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Sore throat, or pharyngitis, is characterized by pain and discomfort in the throat. It is generally a mild problem that is aggravated by the act of swallowing.
Multiple different factors can lead to a sore throat, but it is basically a result of an underlying inflammation. A sore throat is frequently associated with sleep apnea, sinus infection, snoring, smoking, and allergy. (1)
Types of Sore Throats
If you feel any discomfort or pain in your throat, it could be any of the following:
1. Viral pharyngitis
A viral infection in the throat, also known as viral pharyngitis, is the most common infectious cause of a sore throat. It triggers inflammation and may even induce cold symptoms.
2. Strep/bacterial pharyngitis
The incidence of sore throat due to an infection with bacteria is low. However, most of these bacterial infections are caused by group A Streptococcus bacteria and the resulting sore throat is commonly known as “strep throat.”
Bacterial pharyngitis is associated with the formation of pus in the tonsils or throat. In children aged 5–15, strep bacteria cause around 20% of sore throat cases. Children below 5 years are less susceptible to strep throat.
Severe swelling in the tonsils, known as tonsillitis, is a type of pharyngitis that may occur due to a bacterial or viral infection. Symptoms of tonsillitis include pain, redness, inflammation, and pus or debris accumulation in the tonsils.
Causes of a Sore Throat
A sore throat can occur due to various underlying causes, the most common being:
Exposure to allergens or irritants, such as dust, pet dander, mold, pollen, and chemicals, among others.
Infection with viral pathogens. An infection in the throat can cause inflammation in the pharynx (rear of the throat), also known as pharyngitis, ultimately resulting in a painful sore throat.
About 50%–80% of cases of pharyngitis are symptoms of different viral infections, including:
- Common cold
Irritants or throat injuries that cause a sore throat include:
- Low humidity
- Air pollutants
- Postnasal drip – Mucus draining down the rear part of the throat
- Gastroesophageal reflux disease (GERD) – Irritation and pain in the throat due to gastric acid reflux from the stomach; may cause heartburn and an acidic taste in the mouth
- Dry mouth
- Sleeping with an open mouth – Breathing through the mouth can cause a sore throat, which alleviates post-breakfast.
- A cut or puncture at the back of the throat due to any pointed object in the mouth
Symptoms of a Sore Throat
The classic symptom of a sore throat is pain at the back of the throat, which may be accompanied by various other symptoms depending on the underlying cause. You may experience:
- Respiratory problems
- Problem in swallowing
- Loss of appetite
- Pain in the ear
- Symptoms associated with a cold or flu, such as cough, redness in eyes, runny nose, and hoarseness
- Redness and inflammation in the tonsils
- White spots in the throat or tonsils
- Swelling of the face
- Inflammation of the neck glands (lymph nodes)
- Problems in opening the mouth (trismus)
The inflammatory discomfort associated with pharyngitis can be felt in the following areas:
- Roof of the mouth or soft palate
- Tonsils (fleshy tissue involved in providing immunity to the throat)
- Back portion of the tongue
- Back wall of the throat
Clinical Treatment for a Sore Throat
The majority of sore throat cases stem from underlying bacterial or viral infections. Thus, one of the best ways to avoid a sore throat is by getting vaccinated against potential sources of infection.
Consult your doctor for the type of vaccinations that you may need.
Before undergoing any treatment, it is necessary to make sure that you are not allergic to any of the components of the medication. A sore throat generally resolves on its own after a week, but you can take the following medications for quick symptomatic relief:
a. Oral painkillers
Aspirin, acetaminophen, paracetamol, or other anti-inflammatory medications (ibuprofen, naproxen, diclofenac, etc.) can be used to relieve pain.
Note: Aspirin and diclofenac are not the most preferred choice as they produce many side effects and are especially unsafe for children.
Medications containing acetaminophen and ibuprofen can be used to reduce pain and fever.
Prescription antivirals may help relieve a sore throat caused by certain viral infections.
For bacterial infections, your doctor may put you on a short antibiotic course, although this is not the standard practice due to the following reasons:
- The incidence of sore throats due to bacterial infections is extremely low.
- Antibiotics are unable to relieve severe symptoms and may have significant short- and long-term side effects.
- Using antibiotics to treat minor conditions such as a sore throat reduces the overall efficacy of the drug in your body and contributes to the development of resistant bacteria. (2)
The doctor may recommend a tonsillectomy, or the surgical removal of tonsils, in the following cases:
- Formation of an abscess in or around the tonsils that cannot be treated with medications
- Bad taste or malodor in the mouth that does not subside even after treatment
Diagnosing a Sore Throat
A sore throat can be diagnosed based on the symptoms alone, but your doctor may conduct the following tests to determine its exact cause:
1. Throat culture
The doctor will collect a sample of your respiratory secretions from the throat using a soft cotton swab, which is then sent for further lab analysis to identify the exact bacterial strain responsible for your throat infection.
2. Blood test
If the doctor suspects mononucleosis (or other types of infection not detectable through throat culture) to be the cause of your sore throat, you may need to get a blood test.
If the sore throat persists for long, the doctor may perform a biopsy by extracting a piece of tissue from your throat or tonsil and then sending the sample to the lab to test for the presence of tumor cells or other such abnormalities.
When to See a Doctor
Most sore throat symptoms will resolve in 5–7 days. If the symptoms do not subside with at-home treatment, it is recommended to seek medical care. Other cases when you may need to contact a doctor include:
- There is high fever (101°F or higher) without any other symptoms of the common cold.
- A sore throat is prolonged (more than a week) and is accompanied by postnasal discharge, itchy eyes, and sneezing (may indicate influenza or strep throat).
- There is a pain in the ear or prolonged flu symptoms along with the sore throat (may indicate abscess at the rear of the throat or an inflamed epiglottis).
- A sore throat is accompanied by mild pain and no fever for more than 2 weeks (may indicate allergies).
- A sore throat is accompanied by trouble swallowing, breathing problems, and drooling (may indicate a more serious airway infection or mass in the throat).
A sore throat is a common source of discomfort and irritation for many people, but it is usually seasonal and easily manageable through home treatment.
However, if the problem does not subside with home remedies or if the symptoms worsen, it is important to consult your doctor for the appropriate treatment.