Viruses and bacteria are two of the most common causes of sore throats.
Sore throats can be caused by viruses, bacteria, allergies, irritation, and reflux.
- Viruses: Most people experience a sore throat due viral infections such as common colds, influenza, and infectious mononucleosis.
- Bacteria: Strep throat is a common throat infection, and it is caused by a strain of streptococcus bacteria. Symptoms of strep throat include a fever greater than 101°F, white patches on the throat, and swollen or tender glands in the neck area.
Epiglottitis is a dangerous throat infection in which inflammation and swelling of the epiglottis can close the airway. Epiglottitis should be suspected in patients with a sore throat who develop difficulty breathing, a high pitched sound while breathing in, or drooling, and requires immediate medical attention.
Other common causes of a sore throat include:
- Irritation caused by dry heat, pollutants, or chemicals
- Reflux - the regurgitation of stomach acids into the back of the throat
More severe but less common conditions such as HIV and tumors of the throat, tongue, or larynx can also cause a sore throat.
People who are most at risk of frequent sore throats include:
- People with allergies
- People with weakened immune systems
- People who have been exposed to chemical irritants
- People who suffer from long-lasting or frequent sinus infections
The symptoms of a sore throat can vary depending on the exact cause. Common signs and symptoms include:
- A scratchy sensation in the throat
- Pain in the throat area that becomes worse when swallowing or talking
- Difficulty swallowing
- Sore or swollen glands in the neck or jaw area
- Swollen red tonsils in addition to a hoarse or muffled voice
- Runny nose
Children and sore throats
Sore throats are common in every age group, but children seem to be more susceptible. According to the Centers for Disease Control and Prevention (CDC), children and teens between 5 and 15 years old are more likely to get a sore throat than adults.
Children appear to be more susceptible to sore throats than adults.
In children, 20 to 30 out of every 100 sore throats are strep throat. In adults, only 5 to 15 out of every 100 sore throats are diagnosed as strep throat.
The exact symptoms of a child's strep throat depend on the child's age. Toddlers age 1 to 3 may experience thickened discharge from the nose, fever, and tender, swollen lymph nodes in the neck. Children are usually cranky with a reduced appetite.
Children older than 3 who develop strep are usually quite ill. In addition to a very painful throat, common symptoms include a fever over 102°F, swollen lymph nodes in the neck, and pus on the tonsils.
In children, a sore throat is not always strep, but it is important to find out whether it is caused by a bacterial or a viral infection for effective treatment. Viral infections are still the most frequent cause of a sore throat in children.
Strep throat also affects adults, so it is important to recognize the common signs and symptoms. The symptoms may include any of the following:
- A high fever classified as above 101°F
- Sore throat
- Lack of a cough
- Swollen lglands in the neck
When to see a doctor
Most sore throats go away on their own, but if a child has a persistent sore throat, they should see a doctor.
The doctor can use a throat culture to determine what type of infection is present.
There are a few ways to do this. A cotton-tipped applicator can be used to touch the back of the throat and tonsils to take a sample. This sample is then smeared in a culture dish. The dish allows the strep bacteria to grow if present and is usually ready to be examined after 24 hours.
Many pediatric offices now offer the rapid strep test which can provide results in minutes. A culture test may be used to confirm a rapid strep test that is negative. A negative test means that the infection is due to a virus which antibiotics will not help.
If the strep test is positive, the pediatrician can prescribe an antibiotic. If prescribed an oral medication, parents should make sure their child takes it for as long as specified to ensure that they get better. In children, untreated strep throat can increase the risk of rheumatic fever or kidney inflammation.
In adults, the treatment is similar. Sore throats caused by a viral infection generally start to improve within 7 days and do not require medical treatment. Acetaminophen or mild pain relievers may help with the pain and fever.
Children can take over-the-counter pain medication designed specifically for children to help ease symptoms. Adults who are diagnosed with strep or another bacterial infection are also prescribed antibiotics.
There are some home remedies that people can use to try and soothe a sore throat, but these treatments may not help everyone. They will also not cure strep. Some of the remedies may not be safe for children, women who are pregnant, or people suffering from certain health conditions.
Warm liquids can help soothe the pain caused by a sore throat.
Zinc gluconate in the form of lozenges is a common over-the-counter remedy, but there is inconclusive evidence on its effectiveness. It can also have some adverse side effects, including nausea and a bad taste in the mouth.
Some people who have used the zinc nasal sprays have also complained of permanent loss of smell. These are not recommended for children.
Other home remedies for sore throats include slippery elm, serrapeptase, papain, and Andrographis. Studies are inconclusive if these treatments are effective, and they are not recommended for children or adolescents.
A few home care strategies may help to relieve sore throat symptoms:
- Getting plenty of rest
- Drinking plenty of fluids to keep the throat moist and prevent dehydration
- Warm liquids such as caffeine-free tea or warm water with honey can help to soothe a sore throat (avoid using honey in children less than 1 year of age due to risk of botulism)
- Cold treats including popsicles may also provide some comfort
- Gargling with warm salt water may soothe an achy throat
- Lozenges or hard candy can help to soothe a sore throat but are a choking risk for children 4 years and younger
There are simple things that can be done to help prevent a sore throat. People should make a habit out of trying to avoid the germs that can cause a sore throat:
- Practice good hand hygiene
- Make sure to wash hands often, especially after using the bathroom, before eating, and after sneezing or coughing
- Minimize touching your nose or mouth, particularly when in contact with children or sick contacts
- Do not share food, eating utensils, or drinking glasses
- Cough or sneeze into a tissue, throw it away and immediately wash both hands
- Avoid touching public drinking fountains or pay phones with your mouth
- Avoid close contact with people who are sick
- Use alcohol-based hand sanitizers if soap and water are unavailable
Sore throats are not usually very serious and go away quickly. Remember the signs and symptoms of a sore throat and contact a doctor if necessary.
Learn more about the causes of a sore throat.