Sore Throat: Causes, Relief and When You Need a Doctor

5 min read · Conditions · By the Asthra Health Care team

What causes a sore throat?

A sore throat is pain, scratchiness or irritation in the throat that often gets worse when swallowing. Most sore throats are caused by viruses, the same ones that cause colds and flu. A smaller number are caused by bacteria, the best known being streptococcus, which causes "strep throat".

Other causes include shouting or overusing the voice, dry air, smoking, air pollution, acid reflux and allergies. Tonsillitis is infection of the tonsils, the two lumps at the back of the throat, and is especially common in children. Sore throats spread easily in homes, schools and offices through coughs, sneezes and shared cups or spoons.

Symptoms to notice

Along with throat pain, you may have a hoarse voice, mild fever, swollen glands in the neck, cough, runny nose and tiredness. Cough and a runny nose with a sore throat usually suggest a viral cause. Symptoms are often worst in the first two to three days.

• Pain or scratchiness, worse on swallowing
• Red, swollen tonsils, sometimes with white patches
• Tender, swollen glands in the neck
• Fever and body ache
• Hoarse or muffled voice

Viral or bacterial?

It is not possible to tell for sure just by looking. Strep throat is more likely when there is fever, white patches on the tonsils, tender neck glands and no cough. It is more common in children and teenagers, and less common in adults over forty-five.

A doctor may examine the throat and sometimes take a throat swab to check for bacteria. Blood tests are occasionally used, for example if glandular fever is suspected in a young adult with a long sore throat and marked tiredness.

Home care and relief

Drink plenty of warm fluids such as water, soups and weak tea, and eat soft foods like idli, curd rice and porridge. Gargling with warm salt water a few times a day can ease pain. Rest your voice and avoid smoking and smoky places.

Paracetamol or ibuprofen can relieve pain and fever; follow the label or your pharmacist's advice. Throat lozenges and sprays may give short-term relief. Lozenges are not suitable for young children because of the choking risk. Using a humidifier or keeping a bowl of water in a dry room may make the throat feel less scratchy.

When antibiotics are used

Antibiotics do not help viral sore throats. For a confirmed or strongly suspected strep throat, a doctor may prescribe an antibiotic. This is important because untreated strep infection can, in some cases, lead to rheumatic fever, which can damage heart valves. Antibiotics should be taken only on a doctor's prescription and the full course completed as advised.

Special groups

Children with a sore throat and fever, especially school-age children, should be seen by a doctor, as strep throat is common in them. Pregnant women should check with a doctor before using ibuprofen, which is generally avoided in later pregnancy. People with kidney disease, stomach ulcers or asthma should also ask before taking ibuprofen.

Elderly people and anyone with diabetes or weak immunity should not ignore a sore throat that is getting worse. Rarely, a throat infection can spread to deeper tissues of the neck, which needs urgent hospital care. In children, a sore throat can also be the first sign of other infections such as hand, foot and mouth disease.

Preventing sore throats

Wash hands often, do not share cups, bottles or spoons, and replace your toothbrush after a throat infection. Stay away from smoke, including second-hand smoke and smoke from burning waste. Rest your voice if you speak for long hours, such as teachers and call-centre staff, and sip water through the day.

If you get repeated sore throats with heartburn or a sour taste in the mouth, acid reflux may be the cause. Avoid late heavy meals, spicy and oily food at night, and lying down straight after eating, and speak to a doctor about it. Treating the reflux often settles the throat.

When to see a doctor for sore throat

See a doctor if the sore throat lasts more than a week, keeps coming back, or comes with high fever, a rash, or white patches and swollen glands without a cough. Get urgent help for the warning signs below. For any doubt about medicines, ask your doctor or pharmacist.

This article is general health information, not medical advice. Do not start, stop or combine medicines on your own — always follow your doctor's prescription and ask your pharmacist if unsure.