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February 27, 2023

Common causes of sore throats

…and when you should be concerned

Illness Sore Throat

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Sore throats are a common medical concern. They are responsible for two percent of all outpatient visits by adults to primary care doctors, and five percent of all outpatient visits by children to pediatricians.

Sore throats are usually caused by something that doesn’t present a major health problem, such as an allergy or a cold. However, they also can be symptoms of more serious illnesses, such as COVID-19, strep throat, or mononucleosis.


Sore throats generally are caused by one or more of five things:

  1. Allergies
  2. Irritants (such as smoke or air pollution)
  3. Viruses (which are responsible for colds, flu, and COVID-19)
  4. Bacteria (such as the ones that cause strep throat)
  5. Fungi

Sore throats may also be caused by strained throat muscles, gastroesophageal reflux disease (GERD), HIV, or cancer.

When to see a doctor

If you have a sore throat that isn’t causing too much discomfort, you may not need to see a doctor. If it’s severe, or lasts more than the five to 10 days of a typical cold or flu, you should seek medical attention.

Other signs you should see a doctor include:

• Difficulty breathing, swallowing, or opening your mouth
• Swelling of the face or neck
• A lump in the neck
• A temperature higher than 101 degrees
• Earache
• Joint pain
• A rash
• Blood in your saliva or phlegm

If your child has a sore throat, you should call their pediatrician if it doesn’t go away after they drink something in the morning. Seek immediate medical attention if your child seems extremely ill, has difficulty breathing, or has so much trouble swallowing that they’re drooling.

What your doctor will do

To treat a sore throat, a doctor will first try to discover its cause. They usually will do this by giving you a physical exam and looking at the back of your throat.

If the doctor thinks your sore throat might be caused by a bacterial infection, they will swab the back of your throat. A rapid test is usually performed immediately to check for strep throat. They will also send a sample to a lab for more reliable testing. Results are usually available within 24 to 48 hours.

If your doctor thinks you might have mononucleosis, they will order a blood test to confirm the cause.


If your sore throat is caused by a cold or flu, you usually just have to wait for the virus to run its course. In the case of a severe flu, you might be prescribed an antiviral medication.

Antiviral medications may also be provided for sore throats caused by COVID-19 or a severe case of respiratory syncytial virus (RSV). While RSV is rarely serious in adults, people with a severe case may need to be given oxygen via a mask or ventilator, or fluids by intravenous (IV) administration. Doctors may also have to insert a thin tube into your lungs to remove mucus from your airway.

Strep throat can be treated with antibiotics, as can tonsillitis, if it’s caused by bacteria and not by a virus. Both diseases are more common in children than adults.

Mononucleosis, which occurs mostly among teenagers and young adults, is an extremely contagious illness caused by a virus spread through saliva. If it’s severe, doctors may treat the organs it affects. Otherwise, treatment involves getting rest, drinking plenty of fluids, and taking over-the-counter medications for pain and fever. If you have mononucleosis, avoid kissing people and sharing food, utensils, dishes, or glasses with others until you are better.

Rest, fluids, and over-the-counter pain relievers and antihistamines are good treatments for sore throats, regardless of their cause. The fluids can be hot or cold, depending on your preference. Ice or popsicles may also provide relief. Other treatment methods include gargling with a mixture of water and salt or baking soda; steam and humidity, via either a shower or humidifier; and throat lozenges.

Those types of treatments are sufficient for most sore throats. If you have a sore throat that’s severe or won’t go away, however, you should see a doctor to find out if additional treatment is necessary.

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