October 23, 2018
Woman having a sore throat

Sore Throat: Causes and Treatments

by Berkeley Wellness  

A sore throat, or acute pharyngitis, is one of the most common upper respiratory problems, and it ranks as one of the top reasons for visiting a doctor’s office. 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.

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.

What causes a sore throat?

Most sore throats are caused by a virus, primarily those associated with the common cold. Sore throats caused by a virus usually develop gradually. They are often accompanied by a runny nose, congestion, irritation or redness of the eyes, coughing, or hoarseness. If a fever is present, it will generally be 101˚F or below. The flu is a common viral infection accompanied by fever or chills, fatigue, muscle or body aches, loss of appetite, cough, and a sore throat.

A bacterial sore throat usually comes on faster, lymph glands in the neck often swell and become tender. Strep throat, or streptococcal infection, is the most common cause of bacterial throat infection, although less than 15 percent of all sore throats are caused by the Streptococcus pyogenes bacterium. Signs of strep throat include pain in the throat, a fever higher than 100.4˚F, enlarged cervical lymph glands, white patches in the back of the throat, and no presence of a cough or irritation of the eyes. Strep is much less common than virus-linked sore throats. If not properly treated with antibiotics, it can sometimes lead to further complications. For this reason if you believe that you have strep throat, it is important to contact your doctor to get the appropriate antibiotics for treatment.

Infectious mononucleosis, which is usually brought on by the Epstein-Barr virus, can also cause a sore throat. Throat pain can also be caused by other situations such as from dental procedures, spicy foods, excessive shouting, dry heat, smoking, or breathing polluted air. In some cases, a sore throat may also be an early sign of a more serious disorder.

What if you do nothing?

Sore throats caused by a cold or flu virus are 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 throats

  • 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.

How to prevent a sore throat

  • 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.

When to call your doctor about a sore throat

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.

Contact your doctor immediately if, in addition to your sore throat and a high fever, your voice becomes muffled or your tongue and throat swell. These developments indicate an abscess infection that requires early treatment with antibiotics and possibly surgery.

What your doctor will do

After taking a careful medical history, your doctor may take 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 doctor may recommend a tonsillectomy to remove the tonsils. As with all surgical procedures, be sure to get a second opinion.

Also see Cold Sores: Causes and Treatments.