Sore Throat - Easing the pain of a sore throat

2012 rev.
The College of Family Physicians of Canada

This information provides a general overview on this topic and may not apply to everyone. To find out if this information applies to you and to get more information on this subject, talk to your family doctor.

What causes sore throats?

Sore throat, or pharyngitis, is an inflammation of the pharynx (the back of the throat between your tonsils and voice box (larynx). It can be caused by many things, including viruses (such as those that cause colds and mononucleosis), yeast and bacteria (such as those that cause strep throat). Other things that can cause a sore throat include smoking, breathing polluted air, drinking alcohol, hay fever, or allergies to pet dander, pollen and mold. Viruses are the most common cause of pharyngitis (sore throat).

What is tonsillitis?

Tonsillitis is inflammation of the tonsils. Your tonsils are located toward the back of your tongue, on each side of your throat. Tonsillitis causes your tonsils to swell and can lead to a sore throat and other symptoms. It's usually caused by a bacterial infection, though sometimes a virus may be involved. Signs of strep throat and tonsillitis are often alike.

If I have tonsillitis, will I need a tonsillectomy?

A tonsillectomy is the surgery used to remove tonsils. Most people who have tonsillitis don't need a tonsillectomy. You might need a tonsillectomy if you get severe tonsillitis often or if your tonsils are too large and cause problems with your breathing or swallowing. Your doctor can tell you if a tonsillectomy is needed.

What is strep throat?

Strep throat is caused by a type of bacteria called Streptococcus. The pain of strep throat often feels much like sore throats caused by other bacteria or by viruses. What's important and different about strep throat is that untreated strep infections can sometimes result in kidney inflammation or rheumatic fever. Rheumatic fever can lead to a rash, inflamed joints, and, in severe cases, damage to the valves of the heart and other organs of the body. Rheumatic fever can be prevented by taking antibiotics for 10 days.

Symptoms of tonsillitis or strep throat

  • Sore red throat
  • Fever
  • Headache
  • Vomiting (usually in children who have strep throat)
  • White patches in your throat or on your tonsils
  • Pain when you swallow
  • Large, red, swollen tonsils
  • Swollen, sore glands in your jaw or throat
  • Abdominal pain (usually in children)

What is mononucleosis?

Mononucleosis (mono) is a viral infection caused by the Epstein-Barr virus. One of the main signs of mono is a sore throat that may last for 1 to 4 weeks. Other signs and symptoms include swollen glands in your neck, armpits and groin, fever and chills, headache, problems breathing, whitish membrane over your tonsils and feeling tired.

How does a bacterial infection differ from a viral infection?

The main difference is that coughing and a runny nose are more common with viral infections. But it's very hard to tell the difference between a viral infection and a bacterial infection. Your doctor may do tests to find out what's causing your sore throat.

What tests may be used to find the cause of my sore throat?

Your doctor may do a rapid strep test, a throat culture, or both. A rapid strep test will give results fast—usually within about 15 minutes. But the test won't tell if your sore throat is caused by bacteria other than Streptococcus or if it's caused by a virus. A throat culture takes longer—between 24 and 48 hours—but it's more accurate. If your doctor thinks you may have mono, he or she will probably do a blood test.

What is the treatment for a sore throat caused by bacteria?

If your sore throat is caused by Streptococcus, your family doctor will likely prescribe an antibiotic called penicillin, taken by mouth for 10 days. Other antibiotics, such as erythromycin, can be used if you're allergic to penicillin. You will most likely begin to feel better in a few days, but it is very important to take all the antibiotics your doctor prescribes to ensure that the infection doesn't come back or cause you other problems. This also helps prevent antibiotic resistance.

What is the treatment for a sore throat caused by a virus?

If your sore throat is caused by a virus, antibiotics won't help. Infections caused by viruses usually just have to run their course. The symptoms will go away as your body gets rid of the virus. Most symptoms caused by a cold-type virus go away in a week to 10 days.

Symptoms caused by mono can last for 4 weeks or more. If you have mono, your doctor will probably suggest that you should get plenty of rest and not exercise too hard (and avoid contact sports to protect your spleen if it becomes temporarily enlarged). You can take acetaminophen (Tylenol), ibuprofen (Advil or Motrin) or naproxen (Aleve) for the sore throat, headache, fever, and other aches.

Easing the pain of a sore throat

These tips can help ease the pain of sore throat.

  • Take acetaminophen (Tylenol) or ibuprofen (Motrin) to relieve pain. Children should not take aspirin. Aspirin can cause a serious illness called Reye’s syndrome when it is given to children younger than 18 years of age.
  • Gargle with warm salt water (1 teaspoon of salt in 1 cup of water).
  • Suck on throat lozenges (low in sugar).
  • Eat soft foods.
  • Suck on flavoured frozen desserts, such as popsicles.
  • Use a humidifier in your bedroom or other rooms you spend lot of time in.
  • Drink lots of fluids. They help keep your throat lubricated and prevent dehydration.

How can I avoid catching or passing a sore throat?

The best ways to avoid catching or passing viruses or bacteria that can lead to a sore throat are to wash your hands often, avoid touching your eyes or mouth, and cover your mouth when coughing or sneezing.

What about a sore throat that's caused by allergies?

If a sore throat is a symptom of hay fever or another allergy, your doctor can help you figure out how to avoid the things that trigger your allergies. You may also need to take medicine for your allergies.

REFERENCES:

1. Chiappini E, Regoli M, Bonsignori F, Sollai S, Parretti A, Galli L, de Martino M. Analysis of different recommendations from international guidelines for the management of acute pharyngitis in adults and children. Clin Ther. 2011 Jan; 33(1):48-58.

2. Wessels MR. Streptococcal pharyngitis. Clinical practice. N Engl J Med. 2011 Feb 17;364(7):648-55.

3. Keith T, Saxena S, Murray J, Sharland M. Risk-benefit analysis of restricting antimicrobial prescribing in children: what do we really know? Curr Opin Infect Dis. 2010 Jun;23(3):242-8.



This health education material was developed and adapted by The College of Family Physicians of Canada from online materials developed by The American Academy of Family Physicians, with permission. It is regularly reviewed and updated by family physician members of the CFPC Patient Education Committee, who refer to the current evidence-based medical literature. Support for this program has been provided by a grant to the CFPC Research and Education Foundation by Scotiabank.

These pages may be reproduced for not-for-profit educational purposes only.

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