About this symptom
A sore throat is pain, scratchiness or irritation in the throat, often worse when you swallow. Most are caused by viruses, such as the ones behind colds and flu, and they usually get better by themselves. Smoking can also cause one.
Bacteria cause fewer sore throats. The best known is strep throat, which a throat swab can identify. Tonsillitis, laryngitis and glandular fever can also cause a sore throat. Along with pain on swallowing there may be bad breath, a mild cough and swollen glands in the neck. Children may have a high temperature and seem less active.
Possible causes
This is not a diagnosis. These are the causes doctors think about, with the ones that are most urgent to rule out first.
- Quinsy (pus collecting behind a tonsil)Rare. A severe sore throat that quickly gets worse, with swelling in the mouth or throat and trouble speaking, swallowing, breathing or opening the mouth. An emergency.
- Strep throatA bacterial infection. Comes on quickly with fever, pain on swallowing, red swollen tonsils, white patches and swollen neck glands. A cough, runny nose or hoarse voice make it less likely.
- TonsillitisRed, swollen tonsils with pain on swallowing, fever, headache and tiredness, sometimes with pus spots or white patches. Usually a virus, sometimes bacteria. Often clears in 3 to 4 days.Read about it
- Common coldA sore, scratchy throat together with a runny nose, a cough or a hoarse voice, which point towards a virus.Read about it
- FluOne of the viruses that can cause a sore throat. If flu is the cause, a doctor may consider antiviral medicine.Read about it
- COVID-19A sore throat can be one of the symptoms, along with fever or chills, cough, tiredness, body aches, or a new loss of taste or smell.Read about it
- Smoking or smoky airSmoking, or breathing in smoke, can cause a sore throat. It tends to feel dry or scratchy, and staying away from smoke helps.
When to get help
See a doctor soon if you have:
- A sore throat that has not improved after a week
- Pus-filled spots or white patches on the tonsils
- Pain so bad that eating or drinking is a struggle, or signs of dehydration such as dark, strong-smelling urine
- A very high temperature or shivering, especially with diabetes or a weakened immune system
- Sore throats that keep coming back
- A lump in the mouth or neck, or a mouth ulcer that has lasted more than 3 weeks
A child under 5 with a sore throat is best seen by a doctor. Otherwise, if you can swallow and drink, a sore throat can usually be managed at home for a few days.
What you can do at home
Do
- Rest and drink plenty of fluids
- Eat cool or soft foods, and keep away from smoke
- Gargle with warm salt water (adults and older children only)
- Use pain relief such as paracetamol if it suits you, or ask a pharmacist
Do not
- Do not give small, hard sweets or lozenges to young children, who can choke on them
- Do not give aspirin to children under 16
- Do not insist on : they do not help most sore throats
Antibiotics usually do not ease a sore throat or speed recovery. Doctors prescribe them only when a bacterial infection is likely.
What the doctor will do
The doctor will ask how long the sore throat has lasted, whether you have a cough, runny nose or fever, and whether you smoke. They will look at your throat and feel your neck for swollen glands.
If strep throat is possible, they may take a swab for a quick test or a throat culture, because symptoms and an exam alone cannot confirm it. Other tests depend on the suspected cause. are used when a bacterial infection is likely, and antiviral medicine may be considered for flu.
Myths and facts
Things people often say about this. Open each one to see what is true.
Myth“A sore throat always needs antibiotics.”What is true?
Fact
Most sore throats are caused by viruses, and antibiotics do not work against viruses. They usually do not ease the pain or speed recovery, so a doctor prescribes them only when a bacterial infection is likely.
Myth“Cold drinks and ice cream cause a sore throat.”What is true?
Fact
Sore throats are caused mainly by viruses, and sometimes by bacteria or smoke. Cool drinks and foods can even soothe the pain. Anything that hurts to swallow can simply be skipped.
Myth“A salt-water gargle cures the infection.”What is true?
Fact
Gargling with warm salt water can ease the discomfort, but it does not cure the infection. The illness usually clears on its own, and young children should not gargle.
Myth“A sore throat that will not go away is just a bad cold.”What is true?
Fact
Most sore throats improve within a week. If yours has not, or you have a lump in the mouth or neck, or a mouth ulcer lasting more than 3 weeks, see a doctor.
Questions to ask your doctor
Tick the ones you want answered and take them with you.
Common questions
How long does a sore throat last?
Most sore throats get better without treatment. Tonsillitis usually clears in 3 to 4 days, though it can last longer. If a sore throat has not improved after a week, see a doctor.
Do I need antibiotics for a sore throat?
Usually not. Most sore throats are caused by viruses, and antibiotics do not help them. A doctor may prescribe antibiotics if a bacterial infection such as strep throat is likely or has been confirmed by a test.
Is a sore throat contagious?
Often, yes. The infections behind many sore throats spread easily among family and close contacts, and they are most common in the colder months. A sore throat caused by smoke is not contagious.
When should I take my child to a doctor for a sore throat?
A child under 5 with a sore throat is best seen by a doctor. Go sooner if the child has a very high temperature, cannot swallow or drink, shows signs of dehydration, or is drooling or struggling to breathe. Those last two signs need emergency care.
