngitis)
What is sore throat?
When your throat is irritated, inflamed, scratchy, painful, or very dry, it’s called sore throat. Your throat can be sore from a bacterial or viral infection, allergies or irritants, acid reflux, vocal overuse and strain, or even sleeping with your mouth open for too long. The pain may be worse when you swallow.
Depending on what’s causing your sore throat, you can often relieve the pain and irritation by drinking warm liquids or taking throat lozenges. Sore throat caused by a viral infection usually clears up on its own after a few days of rest. A throat infection caused by bacteria is called strep throat. Your doctor can prescribe antibiotics to kill the bacteria.
What causes sore throat?
Many conditions and factors cause sore throat, also called pharyngitis. You may feel pain and irritation anywhere in the back of your mouth, on your tonsils, and down your neck. You may also have a fever, swollen lymph nodes in your neck, and a headache or earache.
Common causes of a sore throat include:
- Viral infection: Most often, sore throats happen as a result of a viral infection, such as the flu or the common cold. Sore throats also occur with hand, foot, and mouth disease (caused by the Coxsackie virus) and mononucleosis (caused by the Epstein-Barr virus). Depending on the type of virus, symptoms typically go away on their own within a week to 10 days. Some viruses cause symptoms for a few months (for example, “mono”). Antibiotic medications do not work on viruses.
- Tonsillitis: Tonsils are the two small lumps of soft tissue at the back of your throat. They trap the germs that make you sick. Tonsillitis occurs when your tonsils become infected and inflamed. Bacteria and viruses can cause tonsillitis.
- Bacterial infection: Strep throat is an infection caused by a group of bacteria called group A Streptococcus. Symptoms of strep include fever and red, swollen tonsils. Your doctor can prescribe antibiotics to treat strep throat. Less common causes of bacterial sore throat include chlamydia, gonorrhea and corynbacterium.
- Allergies: Allergies to pollen, dust mites, pets, or mold can make your throat dry and scratchy. Sore throat from allergies results from postnasal drip (when mucus from your nose drips down the back of your throat). The mucus irritates your throat and causes pain.
- Acid reflux: People with a condition called gastroesophageal reflux disease (GERD) feel burning and pain in their throat. This pain, called heartburn, happens when acid from the stomach backs up into the esophagus. The esophagus is the tube that carries food from your throat to your stomach.
- Overuse or irritants: Yelling, screaming, singing without proper form, or talking too much without resting can lead to a sore throat. Spicy foods, smoking, and hot liquids can burn or irritate your throat.
- Excessive dryness: If you sleep with your mouth open at night, you may wake up with a sore throat. Being congested (clogged up) due to a cold, flu or allergies can force you to breathe through your mouth.
Less common but more serious causes of sore throat are abscess (pockets of pus around the tonsils), infection of the epiglottis (the small flap that covers the entrance to the voice box and windpipe during swallowing) and tumors.
Care and Treatment
How can I ease sore throat pain?
Treatment for a sore throat depends on the cause. Some general tips to relieve sore throat discomfort include:
- Drink warm fluids, such as hot tea with lemon or broth.
- Increase the total amount of fluids you drink. This keeps you hydrated and prevents your throat from getting dry.
- Gargle with salt water (1/4 teaspoon of salt per cup of water).
- If you are an adult, keep your throat moist with throat lozenges, ice chips, or hard candies. Do not give lozenges or hard candies to children under two years of age. They are a choking hazard. Instead, give your child a popsicle.
- Use a numbing throat spray or cold liquids to reduce pain.
- Use a humidifier or vaporizer to add moisture to rooms you spend time in, especially your bedroom when you are sleeping.
- Get plenty of rest -- at least 8 hours of sleep a night.
- Ask your doctor or pharmacist about possible over-the-counter medicines to try. Never give aspirin to children because it can cause Reye’s syndrome. Do not give cough or cold medicines to children under four years of age unless your doctor tells you to.
More specific sore throat treatments based on its cause include the following:
- Bacterial infection: If you’ve tested positive for strep throat following a throat swab, your doctor will prescribe an antibiotic to clear up the infection. Common antibiotics to treat strep throat include penicillin and clindamycin. It’s important to finish the entire course of antibiotics (even if you feel better after a few doses) so the infection doesn’t return.
- Viral infection: Viruses cause most sore throats. Your doctor may recommend drinking lots of fluids, taking over-the-counter pain relievers (such as acetaminophen or ibuprofen), and getting plenty of rest. You can also try throat lozenges.
- Allergies: Over-the-counter antihistamine medication can relieve nasal congestion that causes postnasal drip.
- Acid reflux: In addition to over-the-counter antacids, lifestyle changes may relieve your heartburn and sore throat. Try sleeping on your left side with your head slightly elevated. Don’t overeat, and don’t eat right before bedtime. If your symptoms don’t improve, talk to your doctor.
- Vocal overuse: Resting your voice will allow your throat time to heal. Try not to talk as much or sing for a couple of days. You can also drink tea and other warm liquids. Avoid irritants like smoke/secondhand smoke and spicy foods because they can make your sore throat worse.
To prevent infections that cause sore throat, wash your hands often (with soap and water for at least 20 seconds or alcohol-based hand sanitizers), stay away from people who are sick and sneezing and coughing, and don’t share utensils, food or drink with people who are sick.
When to Call the Doctor
When should I call my doctor about my sore throat?
Most of the time, a sore throat isn’t a sign of a serious condition. You should call your doctor if your sore throat lasts longer than a few days. Your doctor will determine what is causing your symptoms.
See your doctor right away if you also have:
- Trouble breathing or swallowing.
- A visible bulge in the back of the throat.
- Excessive drooling (in young children).
- Blood in saliva or phlegm.
- Severe throat pain.
- Extreme tiredness.
- A fever, especially if it’s over 100.4 degrees Fahrenheit.
- Stomach ache, nausea/vomiting (usually in children).
- Difficulty sleeping.
- Rash anywhere on your body.
- Flu-like symptoms, such as body aches and cough.
- Pain in your ears.
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