Causes of Sore Throat

Sore Throat Overview

Common causes include a viral infection, such as a cold or the flu, and bacteria. Most of the times sore throats are not serious, but severe symptoms can make breathing difficult.

How a person deals with a sore throat depends on the severity and the cause. Usually, home remedies can soothe the discomfort until it goes away. However, sometimes it needs medical treatment.

What Does a Sore Throat Feel Like?

A sore throat may start with a raspy feeling in your throat, as if your throat is dry. It may also feel like your throat is on fire. If your sore throat gets worse, you may feel a sharp pain in your throat when you swallow or talk. You may feel pain in your ears or down the side of your neck.

Is a Sore Throat a Serious Tissue?

It can be. For example, a sore throat that lasts more than two weeks may be a symptom of throat cancer A sore throat is one symptom of COVID-19. Most of the time, however, a sore throat is a symptom of less serious conditions.

Causes of Sore Throat

Viruses and bacteria are two common causes of sore throats.

Viruses

Many sore throats are due to viral infections, such as:

• COVID-19
• Common colds
• Influenza (Flu)
•  The Epstein-Barr virus (EBV) may lead to infectious mononucleosis, which is sometimes known as glandular fever or mono

If symptoms are severe, the person should speak with a doctor. However, a healthcare professional will not prescribe antibiotics for a virus.

Bacteria

Strep throat is a common type of throat infection due to exposure to a strain of Streptococcus bacterium.

Symptoms may include the following:

• A sore throat that develops suddenly
• Fever
• Pain when swallowing
• White patches on the throat
• Red or swollen tonsils
• Spots on the roof of the mouth usually red in color
• Swollen or tender lymph nodes in the neck

The patient may need antibiotics to fight the infection and prevent complications. Without treatment, strep throat can increase the risk of rheumatic fever or kidney inflammation in children.

Strep throat accounts for 20–30% of sore throats in children and around 10% in adults, according to the Centers for Disease Control and Prevention (CDC).

Other common causes of a sore throat include the following:

• Allergies
• Cold air
• Irritation due to dry heat, pollutants, or chemicals
• Gastroesophageal Reflux (GERD) reflux, when stomach acids come up into the back of the throat 
• Mouth breathing: You may have a sore throat if you breathe through your mouth instead of your nose when you’re sleeping. 
• Overuse or irritants: You can strain your throat by yelling or screaming. You may also develop a sore throat if you eat spicy food, smoke or drink very hot liquids.

More severe but less common conditions that can involve a sore throat include:

• Epiglottitis
• HIV infection
• Tumors of the throat, tongue, or larynx

Epiglottitis is a rare but potentially dangerous throat infection where Inflammation and swelling of the epiglottis can close the airway, making it difficult to breathe. It is a medical emergency.

Anyone with ongoing or severe symptoms should consult a doctor, as they may have an underlying condition that needs further treatment.

Signs and Symptoms of Sore Throat

The signs and symptoms of a sore throat can vary depending on the exact cause.

Common signs and symptoms include the following:

• A scratchy sensation in the throat
• Coughing, sneezing, and a runny nose
• Fever
• Pain in the throat area that becomes worse when swallowing or talking
• Difficulty swallowing (dysphagia)
• Hoarse or muffled voice
• Runny nose
• Sore or swollen lymph nodes in the neck or jaw area
• Swollen red tonsils
• Upset stomach 

Sore Throat in Adults

Bacterial and viral infections are also common in adults. The symptoms and treatment are similar to those for children.

Epiglottitis causes the same symptoms in adults as in children and requires needs emergency medical attention. Thie condition is rare, but the annual incidence in adults has risen since 1986 from one in every 100,000 people to around 2–3 adults every 100,000.

Sore Throat in Children

Sore throats can affect any age group, but according to the CDC they are most common among children aged 5–15 years. 

Strep throat is more common in children than in adults. The exact symptoms depend on the age, but, as well as a sore throat, they may include:

• A fever
• An irritated mood
• Headaches
• A reduced appetite
• Swollen tonsils with signs of pus
• Small red spots on the roof of the mouth
• Tender, swollen lymph nodes in the neck
• Abdominal Pain, nausea, and vomiting, especially in children

Patients with strep throat often have pain and fever without a cough.

Before the age of 3 years, strep throat is uncommon.

A doctor may prescribe antibiotics for strep throat to prevent future complications.

Viral infections are the most frequent cause of sore throat in children. And while these infections will not respond to antibiotics, a doctor may prescribe treatment to relieve the discomfort.

The symptoms of epiglottitis include the following:

• A severely sore throat
• Difficulty swallowing and breathing
• Drooling
• High pitched sound when breathing in
• Skin that looks blue, or gray in darker skin, due to a lack of oxygen

If a child has these symptoms, they need immediate medical attention.

In the past, epiglottitis was common, but since routine Haemophilus influenza type b vaccinations began in 1985, its yearly incidence in children has fallen by 99% to fewer than 1 in every 100,000 children.

When to Consult with a Doctor for Sore Throat

Most sore throats go away on their own within 5–10 days, and home treatment is usually sufficient.

Sometimes, however, medical treatment is necessary.

The American Academy of Otolaryngology, Head, and Neck Surgery suggests that a person should consult a doctor if they have:

• A severe and persistent sore throat that does not go away
• Blood in the saliva or mucus
• Difficulty breathing, swallowing, or opening the mouth
• Earache
• Fever of 101°F (38.3°C) or above
• Hoarseness that lasts over 2 weeks
• Lump in the neck
• Rash
• Swelling in the face or neck

Diagnosis of Sore Throat

Taking a Swab Test

Healthcare providers diagnose sore throats by examining your throat, tongue and possibly your ears. They may do a strep test to rule out strep throat.

If a doctor suspects a sore throat is bacterial, they may take a throat swab for testing to determine if a strep infection is present.

The healthcare professional can take a sample by touching the back of the throat and tonsils with a cotton-tipped applicator. This can show quickly if group A Streptococcus is causing the infection. If the test is negative but the doctor still suspects strep throat, they may send a sample to a lab for a culture test, to see if bacteria grow over time.

They may do this for teenagers and children, as they have a higher risk of developing rheumatic fever after a strep throat infection, but adults are unlikely to develop this.

If the strep test is positive, a person may need prescription antibiotics.

EBV Test

If a doctor suspects EBV, they can recommend a blood test to confirm the condition.

Treatment of Sore Throat

Most sore throats resolve without treatment after around a week, but this will depend on the cause.

If a sore throat is due to a bacterial infection, a doctor may prescribe a course of antibiotics. People should always take the complete course, even if they feel better before finishing all the medication.

Sore throats due to a viral infection do not usually need medical treatment. Acetaminophen or mild pain relievers may help with the pain and fever, and children can use pediatric versions of these medications. A pharmacist can advise which ones to use and correct dosages.

It is important always to follow the instructions on any medication and not to take more than the guidelines suggest.

A person with epiglottitis may need to spend time in the hospital. In severe cases, they may need intubation to help them breathe.

If tests reveal a tumor or another cause, the doctor will discuss appropriate treatment options with the individual.

Home Remedies

A few home care strategies may help relieve sore throat symptoms, including:

• Drinking plenty of fluids to keep the throat moist and prevent dehydration
• Getting plenty of rest
• Taking vitamin C supplements if a person is under severe stress, although there is not enough evidence indicating this is beneficial for most people
• Gargling with warm, saltwater
• Having cold treats, such as popsicles
• Lozenges or hard candy to soothe a sore throat and a cough for children over 2 years and adults
• Rinsing the nose and sinuses, for example, with a neti pot
• Taking honey to soothe a sore throat, except for children under 12 months
• Using a humidifier or vaporizer

Additionally, honey is not safe for children aged under 1 year due to the risk of botulism, a type of food poisoning.

Patients should also avoid using tap water with neti pots, as there is a risk of infection. Ask a pharmacist which type of water to use.

Soothing Drinks for a Sore Throat

Consuming warm liquids can help ease the discomfort from a sore throat.

Drinks that people may consume include:

• Green Tea
• Ginger Tea
• Warm lemon or water with honey, remember not to give honey to infants under 12 months of age

A 2019 study concluded that some herbal teas may help manage the symptoms of pharyngitis due to strep throat. These teas included:

• Barberry
• Licorice
• Oregano
• Thyme

Alternative Remedies

Some other home remedies may be useful, but they may not be safe for everyone.

They include the following:

• American ginseng
• Echinacea
• Garlic
• Oscillococcinum
• Vitamin D 
• Elderberry

However, there is insufficient evidence to show that these are helpful.

A 2017 study concluded that extracts of clove, ginger, danshen root, and echinacea flower may reduce the inflammation from strep throat.

Zinc Lozenges

A 2015 review of three studies concluded that dissolving tablets containing a high dose of zinc acetate in the mouth may relieve symptoms of a common cold in adults, including a sore throat.

However, more evidence is necessary to show that it is effective and safe in the long term. It can also have some adverse effects, including nausea and a bad taste in the mouth.

The National Center for Complementary and Integrative Health (NCCIH) says zinc lozenges may help manage a common cold if people start using them within 24 hours of symptoms appearing.

However, the NCCIH advises people not to use zinc lozenges for more than 2 weeks. Individuals should also avoid nasal zinc products, as these may lead to a permanent and severe loss of smell.

Zinc may also interact with antibiotics, penicillamine, and other drugs.

Patients should always check with their doctor or health professional before taking any alternative remedies to make sure they are safe to use and will not interact with another medication.

Prevention of Sore Throat

Some simple steps can help prevent infections that cause a sore throat.

For example:

• Avoid close contact with people who have an infection and stay away from others if you have an infection.
• Cough or sneeze into a tissue, throw it away, and immediately wash both hands
• Disinfect frequently touched surfaces, such as tabletops.
• Follow a diet and exercise plan that helps boost overall health 
• Avoid touching the nose or mouth.
• Seek advice on COVID-19 PCR testing if symptoms may indicate a SARS-CoV-2 infection
• Use alcohol-based hand sanitizers if soap and water are unavailable
• Wash the hands often, including after sneezing and coughing

 

Prognosis of Sore Throat

A sore throat can be uncomfortable, but most are not serious and usually go away without treatment. Home remedies and over-the-counter medication can soothe the symptoms.

However, a person should speak with a doctor if symptoms are severe or persistent or they have difficulty breathing. If it is due to a bacterial infection, such as strep throat, the doctor will prescribe antibiotics.

Most of the time, a sore throat isn’t a serious medical issue. Most sore throats go away within a few days. You should contact a healthcare provider if your sore throat lasts longer than a few days or if you have a sore throat and the following issues:

• A fever, especially if it’s over 100.4 degrees Fahrenheit (38 degrees Celsius)
• Blood in your saliva or phlegm
• Extreme tiredness
• Severe throat pain
• Rash anywhere on your body
• Trouble breathing or swallowing
• A visible bulge in the back of your throat

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