A sore throat, or acute pharyngitis, is one of the most common winter complaints and ranks as one of the top reasons for visiting a doctor's office. It's also the cause of more than 100 million days of absence from work each year as well as countless days of missed school for children.
Sore throat is usually a symptom of an infection—typically viral but in some cases bacterial—or an irritation of the pharynx, the back column of the mouth behind the tongue.
It’s not surprising that the throat is the site of pain. Along with the nose, the throat is the first defense the body has against invading viruses or bacteria. As a rule of thumb, sore throats caused by a virus develop gradually over a period of time. They are often accompanied by the flu or a cold, and if a fever is present, it will generally be 101°F or below.
A bacterial sore throat usually comes on fast, lymph glands in the neck often swell and become tender, and a headache develops. Fever is typically 102°F or higher. The throat may appear to be extremely red and have either white or yellow spots on the back.
Strep throat, or streptococcal infection, is the most common bacterial throat infection. Strep is less common than virus-linked sore throats, but if not properly treated with antibiotics, it can lead to complications such as glomerulonephritis (kidney inflammation) or rheumatic fever, which may be associated with serious problems of the heart, brain, skin, and joints.
Symptoms of Sore Throat
- Burning, scratchy sensation in the back of the throat
- Visible redness and swelling
- Discomfort when swallowing and talking
What Causes Sore Throat?
Most sore throats are caused by a virus, primarily those associated with the common cold. Less than 15 percent of all sore throats are caused by Streptococcus pyogenes, the bacterium that produces the illness known as strep throat.
Irritation may result from a local throat infection or from postnasal drip, which is often a symptom of sinusitis, colds, or various allergic reactions. Allergy-related sore throats are typically accompanied by itchy eyes and a congested or runny nose.
Flu is a common viral infection that’s accompanied by high fever, fatigue, loss of appetite, cough, and a sore throat. Infectious mononucleosis, which is usually brought on by the Epstein-Barr virus, also has sore throat as a common symptom. Dental procedures can sometimes cause throat pain, while some sore throats are caused by eating spicy foods. Overenthusiastic cheering at sporting events can also leave a throat sore and painful. Other minor causes of sore throat include dry heat, smoking, and breathing polluted air.
A sore throat may also be an early sign of a more serious disorder such as aplastic anemia.
What If You Do Nothing?
Sore throats caused by a cold or flu virus are usually self-limiting and will clear on their own in a few days as your body builds up defenses against the virus. Viral sore throats don’t respond to antibiotics, but symptoms can be diminished with self-help measures. Sore throats from bacterial infections require treatment with prescription antibiotics. Going without treatment can allow an infection such as strep to lead to rheumatic fever or other serious complications.
Home Remedies for Sore Throat
- Try pain relievers. Adults and children can take over-the-counter pain relievers such as ibuprofen or acetaminophen according to label directions. (Since a sore throat may be due to flu, children age 19 or younger with a sore throat should not take aspirin because aspirin use and flu in children is associated with a risk of Reye's syndrome, a rare but potentially fatal disorder.)
- Use a home gargle. Gargling several times a day with a mixture of one teaspoon of salt stirred into eight ounces of warm water may temporarily soothe a sore throat and also help to break up any congestion.
- Have a hot drink. A cup of herbal tea or chicken soup can help relieve a sore throat by warming and flushing the irritated membranes.
- Use a humidifier or cool-mist vaporizer. This will add extra moisture to the air and help keep your nasal membranes and throat lining moist.
- Suck on hard candy. This will help stimulate saliva production, thereby keeping your throat moist.
- Practice sanitary measures. The best ways to avoid catching or passing the microorganisms that trigger sore throats are to wash your hands regularly, avoid touching your nose, eyes, and mouth, and cover your mouth when coughing and sneezing.
- Don’t smoke. Avoid cigarette smoke and other throat irritants.
Beyond Home Remedies: When To Call Your Doctor
Contact your doctor if the sore throat lasts longer than one to two days and you have a fever over 102°—you may have a bacterial infection. Also see your doctor if you develop an earache, rash or lump in your neck, or if you have noticed traces of blood in your saliva or phlegm.
Contact your physician immediately if, in addition to your sore throat and a high fever, your voice becomes muffled and/or your tongue and throat swell. These developments may indicate that an abscess has formed in the throat and that pus is collecting beyond the wall of the tonsils. Such an infection requires early treatment with antibiotics and possibly surgery.
What Your Doctor Will Do
After taking a careful medical history, your doctor may obtain a throat culture if bacterial infection is suspected. If the diagnosis is positive, antibiotics may be prescribed. If mononucleosis is suspected, a special blood test will be done.
If you have recurrent sore throats and the cause is tonsillitis (an infection of the tonsils, which are located on each side of the throat), your physician may recommend a tonsillectomy to remove the tonsils. As with all surgical procedures, be sure to get a second opinion.
The Complete Home Wellness Handbook
John Edward Swartzberg, M.D., F.A.C.P., Sheldon Margen, M.D., and the editors of the UC Berkeley Wellness Letter
Updated by Remedy Health Media