Sore Throat (Pharyngitis)

A sore throat (pharyngitis) is a scratchy or burning feeling in the back of your throat. It may hurt to swallow or talk. Most sore throats happen because of a viral infection, like the common cold or flu. In addition to the soreness, you may have symptoms like a cough or runny nose. Most sore throat symptoms go away within three to 10 days.

What is a sore throat?

A sore throat, or “pharyngitis,” is a scratchy, painful feeling in the back of your throat (pharynx). It happens when the tissue lining your throat (mucosa) becomes inflamed. If you have a sore throat, it may hurt to swallow or talk.

Many things cause pharyngitis, from viral and bacterial infections to allergies and sleeping with your mouth open. Most sore throat symptoms go away with home care within a few days. But you should contact a healthcare provider if your sore throat lasts longer than a week, gets worse or you develop symptoms like a fever or swollen lymph nodes.

Types of pharyngitis

There are two main types of pharyngitis. Healthcare providers categorize them based on how long symptoms last:

• Acute pharyngitis: a sore throat that lasts from about three to 10 days. Most sore throats are acute pharyngitis.
• Chronic pharyngitis: a sore throat that lasts for more than 10 days (usually several weeks) or that keeps returning after you get better.

Symptoms and Causes

What are the symptoms of a sore throat?

Pharyngitis may start with a raspy feeling in your throat, as if your throat is dry. If your sore throat gets worse, you may feel a sharp pain in your throat when you swallow or talk. You may feel the pain in your ears or down the side of your neck.

If an infection is causing your sore throat, additional symptoms may include:

• Fever.
• Headache.
• Upset stomach.
• Swollen lymph nodes.
• Nasal congestion (stuffy nose).
• Runny nose.
• Cough.
• Fatigue.
• Hoarseness.
• Redness or swelling in your throat and tonsils.
• White patches, spots, or streaks in your throat and tonsils.

What causes a sore throat?

Most sore throats happen because you have a viral infection, like the common cold or flu. Less often, a sore throat (pharyngitis) may be a sign of the following conditions or issues:

• Bacterial infection: Conditions like strep throat and bacterial sinus infections may cause a sore throat.
• Tonsillitis: Tonsillitis occurs when your tonsils become infected and inflamed. Bacteria and viruses can both cause tonsillitis.
• Allergies: Allergic reactions from pollen, dust mites, pets, or mold can cause mucus from your nose to drip down the back of your throat (postnasal drip). This can lead to a sore throat.
• Acid reflux: People with gastroesophageal reflux disease (GERD) feel burning and pain in their throats. This pain, called heartburn, happens when acid from your stomach backs up into your food tube (esophagus).
• Overuse or irritants: You can strain your throat by yelling or screaming. You may also develop a sore throat if you eat spicy food, smoke, or drink very hot liquids.
• Mouth breathing: You may have a sore throat if you breathe through your mouth instead of your nose when you’re sleeping.
• Tumors: Although a sore throat rarely means cancer, it’s one potential symptom of throat cancer or benign (noncancerous) growths.

Diagnosis and Tests

How is pharyngitis diagnosed?

Your healthcare provider will ask about your symptoms. They’ll perform a physical exam that involves looking at your throat, tongue, and possibly your ears. They may do a strep test to check for the bacteria that causes strep throat.

Testing is important in case your provider can’t tell from your symptoms alone if your sore throat is related to a virus or bacteria. The results determine what treatments you’ll need.

Management and Treatment

How is a sore throat treated?

Treatment depends on what’s causing your pharyngitis. Viral infections usually clear up on their own within a week. In the meantime, your healthcare provider may recommend over-the-counter (OTC) medicines to ease your sore throat.

Other treatments for a sore throat may include:

• Antibiotics: You may need antibiotics to treat a bacterial infection. Most people need to take them for 10 days.
• Over-the-counter antihistamine medications: Antihistamines may dry postnasal drip related to allergies.
• Over-the-counter antacids: Antacids may help with acid reflux that causes heartburn and sore throats. Other steps, like avoiding big meals right before bedtime, may help.
• Prescription mouthwash: For a severe sore throat related to conditions like cancer, your provider may prescribe a special mouthwash (sometimes called “magic mouthwash”) that contains a mix of a numbing agent (like lidocaine), Benadryl®, and Maalox®.

Prevention

How can I prevent a sore throat?

Viral infections like colds and the flu often cause pharyngitis. You can reduce your chances of getting a sore throat by protecting yourself against these common infections. You can:

• Stay up to date on vaccinations for the flu and COVID-19.
• Wash your hands often, using soap and water or alcohol-based sanitizers.
• Avoid sharing food, drinks, or utensils.
• Avoid people with colds or other contagious respiratory infections.
• Avoid being around others when you’re sick to reduce the risk of spreading infectious diseases