Is it Normal to Have a Sore Throat With No Tonsils?

Key takeaways:

• Removing your tonsils does not mean that you will never experience another sore throat.
• Sore throats after tonsil removal are normal but should be less severe and more infrequent.
• You can effectively manage most sore throats after tonsil removal with home remedies and plenty of rest.

Even if you don't have tonsils, you can still experience a sore throat. And while the chances are lower, you may still be at risk of strep throat. However, you are less likely to experience a sore throat due to swollen tonsils. Various factors can cause a sore throat, and it does not always point to an infection.

Fortunately, many home remedies, such as rest and staying hydrated, effectively provide relief, regardless of the sore throat's cause. In some cases, you may need to seek medical attention if you have more serious symptoms or home remedies are not effective. Read on to learn more about possible causes and recommended solutions.

Is it possible to get a sore throat, strep, or tonsillitis without tonsils?

The commonly removed tonsils are called the palatine tonsils, visible at the back of your throat. However, there are other tonsils in your body that you cannot see. One of these is the adenoid, also known as the nasopharyngeal tonsil, which can also be removed. Additionally, tonsils are located at the back of your nose and the base of your tongue, although these are rarely removed.

Your tonsils are crucial in defending against inhaled or ingested pathogens, acting as an initial barrier to external threats. This protective function is part of a structure known as Waldeyer's ring, and it's a crucial part of our immune system.

Common causes of a sore throat without tonsils

Sore throats can occur after a tonsillectomy for various reasons. Understanding these potential causes can help you find relief. The good news is that once your tonsils have are gone, the odds of developing a sore throat due to an infection like strep throat decrease. If you do get strep throat after removing your tonsils, the infection will likely be easier to treat, and you should recover faster.

Allergies

Removing your tonsils will not affect whether you have allergies. A sore throat can occur due to environmental allergies that lead to postnasal drainage, a stuffy nose, coughing, and nasal congestion. The most common allergens that may cause a sore throat include dust, mold, pollen, pet dander, and cockroaches.

Infection or irritation

After having a tonsillectomy, it is common to experience a sore throat, which can be due to infection or irritation. Many people mistakenly believe that removing their tonsils will completely eliminate the risk of sore throats and throat infections. However, it is still possible to develop throat infections caused by viruses or bacteria. Although the likelihood of contracting group A streptococcal infections will be significantly reduced, the risk of other types of throat infections remains.

Dryness

A sore throat can be caused by dryness, which may be a sign of dehydration, excessive exertion, or breathing through your mouth at night. Removing your tonsils does not necessarily impact throat dryness, especially if you live in a dry, arid climate. Eating salty foods can also lead to a dry throat.

Gastroesophageal or laryngeal reflux

If you experienced heartburn or reflux symptoms before your tonsil removal, these symptoms will likely continue after the procedure. You may experience a burning sensation or sore throat, leading to hoarseness. Additionally, if you have gastroesophageal reflux, you might notice a sour taste in your mouth, difficulty swallowing, and mild discomfort in your chest. After the tonsil removal, your sore throat could be unrelated to the surgery.

Lifestyle factors

After having your tonsils removed, you are likely to feel better overall. Your diet may improve, and you might become more open to trying foods or drinks you previously avoided, such as salty, spicy, or acidic items.

Additionally, if you did not smoke, vape, or drink alcohol before the surgery due to repeated strep throat infections, you may have resumed these habits afterward. This could contribute to a sore throat.

At-home remedies for relieving a sore throat without tonsils

After removing your tonsils, you may be surprised to experience a sore throat again. This is common, as the procedure can be challenging and painful. However, most sore throats that develop after a tonsillectomy can be managed with home remedies and are usually less severe than the sore throat you experienced before the surgery.

Hydration

Staying hydrated is crucial for our health, but it's still possible to become dehydrated, especially if you only drink water. Our bodies require electrolytes like sodium, potassium, calcium, and magnesium to maintain the proper water balance in our cells, tissues, and organs.

You risk depleting essential electrolytes if you consume too much water without complementing it with fruits, vegetables, natural juices, and sports drinks. Therefore, eating a balanced diet and drinking fluids is crucial, especially when exercising and sweating heavily.

Throat lozenges, honey, and other natural remedies

Topical treatments can be helpful for soothing a sore throat after removing your tonsils. Throat lozenges provide relief by calming and cooling your sore throat and can also help suppress your cough reflex. The most common ingredient found in throat lozenges and sprays is menthol derived from peppermint, eucalyptus, and other mint oils.

You may be concerned about the possibility of overdosing on menthol if you use too many tablets. However, rest assured that in these over-the-counter products, the menthol gets diluted to a level that makes overdose nearly impossible.

Anti-reflux medicine and precautions

After removing your tonsils, it's common to experience a sore throat. This discomfort may be due to gastroesophageal reflux (acid reflux), which occurs when stomach acid enters your esophagus and throat.

To address this issue, consider using antacids or over-the-counter anti-reflux medications. You can also take preventive measures by avoiding acidic or spicy foods and elevating your head with extra pillows while you sleep.

Cold medicines and analgesics

Even if you've had your tonsils removed, it's still possible to develop a sore throat due to an infection. Most of these infections are viral. Over-the-counter cold medications and pain relievers, such as Tylenol, ibuprofen, or naproxen, can help alleviate your sore throat.

Additionally, using nasal sprays, decongestants, or antihistamines may assist in reducing or preventing post-nasal drip and nasal congestion, which can exacerbate a sore throat after a tonsillectomy.

When you should see a doctor about a sore throat without tonsils

Even after removing your tonsils, you may still experience a sore throat and should consider contacting your doctor. It's crucial never to hesitate regarding medical care, especially when you have certain symptoms.

You should see a doctor if:

Consult your doctor if you experience one or more of the following symptoms:

• A sore throat doesn’t go away after about a week.
• A persistent fever of over 1010F.
• Red spots or white patches on the roof of your mouth.
• Nausea, vomiting, and headaches.
• Joint pain or swelling.
• An unusual rash.

You should go to the emergency room if:

Seek immediate medical care if you experience symptoms such as:

• Difficulty breathing or making strange sounds when breathing.
• Persistent hoarseness or loss of voice.
• Chest or abdominal pain.
• Coughing or vomiting blood.
• Dehydration (decreased urine output, dark urine, dizziness, etc.)
• Neck swelling or drainage.

Questions to ask your doctor about a sore throat without tonsils

• What could be causing my sore throat after having my tonsils removed?
• Do I need antibiotics?
• Am I contagious, and if so, how long will I be contagious?
• Do I need tests to determine why I have a sore throat after removing my tonsils?

Diagnosing a sore throat without tonsils

If you're still unwell despite home remedies and need to see your doctor about your sore throat following your tonsil removal, your doctor will likely start by reviewing your complete medical history. They may also conduct a physical examination. Additionally, your doctor may conduct blood tests or perform other assessments, such as a throat culture.

Based on the results of these tests, your doctor can diagnose what’s causing your pain and help you figure out which treatment is right for you.

How a doctor may help treat a sore throat without tonsils

Your doctor will likely initially suggest home remedies for your sore throat, such as rest, staying hydrated, gargling with salt water, and taking cold medicines or pain relievers. If your doctor diagnoses you with an infection or another medical condition, they may prescribe additional treatments or medications.

Antibiotics

Your doctor may diagnose you with a bacterial infection, even if you no longer have your tonsils. In this case, they will probably prescribe you an antibiotic. Typically, this will be either oral penicillin or amoxicillin. Sometimes, your doctor might recommend a mouthwash containing an antibiotic, steroid, or a numbing medication for your throat.

Antiviral medicines

Several antiviral medications are available, including Amantadine, Rimantadine, Oseltavmivir, Acyclovir, Valacyclovir, and Famciclovir. Most of these medications need to be started within two days of the onset of symptoms to be effective. Their effectiveness varies, and they are not always prescribed.

Topical anesthetics

Topical spray anesthetics are medications that numb the throat. Most of these sprays contain benzocaine or similar ingredients. While they can temporarily relieve sore throat symptoms, they do not cure the underlying issue. Additionally, these sprays may make swallowing more complex, so they should be used with care.

Frequently asked questions: sore throat without tonsils

After having a tonsillectomy, it can be frustrating to continue experiencing sore throats. There are various reasons for this ongoing discomfort, and your doctor can offer advice on resolving the issue effectively.

Why do you keep getting strep throat, but have had your tonsils removed?

Deciding to have your tonsils removed is a significant choice. The main purpose of this surgery is to reduce the chances of getting sore throats and to prevent other potentially serious medical conditions. Although you may still experience sore throats after the removal, they are likely to occur less frequently and be easier to treat.

What does strep throat look like when you don’t have tonsils?

Without your tonsils, the back of your throat may appear red and swollen. You might also notice white or yellow patches if you have strep throat. However, the main difference is that you will likely experience less severe swelling in your throat and won’t have the pus pockets associated with your tonsils.

Final thoughts

It can be frustrating to experience sore throats after having your tonsils removed. However, the procedure usually reduces the frequency and intensity of these sore throats. Most sore throats after tonsil removal can be managed effectively with home remedies, without antibiotics or other prescription medicines. If your symptoms don’t subside or continue to worsen, however, it’s important to speak to your doctor about possible causes and effective treatments.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Pallabi Sanyal-Dey, MD.

Sources

Masters, Kenneth G., et al. “Anatomy, Head and Neck, Tonsils.” StatPearls, StatPearls Publishing, 17 July 2023, https://www.ncbi.nlm.nih.gov/books/NBK539792/

Perkins, A. “An approach to diagnosing the acute sore throat.” American Family Physician, vol. 55, 1, pp.131-8, 141-2, January 1997, https://pubmed.ncbi.nlm.nih.gov/9012273/