Sore Throat: What It Could Be and How to Get Rid of It

A sore throat—also called pharyngitis—is typically caused by inflammation and swelling of throat (pharyngeal) tissues due to a bacterial or viral infection, allergies, or irritants. It may also be caused by overuse of the vocal cords.

Most often, viral sore throats require symptom management at home until they resolve on their own, but other causes, such as strep throat, require treatment to prevent related complications.

Symptoms

Sore throat symptoms typically include:

• Dry or scratchy sensation in the throat
• Continuous pain or pain when swallowing
• Swelling in the tonsils or the back of the throat

Most people with pharyngitis have other symptoms as well. The symptoms accompanying throat pain can help you decide whether to call your healthcare provider. They can also help a healthcare provider determine the cause of your pain. These symptoms may include:

• Runny nose
• Cough
• Hoarseness
• Red, runny eyes
  

Causes

A sore throat may have viral or bacterial causes, or it may have non-infectious causes.

Viral

The most common causes of a sore throat are viral infections including:

• The common cold
• Influenza (flu)
• COVID 19
• Mononucleosis

In young children, coxsackievirus and herpangina are two other viral causes.

Bacterial

Severe sore throat may be caused by a bacterium called group A Streptococcus. You can't always tell whether a throat infection is viral or bacterial, but with strep throat there aren't usually other respiratory symptoms such as nasal drainage, cough, or congestion.

You may also have:

• Fever
• Enlarged glands on the neck
• White spots on the back of the throat

See your healthcare provider for a rapid strep test or a throat culture if this is suspected.

Non-Infectious Causes

You may also experience a sore throat with allergies, post-nasal drip, overuse of the vocal cords, and smoking. Acid reflux can cause a sore throat when stomach acid enters the esophagus and irritates the tissues.

Environmental irritants such as smoke, air pollution, and industrial fumes can also irritate your throat. Dry air itself can cause a dry and scratchy throat.

Risk Factors

Anyone can get a sore throat, but some people are more at risk than others. For example:

• Strep throat is more common in children between the ages of 5 and 15.
• Parents of school-aged children and people who work with children are also at higher risk.
• People who live and work in crowded settings such as military training facilities and correctional centers are more likely to be exposed to the microbes that cause sore throat.
  

Prevention

You can prevent getting or spreading a sore throat by:

• Washing your hands frequently
• Covering your coughs and sneezes
• Avoiding sharing food or utensils
• Avoiding contact with people who are sick
• Regularly disinfecting frequently touched surfaces such as doorknobs and countertops
• Taking a daily antihistamine (if your sore throat is caused by allergies)
• Wearing a mask when working with chemical fumes or dust
• Avoiding going outdoors when the air quality is poor
• Avoiding shouting or other situations that may cause overuse of your vocal cords
  

Treatment

A bacterial infection such as strep throat is typically treated with antibiotics such as penicillin or amoxicillin.

If your sore throat is caused by a virus or a non-infectious cause, it can be managed with over-the-counter (OTC) or home remedies, such as drinking soothing teas or taking OTC pain medications like Advil (ibuprofen) and Tylenol (acetaminophen).

Few high-quality studies support the use of alternative therapies. Sage, slippery elm, and licorice root may be found in some herbal teas and lozenges and are believed, though not proven, to have soothing effects. 

Always discuss herbal medications and supplements with your healthcare provider, as some may interact with other medications.

When to See a Healthcare Provider

Even with no other symptoms, if your throat is so sore that you can't swallow or sleep, seek medical attention. Other symptoms that indicate you should see a healthcare provider include:

• Fever greater than 101 degrees
• Difficulty breathing, swallowing, or opening your mouth
• Lump in your neck
• Hoarseness lasting more than two weeks
• Blood in mouth or sputum
• Rash
• Throat so sore you can't swallow or sleep

If your sore throat worsens or continues to progress after five to seven days, see a healthcare provider for further evaluation.

Summary

Sore throats usually have viral causes such as the common cold, influenza, or COVID-19. A severe sore throat with a fever may be strep throat.

Most viral causes of sore throat will resolve on their own. You can treat your symptoms with OTC or home remedies. If you have strep throat, your healthcare provider will prescribe antibiotics to help clear up the infection.