Overview
Sore throats are common. Most of the time the soreness is worse in the morning and improves as the day progresses.Like colds, the vast majority of sore throats are caused by viral infections. This means most sore throats will NOT respond to antibiotics. Many people have a mild sore throat at the beginning of every cold. When the nose or sinuses become infected, drainage can run down the back of the throat and irritate it, especially at night. Or, the throat itself can be infected.
Some viruses can cause specific types of sore throat. For example, Coxsackievirus sometimes causes blisters in the throat, especially in the late summer and early fall. Mononucleosis and the flu can also cause specific viral throat infections.
Strep throat is the most common bacterial cause of sore throat. Because strep throat can occasionally lead to rheumatic fever, antibiotics are given. Strep throat often includes a fever (greater than 101°F), white, draining patches on the throat, and swollen or tender lymph glands in the neck. Children may have a headache and stomach pain.
Causes
- Breathing through the mouth (can cause drying and irritation of the throat)
- Common cold
- Endotracheal intubation (tube insertion)
- Flu
- Infectious mononucleosis
- Something stuck in the throat (See: Choking child or adult and CPR)
- Strep throat
- Surgery such as tonsillectomy and adenoidectomy
- Viral pharyngitis
Home Care
Most sore throats are soon over. In the meantime, the following remedies may help:
- Drink warm liquids. Honey or lemon tea is a time-tested remedy.
- Gargle several times a day with warm salt water (1/2 tsp of salt in 1 cup water).
- Cold liquids or popsicles help some sore throats.
- Sucking on hard candies or throat lozenges can be very soothing, because it increases saliva production. This is often as effective as more expensive remedies, but should not be used in young children because of the choking risk.
- Use a cool-mist vaporizer or humidifier to moisten and soothe a dry and painful throat.
- Try over-the-counter pain medications, such as acetaminophen. Do NOT give aspirin to children.
Treatment
Usually, treatment will be delayed until lab test results are known. Doctors will often begin treatment of a sore throat immediately if there is a family history of rheumatic fever, if the patient has scarlet fever, or if rheumatic fever is commonly occurring in the community at the time.
Antibiotics are usually NOT wise if the strep test or throat culture is negative, and they can have serious side effects.
When antibiotics are started, it is important to complete the entire course as directed, even after symptoms improve. Children can return to school or day care 24 hours after antibiotics are started.
For a sore throat caused by infectious mononucleosis, rest and home treatment is recommended. For a sore throat caused by bacterial tonsillitis, antibiotic treatment may be recommended. Some tonsillitis is viral and will clear up without treatment (surgery is rarely necessary). Recurrent or persistent sore throats without bacterial infection may be due to allergies and require anti-allergy treatment.
Prevention
Clean your hands frequently, especially before eating. This is a powerful way to help prevent many sore throat infections. You might avoid some sore throats by reducing contact with people with sore throats, but often these people are contagious even before they have symptoms, so this approach is less effective.
Not too long ago, tonsils were commonly removed in an attempt to prevent sore throats. This is no longer recommended in most circumstances.
A cool mist vaporizer or humidifier can prevent some sore throats caused by breathing dry air with an open mouth.
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