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Sore Throat and Other Throat Problems
Topic Overview
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
Sore throats may be 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).
- An infection of the tissues around the tonsils (peritonsillar abscess).
- Inflammation of the epiglottis (epiglottitis).
- Inflammation of the uvula (uvulitis).
- In rare cases, a sexually transmitted infection (STI), such as gonorrhea or chlamydia. If you have engaged in high-risk sexual behavior, consider whether you may have gonorrhea or chlamydia. For more information, see the topic Sexually Transmitted Infections.
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 GERD 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.
- Myalgic encephalomyelitis/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. For sore throats caused by strep, treatment with antibiotics may be needed.
Check your symptoms to decide if and when you should see a doctor.
Health Tools
Health Tools help you make wise health decisions or take action to improve your health.
Check Your Symptoms
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
- Your age. Babies and older adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
- Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
- Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
- Try home treatment to relieve the symptoms.
- Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
Symptoms of difficulty breathing can range from mild to severe. For example:
- You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
- It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).
Symptoms of difficulty breathing in a baby or young child can range from mild to severe. For example:
- The child may be breathing a little faster than usual (mild difficulty breathing), or the child may be having so much trouble that the nostrils are flaring and the belly is moving in and out with every breath (severe difficulty breathing).
- The child may seem a little out of breath but is still able to eat or talk (mild difficulty breathing), or the child may be breathing so hard that he or she cannot eat or talk (severe difficulty breathing).
Pain in children under 3 years
It can be hard to tell how much pain a baby or toddler is in.
- Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
- Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
- Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.
Pain in adults and older children
- Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
- Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
- Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.
Severe trouble breathing means:
- The child cannot eat or talk because he or she is breathing so hard.
- The child's nostrils are flaring and the belly is moving in and out with every breath.
- The child seems to be tiring out.
- The child seems very sleepy or confused.
Moderate trouble breathing means:
- The child is breathing a lot faster than usual.
- The child has to take breaks from eating or talking to breathe.
- The nostrils flare or the belly moves in and out at times when the child breathes.
Mild trouble breathing means:
- The child is breathing a little faster than usual.
- The child seems a little out of breath but can still eat or talk.
Severe trouble breathing means:
- You cannot talk at all.
- You have to work very hard to breathe.
- You feel like you can't get enough air.
- You do not feel alert or cannot think clearly.
Moderate trouble breathing means:
- It's hard to talk in full sentences.
- It's hard to breathe with activity.
Mild trouble breathing means:
- You feel a little out of breath but can still talk.
- It's becoming hard to breathe with activity.
Temperature varies a little depending on how you measure it. For adults and children age 12 and older, these are the ranges for high, moderate, and mild, according to how you took the temperature.
Oral (by mouth) temperature
- High: 104°F (40°C) and higher
- Moderate: 100.4°F (38°C) to 103.9°F (39.9°C)
- Mild: 100.3°F (37.9°C) and lower
A forehead (temporal) scanner is usually 0.5°F (0.3°C) to 1°F (0.6°C) lower than an oral temperature.
Ear or rectal temperature
- High: 105°F (40.6°C) and higher
- Moderate: 101.4°F (38.6°C) to 104.9°F (40.5°C)
- Mild: 101.3°F (38.5°C) and lower
Armpit (axillary) temperature
- High: 103°F (39.5°C) and higher
- Moderate: 99.4°F (37.4°C) to 102.9°F (39.4°C)
- Mild: 99.3°F (37.3°C) and lower
Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in children are:
- Diseases such as diabetes, cystic fibrosis, sickle cell disease, and congenital heart disease.
- Steroid medicines, which are used to treat a variety of conditions.
- Medicines taken after organ transplant.
- Chemotherapy and radiation therapy for cancer.
- Not having a spleen.
If you're not sure if a fever is high, moderate, or mild, think about these issues:
With a high fever:
- You feel very hot.
- It is likely one of the highest fevers you've ever had. High fevers are not that common, especially in adults.
With a moderate fever:
- You feel warm or hot.
- You know you have a fever.
With a mild fever:
- You may feel a little warm.
- You think you might have a fever, but you're not sure.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:
- Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
- Long-term alcohol and drug problems.
- Steroid medicines, which may be used to treat a variety of conditions.
- Chemotherapy and radiation therapy for cancer.
- Other medicines used to treat autoimmune disease.
- Medicines taken after organ transplant.
- Not having a spleen.
Sudden drooling and trouble swallowing can be signs of a serious problem called epiglottitis. This problem can happen at any age.
The epiglottis is a flap of tissue at the back of the throat that you can't see when you look in the mouth. When you swallow, it closes to keep food and fluids out of the tube (trachea) that leads to the lungs. If the epiglottis becomes inflamed or infected, it can swell and quickly block the airway. This makes it very hard to breathe.
The symptoms start suddenly. A person with epiglottitis is likely to seem very sick, have a fever, drool, and have trouble breathing, swallowing, and making sounds. In the case of a child, you may notice the child trying to sit up and lean forward with his or her jaw forward, because it's easier to breathe in this position.
Babies can quickly get dehydrated when they lose fluids because of problems like vomiting or fever.
Symptoms of dehydration can range from mild to severe. For example:
- The baby may be fussy or cranky (mild dehydration), or the baby may be very sleepy and hard to wake up (severe dehydration).
- The baby may have a little less urine than usual (mild dehydration), or the baby may not be urinating at all (severe dehydration).
Severe dehydration means:
- The baby may be very sleepy and hard to wake up.
- The baby may have a very dry mouth and very dry eyes (no tears).
- The baby may have no wet diapers in 12 or more hours.
Moderate dehydration means:
- The baby may have no wet diapers in 6 hours.
- The baby may have a dry mouth and dry eyes (fewer tears than usual).
Mild dehydration means:
- The baby may pass a little less urine than usual.
If you're not sure if a child's fever is high, moderate, or mild, think about these issues:
With a high fever:
- The child feels very hot.
- It is likely one of the highest fevers the child has ever had.
With a moderate fever:
- The child feels warm or hot.
- You are sure the child has a fever.
With a mild fever:
- The child may feel a little warm.
- You think the child might have a fever, but you're not sure.
Temperature varies a little depending on how you measure it. For children up to 11 years old, here are the ranges for high, moderate, and mild according to how you took the temperature.
Oral (by mouth), ear, or rectal temperature
- High: 104°F (40°C) and higher
- Moderate: 100.4°F (38°C) to 103.9°F (39.9°C)
- Mild: 100.3°F (37.9°C) and lower
A forehead (temporal) scanner is usually 0.5°F (0.3°C) to 1°F (0.6°C) lower than an oral temperature.
Armpit (axillary) temperature
- High: 103°F (39.5°C) and higher
- Moderate: 99.4°F (37.4°C) to 102.9°F (39.4°C)
- Mild: 99.3°F (37.3°C) and lower
Note: For children under 5 years old, rectal temperatures are the most accurate.
A baby that is extremely sick:
- May be limp and floppy like a rag doll.
- May not respond at all to being held, touched, or talked to.
- May be hard to wake up.
A baby that is sick (but not extremely sick):
- May be sleepier than usual.
- May not eat or drink as much as usual.
You can get dehydrated when you lose a lot of fluids because of problems like vomiting or fever.
Symptoms of dehydration can range from mild to severe. For example:
- You may feel tired and edgy (mild dehydration), or you may feel weak, not alert, and not able to think clearly (severe dehydration).
- You may pass less urine than usual (mild dehydration), or you may not be passing urine at all (severe dehydration).
Severe dehydration means:
- Your mouth and eyes may be extremely dry.
- You may pass little or no urine for 12 or more hours.
- You may not feel alert or be able to think clearly.
- You may be too weak or dizzy to stand.
- You may pass out.
Moderate dehydration means:
- You may be a lot more thirsty than usual.
- Your mouth and eyes may be drier than usual.
- You may pass little or no urine for 8 or more hours.
- You may feel dizzy when you stand or sit up.
Mild dehydration means:
- You may be more thirsty than usual.
- You may pass less urine than usual.
You can use a small rubber bulb (called an aspirating bulb) to remove mucus from your baby's nose or mouth when a cold or allergies make it hard for the baby to eat, sleep, or breathe.
To use the bulb:
- Put a few saline nose drops in each side of the baby's nose before you start.
- Position the baby with his or her head tilted slightly back.
- Squeeze the round base of the bulb.
- Gently insert the tip of the bulb tightly inside the baby's nose.
- Release the bulb to remove (suction) mucus from the nose.
Don't do this more than 5 or 6 times a day. Doing it too often can make the congestion worse and can also cause the lining of the nose to swell or bleed.
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
- Call your doctor now to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care in the next hour.
- You do not need to call an
ambulance unless:
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
Seek Care Today
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
- Call your doctor today to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care today.
- If it is evening, watch the symptoms and seek care in the morning.
- If the symptoms get worse, seek care sooner.
Make an Appointment
Based on your answers, the problem may not improve without medical care.
- Make an appointment to see your doctor in the next 1 to 2 weeks.
- If appropriate, try home treatment while you are waiting for the appointment.
- If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
Home Treatment
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 in8 fl oz (240 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 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. But 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 Smoking.
- 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. Be safe with medicines. Read and follow all instructions on the label.
- Use nonprescription throat lozenges.
- Medicated throat lozenges or sprays have medicine (local anesthetic) that numbs the throat to soothe pain.
- Hard candy may also help.
- Think about buying the sugar-free kind.
- Use a decongestant or a steroid nasal spray if you have a stuffy nose (congestion).
- These medicines 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.
- These medicines may not be safe for young children or for people who have certain health problems. Before you use them, check the label. If you do use these medicines, always follow the directions about how much to use based on age and in some cases weight. For more information about medicine safety, see Over-the-Counter Medicine Precautions and Quick Tips: Giving Over-the-Counter Medicines to Children.
Try a nonprescription medicine to help treat your fever or pain: |
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Be sure to follow these safety tips when you use a nonprescription medicine: |
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More 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
Call your doctor if any of the following occur during home treatment:
- Difficulty breathing develops.
- Severe pain develops.
- Inability to drink enough fluids develops.
- A new rash or fever develops.
- Symptoms lasting longer than 2 weeks.
- Symptoms become more severe or more frequent.
Prevention
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 Smoking.
- 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.
Preparing For 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 immunizations have you had?
- 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?
Related Information
Credits
ByHealthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Kathleen Romito, MD - Family Medicine
E. Gregory Thompson, MD - Internal Medicine
Adam Husney, MD - Family Medicine
Current as ofNovember 20, 2017
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