In this article:
- A sore throat often results from an underlying cause rather than being a disease by itself.
- Bacterial and viral infections or reactions to an allergen or irritant are the common causes of a sore throat.
- A sore throat can be treated by avoiding risk factors and making some lifestyle changes.
- Antibiotics can be used in a few cases only. Following self-care measures helps in quicker relief.
A sore throat is characterized by pain and discomfort in the throat. It is a mild problem and may cause scratchiness and irritation. The burning pain sensation may be aggravated while swallowing.
A sore throat is primarily the result of inflammation; however, this condition has many causes.
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. Pharyngitis may involve the following parts:
- 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
What Causes a Sore Throat?
Sore throats are common and can be due to various causes mentioned below.
Interaction with substances that may induce an allergic response, such as:
- Pet dander
Infection with viral pathogens. About 50%-80% of pharyngitis cases are symptoms of different viral infections, including:
Exposure to irritants or throat injuries, including:
- Low humidity
- Air pollutants
- Postnasal drip (mucus drainage 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)
- Cut or puncture in the back of the throat due to any pointed object in the mouth
Types of Sore Throats
If you feel any discomfort or pain in your throat, it could be any of the following:
- Viral pharyngitis: A viral infection in the throat, also known as viral pharyngitis, is the most common infectious cause of a sore throat. A viral infection causes inflammation in the throat, and, in certain cases, other cold symptoms may accompany it.
- 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.”
It 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.
- Tonsillitis: 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.
Symptoms of a Sore Throat
The most common and discomforting symptom of a sore throat is pain at the back of the throat. Depending on the underlying cause, many other symptoms can accompany a sore throat.
A few of the many symptoms that occur with a sore throat are:
- 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)
Diagnosing a Sore Throat
A sore throat can be diagnosed by analyzing the classic symptoms such as pain and inflammation. However, it is essential to determine the reason behind the sore throat. To do this, your doctor may require these tests to be done:
- Throat culture: The most common test used to investigate the cause of your sore throat involves the sample collection of secretions in your throat using a soft cotton swab. The sample is then used for culturing in a lab.
The culture helps to identify the virus or bacteria that may have infected the throat. This information helps guide optimal treatment.
- 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.
- Biopsy: In case the sore throat persists for long, the doctor may perform a biopsy by extracting a piece of tissue from your throat or tonsil and send it for testing. This helps in identifying any problems in the throat, such as a tumor.
Clinical Treatment for a Sore Throat
Most of the cases of sore throat are symptoms of a bacterial or viral infection. Therefore, getting vaccinated against these microbes can help in preventing a sore throat. Consult your doctor for the kind 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 used.
Most of the cases of sore throat subside after a week, but you may seek the help of medications to get quick relief from the discomfort. The drugs that can be used include the following:
- Oral painkillers: Aspirin, acetaminophen, paracetamol, or other anti-inflammatory medications (ibuprofen, naproxen, diclofenac, etc.) can be used to relieve pain.
Acetaminophen and paracetamol are highly recommended as aspirin and diclofenac can produce many side effects. Avoid giving aspirin to children.
- Antipyretics: Medications containing acetaminophen and ibuprofen can be used to reduce pain and fever.
- Antivirals: Prescription antivirals are useful in some viral infections that cause the sore throat.
- Antibiotics: You may be prescribed antibiotics if your doctor has confirmed the presence of a bacterial infection that causes the sore throat. However, antibiotics are not highly recommended because:
- The incidence of sore throats due to bacterial infections is extremely low.
- In the case of a bacterial infection, antibiotics will be unable to relieve any severe symptoms and may have significant short- and long-term side effects.
- Using antibiotics to treat minor conditions such as a sore throat reduces antibiotic efficacy and also contributes to the development of resistant bacteria. (2)
In severe cases, the doctor may recommend surgical removal of the tonsils. This procedure is known as a tonsillectomy and may be required due to the following reasons:
- 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
Sore Throat: Prevention Tips
Taking measures toward a hygienic and healthy lifestyle can help in the prevention of a sore throat. The following guidelines may be useful:
- Keep your hands clean at all times.
- Do not come in close physical contact with people having a cold, respiratory tract infections, or a sore throat.
- Avoid sharing foods, drinks, or utensils with others.
- Avoid going to heavily polluted areas.
- Use public drinking fountains and telephones carefully to prevent their contact with your mouth or nose.
- Change your toothbrush monthly to prevent infection.
Self-Care Tips for Pain Relief
Sore throats can generally be treated without the use of medications. You can follow these tips to relieve the pain from a sore throat:
- Give children above 1-year warm fluids such as apple juice and chicken broth.
- Children above 6 years of age can suck on hard candy and lollipops.
- People over 8 years are recommended to gargle with warm salt water. You may use a liquid antacid available OTC in place of the salt.
- Suck on ice chips, sugar-free lozenges, or popsicles to get relief. Lozenges should not be given to children below 2 years of age. (4)
- Use a steamer or humidifier.
Lifestyle Changes for Sore Throat Relief
Changing certain aspects of your lifestyle can help manage a sore throat.
- Consume foods that can be swallowed easily.
- Cover your mouth with a tissue or your upper arm when sneezing and coughing to prevent infection.
- Rest adequately. Undisturbed sleep and adequate rest are essential to boost your immune system to fight the infection. The amount of sleep required differs among people. It is recommended to avoid any strenuous physical exercise during the recovery period.
- Avoid smoking. Smoking cigarettes and vaping are risk factors for a sore throat. Therefore, it is necessary to avoid smoking and prevent yourself from being exposed to secondary smoke.
Studies have established an association between smoking and sore throat in US college students and Japanese women. In one study, 46 French nonsmokers had sore throat due to passive, secondhand tobacco smoke exposure. (3)
- Do not shout. Excessive voice use or shouting has been reported as a cause of sore throat in people who must often raise their voice during work, such as aerobics instructors and school teachers.
Aerobics instructors claim that they experienced a sore throat, unrelated to any illness, with the beginning of their classes, and the conditions worsened with an increase in the frequency of the classes.
- Use limited medications. A sore throat is often a side effect of a wide variety of drugs. Consult your doctor before using any medications and discuss their possible side effects.
Taking measures for vocal hygiene, avoiding allergens and irritants, and using OTC medications can help reduce the symptoms of a sore throat. (3)
Dietary Changes for Managing a Sore Throat
It is necessary to modify your diet according to your bodily needs. While suffering from a sore throat, you should:
- Avoid solid foods. A sore throat may cause pain when swallowing. To prevent this, avoid foods that are hard to chew or have high citrus, spice, or salt content. Increase your fluid intake and consume soft foods. Cut your food into smaller pieces before consuming it and chew your foods well.
- Avoid hot foods. Consuming hot foods or drinks can irritate your throat.
- Drink plenty of fluids. Children should be given milkshakes, sherbet, and slushes to keep them hydrated. Intake of fluids is vital, especially when suffering from a fever.
- Use sage leaves. Consumption of sage leaves or the use of throat sprays, lozenges, tablets, capsules, and liquids containing sage leaf extracts can help in relieving a sore throat.
Home Remedies for a Sore Throat
Many home remedies are available that can provide relief from a sore throat by acting on the symptoms or even the cause.
1. Salt Water Gargle
Salt is antiseptic and can help in treating the underlying inflammation and infection. The use of salt stimulates the release of water from the mucous membranes in the throat. This dilutes the phlegm, helps in its easy expulsion, and may also reduce the swelling in the throat.
To treat a sore throat, follow a liquid diet, and gargle frequently with warm salt water using the garagara-ugai method (rinsing the throat). This is a safe method of treatment and should be repeated multiple times a day.
How to use:
- Mix ½ teaspoon of salt in 1 glass of warm water and use this solution for gargling.
2. Honey May Help Soothe Sore Throat
Infections that cause a sore throat can be treated using the antimicrobial and antioxidant properties of honey. Honey can also be used as an anti-inflammatory agent; it helps in reducing the swelling in the throat by removing water from the swollen tissues.
Studies suggest that the use of a combination of honey, glycerol, and lemon mixture may also alleviate cough. (11)
Honey can induce saliva formation and mucus production, providing a protective coating to the throat and a soothing effect. Other sweet foods may also have compounds that act as antimicrobial, antioxidant, or pharmacological agents. (12)
How to use:
- Up to 2.5 mL of honey before bedtime is recommended for children above 1 year.
If honey causes irritation, discontinue use, and seek medical advice.
3. Sipping on Ginger Tea May Help
The active compounds in the ginger act as immunomodulatory, anti-inflammatory, and analgesic agents, which help in reducing inflammation. Consumption of ginger also helps in boosting the immune system and fighting infection. (8)
How to use:
- Add an inch of ginger root to boiling water and simmer for 5 minutes. Strain the brewed tea and drink it while it is slightly warm.
4. Add Vitamin C Rich Food to Your Diet
Vitamin C, or ascorbic acid, is useful in the treatment of the common cold and its symptoms. Several trials have found that vitamin C may help reduce the symptoms of a sore throat and pneumonia. Vitamin C may also help in alleviating other types of inflammation. (9)(10)
5. Essential Oils
The oil obtained from the leaves of eucalyptus has antiseptic properties and can be used to alleviate the symptoms of cold, cough, sore throat, and other infections. (6) Tea tree, thyme, and peppermint oils are also antiseptic and act against oral pathogens. (7)
How to use:
- Take hot water in a heat-proof bowl and add a few drops of essential oil to it. Cover your head with a towel and inhale the steam.
- Alternatively, you may add the essential oil to your electric steam inhaler.
6. Vapor Rub
The use of vapor rub can provide relief from cough and sore throat in children, enabling them to sleep better. However, vapor rub can have some mild discomforting side effects. (5)
Myths About Sore Throat
- A sore throat and fever mean that antibiotics are necessary.
Antibiotics can be used to treat a sore throat if it is the result of a bacterial infection.
However, most cases of sore throat are NOT caused by bacteria but by viruses or other reasons where the antibiotics do not have any effect and may be more dangerous than beneficial.
- When the symptoms subside, the sickness is no longer communicable.
A bacterial or viral infection may be highly contagious and spread through airborne droplets that are released when coughing and sneezing. The common cold, especially, is highly infectious during the start of the illness.
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 where you may need to contact a doctor include:
- The symptoms do not improve even though the child remains well hydrated.
- A sore throat is associated with any of the following:
- High fever
- Stomach pain
- Trouble swallowing
For adults and teenagers:
- 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).
- Infectious mononucleosis is more common in this age group.
What you may ask your doctor:
- What measures at home can I take to manage my sore throat?
- Should I take medicines?
- What kind of diet should I follow to avoid pain while swallowing?
- How long will I experience the symptoms?
What your doctor may ask you:
- When did the symptoms begin?
- Do you experience pain while swallowing?
- Are you taking any medication?
- Do you smoke?
- Do you have allergies?
A sore throat is a common problem that causes discomfort and irritation for many people. This condition is often seasonal. Because many steps can be taken to prevent and treat a sore throat at home, the problem can be easily managed.
However, if the problem does not subside with the help of home remedies or if the symptoms worsen, it is important to consult your doctor for appropriate treatment.