Many people experience a sore throat alongside neck pain. This common combination of symptoms has numerous possible causes, ranging from mild infections to more severe conditions.

The neck contains several structures, including:

  • the throat (pharynx)
  • the cervical spine
  • nerves
  • blood and lymphatic vessels
  • lymph nodes
  • muscles, ligaments, and tendons

Medical conditions and injuries that affect one of these structures can also affect nearby structures.

In this article, we discuss possible causes of a sore throat and neck pain, how to treat them, and when to see a doctor.

a man holding his neck because he has both a sore throat and neck painShare on Pinterest
Infection may cause symptoms in the throat and neck.

The muscles, blood vessels, and lymphatic vessels of the neck overlap one another and surround the throat, which is a muscular tube that runs from the back of the mouth to the stomach.

The throat also contains blood vessels, lymphatic vessels, and nerves. In addition, it includes the tonsils, esophagus (food pipe), trachea (windpipe), and epiglottis.

A condition that affects one of these structures may affect one or more of the others.

Conditions that may produce symptoms in the throat and neck include:

Infections

Viral and bacterial infections that begin in the throat can lead to painful inflammation of the surrounding neck muscles.

Infections also trigger the lymphatic system, which contains white blood cells that kill invading microbes. This system also collects toxins and other waste material from the body.

The lymph nodes filter and collect this waste, which is why people who are sick may develop swollen lymph nodes. Swollen lymph nodes can feel tender and also make the neck feel sore or stiff.

Examples of infections that can cause both a sore throat and neck pain include:

Cold and flu

The common cold and the flu are two common types of viral infections that affect the respiratory system.

Both a cold and the flu can lead to sore throats and swollen, tender lymph nodes in the neck. People who have a common cold may experience:

  • body aches
  • coughing and sneezing
  • chest discomfort
  • mild fever

These symptoms also occur in people who have the flu. However, flu symptoms are usually more severe than the symptoms of a cold.

People who have the flu may also experience:

  • fever
  • headaches
  • chills
  • muscle weakness
  • body aches
  • fatigue
  • nausea or vomiting

Tonsillitis

Tonsillitis is the inflammation of the tonsils, which are oval-shaped mounds of soft tissue in the back of the throat.

Both viral and bacterial infections can lead to tonsillitis. Symptoms include fever, a sore throat, and swelling of the tonsils and lymph nodes in the neck.

Strep throat

Strep throat, also known as pharyngitis, occurs when the bacterium Streptococcus pyogenes infects the throat. People who have strep throat may experience the following symptoms:

  • sudden onset of a sore throat
  • painful swallowing
  • red, swollen tonsils
  • white spots, patches, or streaks of pus on the surface of the throat
  • red spots on the roof of the mouth
  • swollen, tender lymph nodes in the neck
  • fever
  • headaches
  • body aches
  • fatigue

Mononucleosis

Mononucleosis is a viral infection that is common among teenagers and young adults. The human herpesvirus 4, also known as the Epstein-Barr virus (EBV), is the most common cause of mononucleosis. Other viruses that can cause mononucleosis include:

Symptoms include:

  • a sore throat
  • a fever
  • swollen lymph nodes in the neck and armpits
  • fatigue
  • headaches
  • body aches
  • muscle weakness
  • a red skin rash
  • swollen spleen or liver

Gonorrhea

Gonorrhea is a sexually transmitted infection (STI) that can infect the genitals, rectum, and throat.

According to the Centers for Disease Control and Prevention (CDC), gonorrhea is one of the most common STIs, especially among teenagers and young adults between the ages of 15 and 24 years. The CDC also estimate that 1.14 million new gonorrhea infections occur in the United States each year.

Although many people who have gonorrhea do not experience symptoms, it can cause white, yellow, or green urethral discharge in males and increased vaginal discharge in females.

Gonorrheal infections of the throat can lead to:

  • a sore throat
  • swelling and redness of the throat
  • swollen lymph nodes
  • difficulty swallowing
  • flu-like symptoms, such as fever, a headache, and chills

Oral gonorrheal infections can result in nonspecific symptoms that mimic those of other, more common throat infections. People who believe that they may have had exposure to gonorrhea should contact a healthcare professional for testing.

Allergies

Airborne and food allergies can lead to swelling and irritation of the throat.

People who have airborne allergies, such as hay fever, may have an itchy or sore throat when they come into contact with pollen, dust, animal dander, or mold. Other symptoms of airborne allergies include:

  • a runny or stuffy nose
  • itchy, watery eyes
  • coughing
  • sneezing
  • fatigue

Some people have food-related allergies, which can cause a sore, itchy throat, as well as:

  • itching or tingling of the mouth
  • redness and swelling of the mouth and lips
  • hives
  • nasal congestion
  • sneezing
  • wheezing
  • nausea or vomiting
  • dizziness

Unlike cold or flu symptoms, which typically resolve within 2 weeks, allergy symptoms persist for as long as a person remains exposed to the allergen.

GERD

Gastroesophageal reflux disease (GERD) occurs when food, fluids, or acids travel back up from the stomach into the throat.

The primary symptom of GERD is heartburn, but it can also cause a variety of throat-related symptoms, including a sore throat. Other symptoms include:

  • trouble swallowing
  • a feeling that there is a lump in the throat
  • a burning sensation
  • hoarseness
  • a dry cough

Anyone experiencing these symptoms should speak to a doctor who may prescribe medication. However, many people can treat or manage GERD with lifestyle and dietary changes.

Tumors

A persistent sore throat is a common symptom of head and neck cancers. Other possible symptoms include:

  • pain when swallowing
  • a lump or sore that is slow to heal
  • a chronic sinus infection
  • frequent headaches
  • swelling near the jaw
  • pain or numbness in the facial muscles

Most people with a sore throat or neck do not have cancer. According to the National Cancer Institute, doctors diagnosed about 53,000 new cases of head and neck cancers in 2019. The CDC estimate that 38–54 million people had the flu between October 2019 and early March 2020.

Head and neck cancers cause symptoms that can also occur in other, less severe conditions. However, it is essential that people discuss their symptoms with a doctor.

People may wish to consider the following treatments if they have a mild sore throat and neck pain:

  • drinking plenty of fluids to stay hydrated
  • gargling warm water with salt
  • drinking warm tea with honey
  • eating soft foods, such as soups
  • using over-the-counter (OTC) anti-inflammatory or pain relieving medications
  • applying a warm compress to the affected area to ease muscle pain
  • using a cold compress or an ice pack to reduce swelling
  • stretching the neck and shoulders to relieve muscle tension

Although cold or flu symptoms usually clear up without medical treatment, home remedies may have minimal effects on the symptoms of a bacterial infection, such as strep throat.

In this case, a doctor will likely prescribe a round of antibiotics. People may notice that their symptoms improve within a few days of starting antibiotics. However, it is essential to complete the entire course to prevent reinfection and the development of antibiotic resistance.

People should see their doctor if they experience a severe or persistent sore throat that does not respond to at-home treatment. They should also seek medical care if they experience severe neck pain that does not go away or spreads to other parts of the body.

People must inform their doctor if they have:

  • difficulty swallowing or breathing
  • a high fever
  • a palpable lump in the neck
  • sudden, severe headaches
  • numbness in the limbs, face, or mouth

A doctor will perform a physical examination to check for swollen lymph nodes and signs of tenderness, redness, and swelling in the neck. They will also review a person’s medical history to determine whether an allergy, chronic condition, injury, or exposure to a particular substance could explain their symptoms.

If a doctor suspects that a person may have a bacterial or viral infection, they may order blood tests to confirm a diagnosis. They might request a blood test that detects specific antibodies or one that measures the number of white blood cells present in the blood.

If a bacterial infection is more likely, the doctor may collect samples from a person’s throat or mouth and send them to a laboratory for further analysis.

A doctor may also follow this procedure if a person has an abnormal lump on their neck. Lab technicians will analyze samples of the tissue for signs of infections or cancer.

A sore throat and neck pain can both occur as a result of mild illnesses, such as a cold, the flu, or strep throat. In most cases, a person with this combination of symptoms does not need to seek immediate treatment. The symptoms should resolve within a few days to a week.

Staying hydrated, getting enough sleep, and drinking warm liquids can help relieve a sore throat. People can treat neck pain with OTC pain relievers, warm or cold compresses, and neck stretches.

Anyone who experiences severe or persistent symptoms may wish to speak with their doctor. A doctor can diagnose the underlying cause of the symptoms and recommend effective treatment options.