A sore throat, medically termed pharyngitis, is a scratchy, painful feeling in the back of the throat that occurs when the tissue lining becomes inflamed. The condition may make swallowing or talking uncomfortable. Many things cause pharyngitis, from viral and bacterial infections to allergies and sleeping with your mouth open. Most sore throat symptoms resolve with home care within a few days, though medical attention becomes necessary if symptoms last longer than a week, worsen or include fever or swollen lymph nodes.
Healthcare providers categorize pharyngitis into two main types based on symptom duration. Acute pharyngitis lasts from approximately three to 10 days, representing most sore throat cases. Chronic pharyngitis persists for more than 10 days, usually several weeks, or keeps returning after initial improvement.
Common symptoms
Pharyngitis may start with a raspy feeling in the throat, as if the throat is dry. As the condition worsens, sharp pain may develop when swallowing or talking. Pain may radiate to the ears or down the side of the neck.
When infection causes the sore throat, additional symptoms may appear including fever, headache, upset stomach, swollen lymph nodes, nasal congestion, runny nose, cough, fatigue and hoarseness. Visible changes may include redness or swelling in the throat and tonsils, along with white patches, spots or streaks in the throat and tonsils.
Primary causes
Most sore throats result from viral infections like the common cold or flu. Less frequently, pharyngitis may signal bacterial infection including conditions like strep throat and bacterial sinus infections. Tonsillitis occurs when tonsils become infected and inflamed, with both bacteria and viruses capable of causing this condition.
Allergic reactions from pollen, dust mites, pets or mold can cause mucus from the nose to drip down the back of the throat, a condition called postnasal drip that leads to sore throat. People with gastroesophageal reflux disease experience burning and pain in their throats when stomach acid backs up into the esophagus.
Throat strain from yelling or screaming can cause soreness, as can consuming spicy food, smoking or drinking very hot liquids. Breathing through the mouth instead of the nose during sleep may result in sore throat. Although rare, pharyngitis can indicate throat cancer or benign growths.
Diagnosis process
Healthcare providers ask about symptoms and perform physical examinations involving inspection of the throat, tongue and possibly ears. They may conduct strep tests to check for bacteria causing strep throat. Testing helps determine whether symptoms relate to viral or bacterial infection, which determines appropriate treatment approaches.
Treatment approaches
Treatment depends on the underlying cause. Viral infections usually clear up independently within a week. Meanwhile, healthcare providers may recommend over-the-counter medicines to ease sore throat discomfort.
Bacterial infections may require antibiotics, with most people needing to take them for 10 days. Over-the-counter antihistamine medications may dry postnasal drip related to allergies. Antacids may help with acid reflux causing heartburn and sore throats, along with lifestyle changes like avoiding large meals right before bedtime.
For severe sore throat related to conditions like cancer, providers may prescribe special mouthwash containing a mix of numbing agents like lidocaine, Benadryl and Maalox.
Home care strategies
While addressing the underlying cause, several at-home remedies can relieve sore throat discomfort. Over-the-counter pain relievers including acetaminophen, naproxen sodium and ibuprofen may help. Sucking on throat lozenges or hard candy increases saliva production, adding soothing moisture to the throat, though this should never be tried with children under 5 who may choke.
Ice chips, popsicles or cold foods can ease pain. Drinking tea with lemon and honey, broth or bouillon may help dry, scratchy throats. If coolness feels better, try sipping ice water. Gargling a mixture of half a teaspoon of salt per cup of water can ease inflammation and irritation.
Adding moisture to the environment through humidifiers or vaporizers, especially in bedrooms during sleep, helps ease dry throats. Resting the voice may help if the throat became sore from shouting, screaming, singing or extensive talking. Avoid exposure to secondhand smoke and steer clear of spicy foods and very hot liquids that may irritate sore throats.
Prevention methods
Viral infections like colds and flu often cause pharyngitis. Reducing chances of getting sore throat involves protecting against these common infections by staying current on vaccinations for flu and COVID-19, washing hands frequently with soap and water or alcohol-based sanitizers, avoiding sharing food, drinks or utensils, avoiding people with colds or other contagious respiratory infections, and avoiding being around others when sick to reduce spreading infectious diseases.
When to seek medical care
Contact healthcare providers if sore throat lasts longer than a week. Seek immediate attention for severe throat pain, trouble breathing or swallowing, fever over 100.4 degrees Fahrenheit, visible bulge in the back of the throat, blood in saliva or phlegm, or rash anywhere on the body.
Most pharyngitis cases happen because of viral infections that run their course in a week or so. Antibiotics may be necessary if soreness stems from bacterial infection. Instances exist when pharyngitis may indicate serious medical issues. Persistent or recurring sore throats warrant consultation with healthcare providers.