Have a Sore Throat? 3 Things You Should Know

Whether it’s a dull ache when you swallow or a burning pain that won’t quit, having a sore throat is never pleasant. But depending on its cause, relief may be as simple as sipping tea—or it could require a visit to your doctor.

“A sore throat is really a symptom, and not a diagnosis. How it feels may depend on what caused it, and everybody’s going to experience it a little bit differently,” says Alissa Chen, MD, a Yale Medicine internal medicine specialist. “To one person, it might be a scratchy feeling. To another, it could feel swollen or painful. Or maybe you only notice it when you are eating. In broad terms, a sore throat means you have pain or discomfort at the back of your throat.”

Often, that discomfort is a temporary nuisance that will resolve on its own. But sometimes, it might be a sign of a more serious illness and require treatment.

Most sore throats stem from infections, either viral or bacterial. Common viral culprits include influenza, COVID-19, respiratory syncytial virus (RSV), mononucleosis, and even the common cold. Bacterial infections, on the other hand, often involve group A streptococcus bacteria, commonly referred to as strep. It’s most common in children ages 5 through 15, but adults can get it, too.

A viral sore throat is typically accompanied by respiratory symptoms including stuffy nose, cough, and other cold-like symptoms. Strep throat, by contrast, rarely features these. It tends to appear suddenly with fever and significant throat pain. Swallowing foods and liquids can be uncomfortable, and you might also notice white patches or streaks on your tonsils or swollen lymph nodes in your neck.

“When someone starts to have a sore throat that is new, the main things we are thinking about is infection. If it’s an adult, most likely it will be a virus, though sometimes it’s bacterial,” Dr. Chen explains. “And the way we usually distinguish between them depends on a few things. First, if it’s a virus, it usually will affect more than their throat. It might start there, but there are often other symptoms like cough, runny nose, or maybe chills and a fever. But if it’s strep, the pain is usually localized to the throat, which may look very red and there may be enlarged tonsils and lymph nodes, too.”

If your symptoms suggest strep, a health care provider will likely perform a rapid strep test in the office by using a swab to take a sample from the back of the throat. If the results are negative, a follow-up culture may be sent to a lab for further testing and to rule out a false-negative result. If the test confirms strep throat, antibiotics can clear it up quickly—often easing symptoms within a day or two.

Most viral sore throats, meanwhile, clear on their own within about a week.

If your sore throat lingers for more than a week or feels just as bad as when it started, something else could be to blame, including seasonal allergies and gastroesophageal reflux disease (GERD), Dr. Chen says.

“With allergies, postnasal drip can irritate the throat and cause pain. With reflux, stomach acid can inflame the throat,” Dr. Chen says. “A physical exam helps us figure it out. If I see mucus in the back of the throat, especially if there is a cobblestone pattern down the back of the throat—that can be telling of allergy.”

If GERD or allergies are causing your sore throat, using acid-suppressing medication for reflux, or antihistamines or nasal sprays for allergies, may help relieve symptoms. Lifestyle tweaks, such as avoiding trigger foods or allergens and keeping your throat well-hydrated, can further reduce irritation.

If a sore throat is caused by a virus, the best medical treatment is taking a nonsteroidal anti-inflammatory (NSAID) pain reliever such as ibuprofen.

“This will help the inflammation at the back of the throat. But for those who can’t take NSAIDs, you can also try acetaminophen. It doesn’t reduce the inflammation as well, but it does help pain,” Dr. Chen says.

Additionally, keeping the air around you moist with a humidifier, drinking plenty of fluids, including warm tea, and gargling with a warm saltwater solution can all help, as can throat drops, especially those with benzocaine, such as Cepacol or Chloraseptic, Dr. Chen adds.

“I advise people to try tea with honey, but only to the point that it is helpful. If you try it and it does nothing, then don’t bother,” Dr. Chen says. “None of these things will make you get better sooner, but it makes you feel better. And feeling better is important, of course.”

While most sore throats are caused by minor infections, certain red flags deserve immediate attention. Seek care if you have trouble swallowing, difficulty breathing, a bulge in your throat, or a muffled voice, especially if speaking suddenly takes extra effort. These can signal a more serious bacterial infection or an abscess behind the throat.

“It's also important to visit a health care provider anytime you feel you may need help, even if it seems like just a sore throat. I’m happy to see patients for whatever reason and they shouldn’t hesitate to come in,” Dr. Chen says.