Health Library Sore ThroatFrom Healthwise

Sore throats can be painful and annoying. Fortunately, most sore throats are caused by a minor illness and go away without medical treatment.

Several conditions can cause a sore throat.

Viral infections

Many sore throats are caused by a viral illness, such as:

• The common cold, the most common type of viral infection.
• Infection of the voice box (laryngitis)
• Mononucleosis (mono, "the kissing disease"), a viral infection that tends to cause a persistent sore throat.
• Other viral infections, such as mumps, herpangina, or influenza.

Bacterial infections

A bacterial infection may also cause a sore throat. This can occur from:

• Strep throat, which usually does not occur with congestion or a cough.
• An inflammation or infection of the tonsils (tonsillitis) and sometimes the adenoids (adenoiditis).
• Inflammation of the epiglottis (epiglottitis).
• Inflammation of the uvula (uvulitis).
• In rare cases, a sexually transmitted disease (STD), such as gonorrhea or chlamydia. If you have engaged in high-risk sexual behavior, consider whether gonorrhea or chlamydia may be present. For more information, see the topic Exposure to Sexually Transmitted Diseases.

Irritants and injuries

A sore throat that lasts longer than a week is often caused by irritants or an injuries, such as:

• Throat irritation from low humidity, smoking, air pollution, yelling, or nasal drainage down the back of the throat (postnasal drip).
• Breathing through the mouth when you have allergies or a stuffy nose.
• Stomach acid that backs up into the throat, which may be a symptom of gastroesophageal reflux disease (GERD). Although this often occurs with heartburn, an acid taste in the mouth, or a cough, sometimes a sore throat is the only symptom.
• An injury to the back of the throat, such as a cut or puncture from falling with a pointed object in the mouth.
• Chronic fatigue syndrome, a condition that causes extreme tiredness.

Treatment for a sore throat depends on the cause. You may be able to use home treatment to obtain relief.

Because viral illnesses are the most common cause of a sore throat, it is important not to use antibiotics to treat them. Antibiotics do not alter the course of viral infections. Unnecessary use of an antibiotic exposes you to the risks of an allergic reaction and antibiotic side effects, such as nausea, vomiting, diarrhea, rashes, and yeast infections. Antibiotics also may kill beneficial bacteria and encourage the development of dangerous antibiotic-resistant bacteria.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a doctor.

• Moderate to severe difficulty breathing:
  • In a child
  • In an adult and older child
• Rapid swelling of the throat or tongue
• Drooling develops with difficulty breathing or the inability to cry or make sounds. This can be caused by epiglottitis.
• Severe dehydration:
  • In a child
  • In an adult and older child

If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.

Review health risks that may increase the seriousness of your symptoms.

If you have any of the following symptoms, evaluate those symptoms first:

• A sore in your mouth that is causing a sore throat: Go to the topic Mouth Problems, Noninjury.
• An injury to the back of your mouth: Go to the topic Mouth and Dental Injuries.
• An allergic reaction: Go to the topic Allergic Reaction.

	Yes	Do you have a sore throat and mild difficulty breathing?
When to See a Doctor See significance of a sore throat and mild difficulty breathing if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Do you have a severe sore throat? Call your health professional today if you answer "Yes" to the following question. Yes Do you have a mild to moderate sore throat? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have a sore throat and drooling?
When to See a Doctor See significance of a sore throat and drooling if you need information to help you answer the question below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Do you have drooling and a sore throat? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have signs of mild to moderate dehydration?
When to See a Doctor See significance of signs of dehydration if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional today if you answer "Yes" to the following question. Yes Do you have signs of moderate dehydration, and you are unable to drink enough to replace lost fluids? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Have you had signs of mild dehydration for 24 hours or longer, and you are not sure you can drink enough to replace the lost fluids? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have a sore throat with a rash?
When to See a Doctor See significance of a sore throat with a rash if you need information to help you answer the question below. Review health risks that may increase the seriousness of your symptoms. Call your health professional today if you answer "Yes" to the following question. Yes Do you have a rash? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have a sore throat with pain when swallowing?
When to See a Doctor See significance of a sore throat with pain when swallowing if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional today if you answer "Yes" to any of the following questions. Yes Do you have moderate to severe pain when swallowing after 6 to 8 hours of home treatment? Yes Do you have swollen tonsils with patches of white or green pus on your tonsils? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Have you had mild to moderate pain when swallowing for longer than 48 hours? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have a sore throat with a muffled voice or hoarseness?
When to See a Doctor See significance of a sore throat with a muffled voice or hoarseness if you need information to help you answer the question below. Review health risks that may increase the seriousness of your symptoms. Call your health professional today if you answer "Yes" to the following question. Yes Do you have a sore throat with a muffled voice or hoarseness after 6 to 8 hours of home treatment? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have symptoms of strep throat?
When to See a Doctor See significance of symptoms of strep throat if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Note: If you need information on how to take a temperature, see the topic Body Temperature. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have diabetes? Yes Do you have a medical condition or take a medicine that impairs your immune system? Call your health professional today if you answer "Yes" to any of the following questions. Yes Does your child have a fever of 101 °F (38 °C) or higher? Yes Do you think that your child has a moderate fever, but you are not able to measure his or her temperature? Yes Do you know or think you have a fever? Yes Do you have a white or yellow coating on your tonsils? Yes Do you have swollen glands in your neck without other cold symptoms, such as a cough, congestion, sneezing, or muscle aches? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Has your child had a mild fever for longer than 48 hours or longer? Yes Have you had a mild to moderate sore throat without other cold symptoms, such as cough, congestion, sneezing, or muscle aches, for 72 hours or longer? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have a sore throat without other symptoms?
When to See a Doctor See significance of a sore throat without other symptoms if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional today if you answer "Yes" to the following question. Yes Have you had a severe sore throat for longer than 12 hours despite home treatment? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Have you had a mild to moderate sore throat for 48 hours or longer? Yes Has a new sore throat (even if mild) continued longer than 1 week? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to any of the following questions. Yes Do you have an ongoing (chronic) sore throat that has not been checked by a doctor? Yes Do you have an ongoing (chronic) sore throat that has changed since being checked by a doctor? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Have you developed a sore throat after being exposed to strep throat?
When to See a Doctor See significance of exposure to strep throat if you need information to help you answer the question below. Review health risks that may increase the seriousness of your symptoms. You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Have you developed a sore throat in the past 48 hours after being in close contact with someone who has had a positive test for strep throat? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.

Other Symptoms to Watch For

Do you have any of the following symptoms?

• A fever: Go to the topic Fever, Age 3 and Younger or Fever, Age 4 and Older.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

Home treatment is usually all that is needed for a sore throat caused by a virus. These tips may help you feel better.

• Gargle with warm salt water to help reduce swelling and relieve discomfort:
  • Gargle at least once each hour with 1 tsp (5 g) of salt dissolved in 8 fl oz (237 mL) of warm water.
  • If you have postnasal drip, gargle often to prevent more throat irritation.
• Prevent dehydration. Fluids may help thin secretions and soothe an irritated throat. Hot fluids, such as tea or soup, may help decrease throat irritation.
• Use a vaporizer or cool air humidifier in your bedroom.
  • Warm or cool mist may help you feel more comfortable by soothing the swollen air passages. It may also relieve hoarseness. However, don't let your room become uncomfortably cold or very damp.
  • Use a shallow pan of water to provide moisture in the air through evaporation if you don't have a humidifier. Place the pan in a safe location where no one will trip on it or fall into it.
• Do not smoke or use other tobacco products and avoid secondhand smoke. For more information, see the topic Quitting Tobacco Use.
• If you suspect that problems with stomach acid may be causing your sore throat, see the topic Heartburn.

Consider taking nonprescription medicine for your symptoms.

• Use nonprescription throat lozenges.
  • Some nonprescription throat lozenges, such as Sucrets Maximum Strength or Spec-T, are safe and effective and have medicine (local anesthetic) that numbs the throat to soothe pain.
  • Regular cough drops may also help.
• Use a decongestant.
  • Decongestants make breathing easier by shrinking swollen mucous membranes in the nose, allowing air to pass through. They also help relieve a runny nose and postnasal drip, which can cause a sore throat.
  • Decongestants can be taken orally or used as decongestant nasal sprays. Oral decongestants (pills) are probably more effective and provide longer relief but may cause more side effects.
  • Do not give decongestants to a child younger than 2 unless your child’s doctor has told you to. If your child’s doctor tells you to give a medicine, be sure to follow what he or she tells you to do.

Additional home treatment can be found in topics related to sore throat.

• If you suspect allergies are causing your symptoms, see the topic Allergic Reaction or Allergic Rhinitis.
• If you have laryngitis, see laryngitis.
• If your sore throat is caused by sores in your mouth, see the topic Mouth Problems, Noninjury.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment:

• Drooling or increased difficulty breathing develops.
• Inability to swallow or drink enough fluids develops.
• A muffled voice develops.
• A new rash or fever develops.
• Signs of dehydration are present.
• A persistent sore throat or fever develops.
• Symptoms become more severe or more frequent.

There is no sure way to prevent a sore throat. To help reduce your risk:

• Drink enough fluids to prevent dehydration.
• Wash your hands often, especially when you are around people who are sick.
• Identify and avoid irritants, such as smoke, fumes, or yelling, that cause a sore throat.
• Do not smoke or use other tobacco products and avoid exposure to secondhand smoke. For more information, see the topic Quitting Tobacco Use.
• Avoid contact with people who have strep throat.
• If you have mononucleosis, do not share eating or drinking utensils to prevent spreading the virus to others. A brief kiss on the lips is not likely to spread mono; it is spread when saliva from an infected person enters another person's mouth.

To prepare for your appointment, see the topic Making the Most of Your Appointment

You can help your doctor diagnose and treat your condition by being ready to answer the following questions:

• When did your throat symptoms begin?
• Do you have a fever? Describe your fever pattern.
• Do other family members, friends, or coworkers have similar complaints?
• Do you have other symptoms associated with the sore throat, such as a head cold?
• What makes the pain worse?
• Have you had your tonsils removed?
• Have you been diagnosed with strep throat in the past? How long ago? Was it found during a doctor visit, with a rapid strep test or with a throat culture? How was it treated?
• What home treatment have you tried? Did it help?
• What prescription and nonprescription medicines have you tried? Did they help?
• Do you have any health risks?

• Acute Bronchitis
• Allergic Reaction
• Allergic Rhinitis
• Chest Pain
• Chronic Fatigue Syndrome
• Coughs
• Croup
• Ear Infections
• Exposure to Sexually Transmitted Diseases
• Facial Problems, Noninjury
• Fever, Age 3 and Younger
• Fever, Age 4 and Older
• Gonorrhea
• Heartburn
• Infectious Mononucleosis
• Influenza
• Mouth and Dental Injuries
• Mouth Problems, Noninjury
• Mumps
• Pneumonia
• Quitting Tobacco Use
• Respiratory Problems, Age 11 and Younger
• Respiratory Problems, Age 12 and Older
• Sinusitis
• Strep Throat
• Swollen Glands and Other Lumps Under the Skin

Author:	Jan Nissl, RN, BS	Last Updated: February 25, 2008
Medical Review:	William M. Green, MD - Emergency Medicine H. Michael O'Connor, MD - Emergency Medicine
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