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Sore throat

Contents of this page:

Illustrations

Throat anatomy
Throat anatomy
Strep throat
Strep throat

Alternative Names    Return to top

Throat - sore; Pain - throat

Definition    Return to top

A sore throat is discomfort, pain, or scratchiness in the throat. A sore throat often makes it painful to swallow.

Considerations    Return to top

Sore throats are common. Most of the time the soreness is worse in the morning and improves as the day progresses.

Like colds, the vast majority of sore throats are caused by viral infections. This means most sore throats will NOT respond to antibiotics. Many people have a mild sore throat at the beginning of every cold. When the nose or sinuses become infected, drainage can run down the back of the throat and irritate it, especially at night. Or, the throat itself can be infected.

Some viruses can cause specific types of sore throat. For example, Coxsackievirus sometimes causes blisters in the throat, especially in the late summer and early fall. Mononucleosis and the flu can also cause specific viral throat infections.

Strep throat is the most common bacterial cause of sore throat. Because strep throat can occasionally lead to rheumatic fever, antibiotics are given. Strep throat often includes a fever (greater than 101°F), white, draining patches on the throat, and swollen or tender lymph glands in the neck. Children may have a headache and stomach pain.

A sore throat is less likely to be strep throat if it is a minor part of a typical cold (with runny nose, stuffy ears, cough, and similar symptoms). Strep can NOT be accurately diagnosed by looking at the throat alone. It requires a laboratory test.

Sometimes breathing through the mouth will cause a sore throat in the absence of any infection. During the months of dry winter air, some people will wake up with a sore throat most mornings. This usually disappears after having something to drink.

In addition, allergies (allergic rhinitis) can cause a sore throat.

With a sore throat, sometimes the tonsils or surrounding parts of the throat are inflamed. Either way, removing the tonsils to try to prevent future sore throats is not recommended for most children.

Causes    Return to top

Home Care    Return to top

Most sore throats are soon over. In the meantime, the following remedies may help:

When to Contact a Medical Professional    Return to top

Call your health care provider if there is:

What to Expect at Your Office Visit    Return to top

Your health care provider will perform a physical examination. He or she may want to know some details about the sore throat, such as:

The following diagnostic tests may be performed:

Treatment

Usually, treatment will be delayed until lab test results are known. Doctors will often begin treatment of a sore throat immediately if there is a family history of rheumatic fever, if the patient has scarlet fever, or if rheumatic fever is commonly occurring in the community at the time.

Antibiotics are usually NOT wise if the strep test or throat culture is negative, and they can have serious side effects.

When antibiotics are started, it is important to complete the entire course as directed, even after symptoms improve. Children can return to school or day care 24 hours after antibiotics are started.

For a sore throat caused by infectious mononucleosis, rest and home treatment is recommended.

For a sore throat caused by bacterial tonsillitis, antibiotic treatment may be recommended. Some tonsillitis is viral and will clear up without treatment (surgery is rarely necessary). Recurrent or persistent sore throats without bacterial infection may be due to allergies and require anti-allergy treatment.

Prevention    Return to top

Clean your hands frequently, especially before eating. This is a powerful way to help prevent many sore throat infections. You might avoid some sore throats by reducing contact with people with sore throats, but often these people are contagious even before they have symptoms, so this approach is less effective.

Not too long ago, tonsils were commonly removed in an attempt to prevent sore throats. This is no longer recommended in most circumstances.

A cool mist vaporizer or humidifier can prevent some sore throats caused by breathing dry air with an open mouth.

References    Return to top

Alcaide ML, Bisno AL. Pharyngitis and epiglottitis. Infect Dis Clin North Am. 2007;21(2):449-69,vii.

Del Mar CB, Glasziou PP, Spinks A. Antibiotics for sore throat. Cochrane Database Syst Rev. 2008:(3):CD000023.

Update Date: 12/1/2008

Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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