Sore throat
A sore throat, or pharyngitis, is characterized by pain and scratchiness in your throat that feels worse when you swallow. Sore throats are most commonly caused by a viral infection such as a cold or the flu.
Common causes of a sore throat in adults and children
Sore throats in adults
Most sore throats in adults are caused by the viruses of the common cold or flu. Other possible causes include:
- Allergies. Pet dander, molds, dust and pollen often cause a sore throat.
- Chickenpox.
- Dry indoor air.
- Gastroesophageal reflux disease (GERD). A digestive system disorder in which stomach acids back up in the esophagus, irritating the throat.
- HIV infection. A sore throat and other flu-like symptoms sometimes appear soon after someone is infected with HIV.
- Irritants. Includes outdoor air pollution, tobacco smoke and chewing tobacco, chemicals, alcohol and spicy foods.
- Measles.
- Mononucleosis.
- Muscle strain.
- Strep throat. Caused by Streptococcus pyogenes (group A streptococcus) bacteria.
- Tonsillitis. If you still have your tonsils, they may be causing problems and might need to be removed.
- Tumors. Cancerous tumors of the throat, tongue or voice box (larynx) can cause a sore throat.
Sore throats in children
Sore throats are very common in children, and most often they are due to a common cold and get better without treatment. Other possible causes include:
- Croup. Also presents with a harsh, barking cough.
- Ingestion. Your child may suddenly complain of a sore throat after ingesting a household product.
- Peritonsillar or retropharyngeal abscess. A collection of pus either behind the tonsils (peritonsillar) or at the back of the throat (retropharyngeal), requiring medical attention.
- Stomatitis. Caused by viruses, which lead to sores in the mouth and throat. It gets better by itself, but treatments can help alleviate the irritation from the sores.
- Strep throat. A swab test and throat culture will determine if your child has strep.
Signs and symptoms of a sore throat in adults and children
In adults
Pain and scratchiness in the throat are the main symptoms, but some underlying causes can result in other symptoms, such as:
- Difficulty swallowing.
- Hoarse voice.
- Pain that worsens with swallowing or talking.
- Sore, swollen glands in your neck or jaw.
- Swollen, red tonsils.
- White patches or pus on your tonsils.
In children
Very young children may have a sore throat if they display any of the following:
- Acting very tired.
- Drooling.
- Having pus in the back of the throat.
- Not drinking liquids.
- Trouble swallowing.
Take your child right away to your primary care provider for a proper diagnosis.
When to see your primary care provider for a sore throat
(and how it is diagnosed)
Adults
You should see your provider if you have a sore throat plus any of the following:
- Allergic reaction to antibiotics.
- Blood in your saliva or phlegm.
- Earache.
- Fever higher than 101 F (38.3 C).
- Joint pain.
- Lump in your neck.
- New symptoms develop.
- Problems swallowing.
- Rash.
- Recurring sore throat.
- Swelling in your neck or face.
- Swollen tonsils that make breathing difficult.
- Symptoms don’t improve within a week or within 2–3 days of starting an antibiotic.
- The pain is severe enough to keep you from drinking liquids.
Seek immediate medical attention if you have a sore throat, plus any of the following:
- Feeling dizzy or faint.
- Feeling of doom.
- Skin is blue, purple or gray in color.
- Trouble breathing or talking.
Children
Take your child to your pediatrician or primary care provider if your child displays any of the symptoms of a sore throat, plus any of the following:
- Fever.
- Rash, headache, stomachache or vomiting.
- So sleepy that they are hard to wake or keep awake.
- Stiff neck.
Seek immediate medical care for your child if he/she has:
- Difficulty breathing.
- Difficulty swallowing.
- Extreme drooling, which might indicate an inability to swallow.
Diagnosing the cause
To diagnose the cause of your sore throat or your child’s sore throat, your primary care provider will take your health history, perform a physical exam and may run some diagnostic tests, such as:
- A blood test to check for mononucleosis.
- A chest X-ray to rule out pneumonia especially if you have a cough.
- A throat swab for a rapid strep test.
Treatment and at-home remedies for a sore throat
Your primary care provider will develop a personalized treatment plan based on the diagnosis and your symptoms. For a simple viral sore throat, there are several things you can do to relieve your symptoms:
- Avoid alcohol, spicy foods and acidic drinks.
- Don’t smoke, and stay away from secondhand smoke.
- Drink warm liquids to soothe a sore throat and help thin mucus.
- Gargle with warm salt water—1 teaspoon of salt to 8 ounces of warm water.
- Over-the-counter (OTC) pain relievers such as acetaminophen or ibuprofen.
- Throat sprays and lozenges.
- Use a humidifier to keep indoor air moist.
Depending on the cause of your sore throat, your provider may include further steps in your treatment plan. They may prescribe an antibiotic for a bacterial infection such as strep throat.
If tonsillitis is the problem, you may need surgery to remove them, called a tonsillectomy. We recommend this in cases of:
- Multiple severe bouts of tonsillitis in a year.
- Tonsillitis caused by food particles collecting in pouches in the tonsils (cryptic tonsillitis).
- Tonsillitis that causes breathing problems during sleep.
Preventing a sore throat
Prevention is all about avoiding germs and practicing good hygiene by following these suggestions:
- Avoid close contact with sick people and sharing food, cups and utensils.
- Clean telephones, TV remotes and computer keyboards with sanitizing cleanser as often as you can.
- Cough or sneeze into a tissue and throw it away, or into your elbow.
- Wash your hands frequently for 20 seconds at a time, especially after using the bathroom, before eating and after sneezing or coughing. Use alcohol-based hand sanitizers as an alternative.
References
Center for Disease Control and Prevention (CDC). Sore Throat (https://www.cdc.gov/antibiotic-use/sore-throat.html)
MedlinePlus: National Library of Medicine. Sore Throat (https://medlineplus.gov/sorethroat.html)
MedlinePlus: National Library of Medicine. Pharyngitis – sore throat (https://medlineplus.gov/ency/article/000655.htm)