Mar. 12, 2025

Why Do I Have a Sore Throat? Causes & Getting Relief

Karen Shackelford, MD

Physician

Why Do I Have a Sore Throat? Causes & Getting Relief

A sore throat might be described as a scratchy sensation, pain or discomfort when speaking or swallowing, or a burning feeling. It is common to also have symptoms like neck swelling, nasal congestion, postnasal drip, fever, and fatigue.

Sore throats are often caused by allergens or contagious illnesses. You may even experience a sore throat after excessive voice use, such as shouting or singing. The most common cause of a sore throat is viral infections. Bacterial infections (such as strep throat), trauma, acid reflux, allergies, sinusitis, dehydration, or even tumors may also be responsible.

Many effective home remedies for a sore throat include hot and cold beverages and over-the-counter medications. If you need medical attention for your sore throat, you will likely undergo various tests, including throat cultures, which can provide quick answers. Remember, you may not need antibiotics for every sore throat.

Sore throat symptoms

Sore throat symptoms vary in character, duration, and severity, among other factors. Your doctor will weigh other signs and symptoms along with your sore throat to determine the cause.

Important criteria used to determine if you have strep throat include:

A fever of 101 degrees Fahrenheit or higher
Enlarged neck lymph nodes
Yellow or white coating over your tonsils or back of the throat (exudate)
Coughing as a symptom (no coughing means you are more likely to have strep throat)

Other important sore throat symptoms can be:

Difficulty or pain with swallowing or speaking
Hot potato voice (muffled speech)
Ear pain, which may be caused by a sore throat
Jaw pain or difficulty opening your mouth (trismus), which may indicate a more serious infection
Neck stiffness and pain with neck extension, which may indicate a more serious infection

Normal vs. abnormal sore throat

Differentiating between a normal and an abnormal sore throat can be challenging, even for healthcare professionals. Doctors will examine your throat for redness, swelling, pus, and a yellow or white coating (exudate) to help determine the culprit. They will also examine your tonsils and look for unusual symptoms, such as bleeding, ulcerations, growths, or asymmetry. They might assess the movement of your tongue and the back of your throat when you swallow.

Risks associated with a sore throat

Most sore throats are temporary and resolve in five to seven days with the help of home remedies. These remedies include hot or cold beverages, throat lozenges, painkillers, hydration, and rest. Sore throats are usually uncomplicated, even when caused by a viral or bacterial infection, and respond well to antibiotics or other medications.

However, there are some risks associated with sore throats, including:

Ear infections (otitis media)
Sinusitis
Mononucleosis
Acute rheumatic fever
Throat abscess
Diphtheria
Herpes simplex virus
Airway obstruction
Post-streptococcal glomerulonephritis (a kidney infection)
Toxic shock syndrome
Cancer of the head and neck (in rare cases)

Causes of a sore throat

A sore throat can have several possible causes, many of which can be treated without prescription medications. More than half of all sore throat infections are caused by viruses. However, it is possible to develop a bacterial infection after initially having a viral infection. Sore throats can also occur without infection.

Infection

Pharyngitis, commonly known as a sore throat, is an infection that usually resolves within one week. You may need medication to get past pharyngitis. Viruses, bacteria, or (in rare cases) fungi can cause the infection. If the cause is bacterial, it’s important to be aware of Streptococcus pyogenes, as this bacteria is responsible for Strep throat.

Infections cause a sore throat through two primary mechanisms:

1) Invading the lining of the throat, which leads to local inflammation, or

2) Irritation from nasal mucus and postnasal drainage.

Allergy

Similar to a throat infection, allergies may cause irritation from nasal mucus and postnasal drainage. Allergens include:

Tree and plant pollen
Animal dander
Dust mites
Cockroaches or other insects

Allergy-related sore throats can present differently than sore throats caused by infections. You may notice that your sore throat worsens at certain times, such as when you're exposed to allergens. Sore throats caused by infections are usually more persistent and often come with additional symptoms, such as fever.

Trauma

The mouth and throat are sensitive parts of the body. Even minor injuries, which can happen after biting your tongue or swallowing food or pills incorrectly, can result in a sore throat. These injuries may involve small lacerations, cuts, or even bruises. The pain and swelling typically subside as the injury heals.

Toxins

You can also experience a sore throat from exposure to various toxins. Symptoms will differ based on the type of toxin, the duration of exposure, and whether the toxin caused any trauma.

Toxins include:

Tobacco smoke
Air pollution
Particulate matter from burning
Occupational hazards such as silicone, asbestos, coal, tar, and others

Neoplasia (abnormal growth)

Neoplasia refers to the abnormal growth of cells or tissue in the throat. While these abnormal growths may be concerning, most are benign and not cancerous. Cancerous growths typically cause more pain and discomfort, often leading to difficulties with breathing or swallowing.

How to get relief from a sore throat at home

Several effective home remedies for a sore throat are easily accessible. Whatever relief you seek at home, it's crucial to get enough sleep and rest your voice.

Warm salt water gargles

Mix ¼ to ½ teaspoon of salt in eight ounces of warm water. Gargle with this solution and spit it out three or four times a day. The saltwater rinses will help soothe your throat and remove any debris from the back of your throat that results from an infection.

Throat lozenges, hard candies, and sprays

These products are easily accessible and provide soothing relief for sore throats. They may also help suppress the cough reflex, with some containing benzocaine or similar ingredients that may cause temporary numbness. The most common ingredients include menthol, eucalyptus, and various other mint oils.

Hot beverages or cold or frozen treats

You might find relief from drinking hot beverages like tea with honey or lemon. Cold or frozen treats might bring similar relief. Both options can soothe your throat and provide temporary numbness. Additionally, adding whiskey and various spices to your drink can enhance comfort. Remember to otherwise limit your alcohol intake and drink responsibly.

Analgesics

Analgesics are over-the-counter pain relievers like Tylenol (acetaminophen), ibuprofen, and naproxen sodium. These medications can help alleviate sore throat discomfort and reduce inflammation. They are also effective in lowering fever.

How to prevent a sore throat

Preventing a sore throat can be challenging because you may not always anticipate its cause(s). However, taking basic steps to stay healthy may help you avoid developing a sore throat.

Avoid irritants

Avoid smoking and exposure to secondhand smoke to prevent throat irritation and inflammation of the airways. To help prevent a sore throat, avoid toxins, chemicals, and environmental pollutants. Coal, silicone, and asbestos are three common pollutants. Chemical irritants you may encounter include household cleaners, bleach, ammonia, and smoke from burning wood or fossil fuels.

Allergy treatment

Avoiding allergens, taking antihistamines, and seeking allergy treatment can help prevent a sore throat. Nasal saline and medications for postnasal drip can also be beneficial.

Hand washing and hygiene

Practicing good hygiene, regularly cleaning surfaces at home, and washing your hands can help prevent the spread of infection. This is especially important if you live or work in crowded offices, schools, dormitories, or military facilities. Try to minimize contact with individuals who seem to be ill. Also, avoid sharing utensils, napkins, or towels with anyone with a sore throat.

When you should see a doctor about a sore throat

A sore throat can be quite uncomfortable. No matter the cause, it can disrupt your sleep and affect your work. It's a good idea to seek medical advice if your sore throat lasts more than a few days or if you experience additional symptoms.

You should see a doctor if:

You have a fever over 101 degrees Fahrenheit
You spend several days coughing up phlegm
You experience a headache
You experience nausea or vomiting
Your lymph nodes become enlarged
You have trouble swallowing
You have neck stiffness
You experience bleeding or pus from the throat

You should go to the emergency room if:

You have chest or abdominal pain
Breathing is difficult, or you are making unusual sounds when breathing
Your airway is obstructed
You have persistent hoarseness or loss of voice
You experience hot potato voice (extremely muffled speech)
You have one-sided throat pain with ear pain and difficulty opening your mouth
You are coughing up or vomiting blood
You are showing signs of dehydration (decreased urine output, dark urine, dizziness, etc.)
You have neck swelling or drainage
You experience joint pain and swelling

Questions to ask your doctor about a sore throat

When can I expect my sore throat to go away?
Should I have a strep test, COVID-19 test, or flu test?
Do I need antibiotics or other medications?

How a doctor may diagnose a sore throat

If your home remedies prove ineffective, it might be time to consult a medical professional. Your doctor will ask numerous questions and take a detailed medical history. They will then examine your throat using a strong light and a tongue depressor. If you decide to see a throat specialist, they may use a lighted scope to look into your nose and throat after applying a numbing medication.

Your doctor's tests may include:

Blood cell counts
Throat cultures, which may involve a rapid antigen detection test (RADT)
A monospot test for infectious mononucleosis
An X-ray or CT scan of your neck

How a doctor may help treat a sore throat

Depending on the cause of your sore throat, your doctor may recommend prescription medications. These medicines can help reduce inflammation and pain and eliminate any underlying infection.

Antibiotics

These medications are typically prescribed for strep throat. Antibiotics help alleviate your discomfort and shorten the duration of your sore throat by at least 24 hours in most cases. They can help prevent potential complications like rheumatic fever, which may lead to lifelong heart valve issues.

The most common antibiotics used are:

Penicillin or amoxicillin
Amoxicillin with clavulanate
Cephalosporins
Macrolides
Clindamycin

If you have infectious mononucleosis, your doctor will probably discontinue antibiotics because they may cause a rash and will not treat the underlying cause of the symptoms.

Corticosteroids

Medications such as prednisone or dexamethasone can help relieve a sore throat, improve swallowing and breathing, and reduce inflammation caused by infection. Corticosteroids can be administered orally or through injection. They are not addictive and do not present the same issues associated with anabolic steroids, which are often misused by athletes.

Medicated oral rinses

Your doctor may prescribe oral rinses that combine various medications to help soothe your throat.. Many doctors have their own special formulation known as “Magic Mouthwash.” This mouthwash allows for targeted symptomatic treatment of a sore throat.

Frequently asked questions: sore throat

Dealing with a sore throat can be difficult and frustrating. You may have many questions about it and potential steps to take to feel better.

How can you get rid of a sore throat quickly?

To quickly alleviate a sore throat, start by drinking plenty of fluids (especially hot teas with honey) and ensure you get enough rest. Throat lozenges, sprays, and salt water gargling may also provide relief. However, if an infection causes your sore throat, you may need to allow it to run its course. In some cases, seeking medical advice is necessary, as you might have strep throat and require antibiotics.

How long can a sore throat last?

In most cases, a sore throat lasts only a few days or, at most, a week. The intensity of the soreness can vary and might make eating or drinking uncomfortable. If your sore throat is caused by allergies, smoke, chemicals, or toxins, it may only be temporary. Sometimes, a sore throat can last just one day before it disappears. The duration of the sore throat largely depends on its cause.

Why does your throat feel sore, but you feel fine otherwise?

A sore throat can result from allergies or exposure to smoke, chemicals, or other toxins. It's possible that you don't have an infection and feel fine otherwise.

Another possibility is that the sore throat is the first symptom of an illness. For example, a sore throat is commonly the first sign of the common cold or COVID-19, often occurring before nasal congestion and stuffiness develop.

Summary of sore throat causes

There are several reasons why someone might experience a sore throat, most of which are due to viruses or bacteria. One of the most commonly discussed causes is strep throat, which often requires antibiotic treatment. If a sore throat worsens or is accompanied by symptoms such as fever, difficulty swallowing, or trouble breathing, it is important to seek medical attention.

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. Jennifer Nadel, MD.

Sources

Rawla, P., Padala, S. A., & Ludhwani, D. (2022, October 9). Poststreptococcal glomerulonephritis. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK538255/

Ross, A., & Schoff, H. W. (2023, August 7). Toxic Shock Syndrome. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK459345/

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