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Sore Throat

(Pharyngitis; Tonsillopharyngitis; Throat Infection)

Definition

A sore throat is the general name for two common conditions:
  • Pharyngitis—swelling and inflammation of the pharynx (the back of the throat, including the back of the tongue)
  • Tonsillopharyngitis—swelling and inflammation of the pharynx and the tonsils (soft tissue that makes up part of the throat's immune defenses)
Sore Throat Due to Inflammation
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Causes

Many things can cause a sore throat, such as:
  • Infection with a virus, such as the viruses that cause influenza (the flu) and the common cold
  • Infection with bacteria, such as the bacteria that cause strep throat
  • Infectious mononucleosis
  • Mucus from your sinuses that drains into your throat
  • Smoking
  • Breathing polluted air
  • Drinking alcoholic beverages
  • Hay fever or other allergies
  • Acid reflux from the stomach
  • Food debris collecting in small pockets in the tonsils

Risk Factors

Sore throats are more common in certain people. However, anyone can get a sore throat. Risk factors that may increase your chance of getting a sore throat include:
  • Age: children and teens, and people aged 65 or older
  • Exposure to someone with a sore throat or any other infection involving the throat, nose, or ears
  • Exposure to cigarette smoke, toxic fumes, industrial smoke, and other air pollutants
  • Having hay fever or other allergies
  • Having other conditions that affect your immune system, such as AIDS or cancer

Symptoms

Along with the sore throat, you may have other symptoms, such as:
  • Pain or difficulty when swallowing
  • Difficulty breathing
  • Fever
  • Enlarged lymph nodes in your neck
  • Hoarse voice
  • Red or irritated-looking throat
  • Swollen tonsils
  • White patches on or near your tonsils
  • Runny nose or stuffy nose
  • Cough

When Should I Call My Doctor?

Call your doctor if you:
  • Experience a worsening of your sore throat or the symptom lasts longer than you or your doctor expect
  • Have difficulty swallowing or breathing
  • Have developed other symptoms, such as:
    • White patches on tonsils (may be a sign of strep throat)
    • Enlarged lymph nodes on your neck
    • Dizziness or lightheadedness
    • Earache
    • Nausea or vomiting
    • Fever
    • Rash
    • Muscle or joint aches
    • Fatigue
    • Blood in saliva
The American Academy of Pediatrics suggests calling your child's doctor if your child has a sore throat that continues through the day (no matter what other symptoms are present).
If you think you have an emergency, get medical care right away.

Diagnosis

Your doctor will do a physical exam. This involves looking closely at your mouth, throat, nose, ears, and the lymph nodes in your neck.
  • This physical exam may include:
    • Using a small instrument to look inside the nose, ears, and mouth
    • Gently touching the lymph nodes (glands) in your neck to check for swelling
    • Taking your temperature
    • Examining your ears
  • The doctor will ask questions about:
    • Your family and medical history
    • Recent exposure to someone with strep throat or any other infection of the throat, nose, or ears
  • Other tests include:
    • Rapid strep test or throat culture—using a cotton swab to touch the back of the throat to check for strep throat
    • Blood tests —to identify conditions that may be causing the sore throat
    • Mono spot test (if mononucleosis is suspected)

Treatment

Treatment depends on the cause of the sore throat. Options include:

Medications

  • Antibiotics for strep throat
  • Drugs to reduce sore throat pain. These drugs include:
    • Ibuprofen (Motrin, Advil)
    • Acetaminophen (Tylenol)
    • Note : Aspirin is not recommended for children or teens with a current or recent viral infection. This is because of the risk of Reye's syndrome . Ask your doctor which other medicines are safe for your child.
  • Numbing throat spray for pain control
  • Decongestants and antihistamines to relieve nasal congestion and runny nose
  • Throat lozenges
  • Corticosteroids (used in combination with antibiotics for severe cases)

Home Care

  • Get plenty of rest.
  • Drink plenty of water.
  • Gargle with warm salt water several times a day.
  • Drink warm liquids (tea or broth), or cool liquids.
  • Avoid irritants that might affect your throat, such as tobacco smoke and cold air.
  • Avoid drinking alcohol.

Prevention

Here are ways to reduce your chance of getting a sore throat:
  • Wash your hands frequently. Do this especially after blowing your nose or after caring for a child with a sore throat.
  • If someone in your home has a sore throat, keep their eating utensils and drinking glasses separate from those of other family members. Wash these objects in hot, soapy water.
  • If a toddler with a sore throat has been sucking on toys, wash the toys in soap and water.
  • Immediately get rid of used tissues, and then wash your hands.
  • If you have hay fever or another respiratory allergy, see your doctor. Avoid the substance that causes your allergy.

RESOURCES

American Academy of Pediatrics http://www.aap.org

National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov

CANADIAN RESOURCES

Canadian Society of Otolaryngology http://www.entcanada.org

Health Canada http://www.hc-sc.gc.ca

References

Brink AJ, Cotton MF, et al. Guideline for the management of upper respiratory tract infections. S Afr Med J . 2004;94:475-483.

Carson-DeWitt R. Common cold. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary . Updated September 1, 2011. Accessed February 21, 2011.

The difference between a sore throat, strep and tonsillitis. Healthy Children.org website. Available at: http://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/Pages/The-Difference-Between-a-Sore-Throat-Strep-and-Tonsillitis.aspx . Updated January 30, 2012. Accessed February 27, 2012.

DynaMed Editorial Team. Streptococcal pharyngitis. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated October 12, 2010. Accessed November 10, 2010.

Editorial staff and contributors. Strep throat. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary . Updated September 20, 2011. Accessed February 21, 2011.

Mayo Clinic. Sore throat. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/sore-throat/DS00526 . Updated October 1, 2007. Accessed June 15, 2008.

Neff D. Discharge instructions for strep throat. EBSCO Patient Education Reference Center (PERC) website. Available at: http://www.ebscohost.com/nursing/products/patient-education-reference-center . December 30, 2011. Accessed February 21, 2011.

Patient UK. Sore throat. Patient UK website. Available at: http://www.patient.co.uk/health/sore-throat . Accessed November 10, 2010.

Perkins A. An approach to diagnosing the acute sore throat. Am Fam Physician . 1997;55:131-138,141-142.

Sore throat. Family Doctor.org website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/sore-throat.html . Updated March 2009. Accessed November 10, 2010.

Throat problems. Family Doctor.org website. Available at: http://familydoctor.org/familydoctor/en/health-tools/search-by-symptom/throat-problems.html . Accessed February 21, 2011.

Vincent MT, Celestin N, et al. Pharyngitis. Am Fam Physician . 2004;69:1465-1470.

11/10/2009 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Hayward G, Thompson M, Heneghan C, Perera R, Del Mar C, Glasziou P. Corticosteroids for pain relief in sore throat: systematic review and meta-analysis. BMJ . 2009;339.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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