Key takeaways:
A sore throat is often caused by viruses, like the ones that cause the common cold. Other common causes include allergies, acid reflux, and dryness.
There are some easy home remedies — like honey, lemon, and saltwater gargles — that can help relieve sore throat symptoms.
If you think you may have strep throat or have had symptoms that are getting worse instead of better, it’s a good idea to contact your primary care provider.
Sore throats are one of the most common reasons people see a healthcare professional. Most of the time it’s caused by a virus and gets better on its own with time. There are other common causes of sore throats, though. Knowing what to look for can help you figure out if you need to get medical care and which home remedies may be helpful. So, let’s review the most common reasons for a sore throat.
1. Viral infection (like the common cold, flu, and COVID-19)
Most sore throats are caused by infections, and the majority of those are caused by viruses. Many viruses can lead to sore throat. These include:
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2. Bacterial infection (like strep throat)
The most common bacterial cause of sore throats is group A Streptococcus, commonly known as strep throat. Viruses are the cause of throat infections in 90% of adults and children younger than 5 years. But, in children between the ages of 5 and 15, about one-third of infections are caused by strep throat. Strep throat is one of the few times you actually need an antibiotic for a sore throat.
3. Allergies
If you have allergic rhinitis, exposure to things like pollen, grass, or dust can often trigger sneezing, nasal congestion, and cough. When this happens, postnasal drip can make you feel a scratchy, uncomfortable sensation in your throat. Also, if you have an allergic cough, you may feel a sore throat due to irritation from coughing.
4. Sinusitis
Sinus infections are usually caused by viruses. They’re an infection of the open and air-filled spaces in your facial bones. When they get infected, they become filled with mucus. Because this can lead to postnasal drip, sinus infections can cause a sore throat. But this is usually not as noticeable as the other — and often more painful — symptoms. These include:
Facial tenderness
Stuffiness and congestion in the nose and face
5. Reflux (heartburn or indigestion)
Reflux is a common cause of sore throat. If you have reflux, some of the acidic content of the stomach comes up and can go high enough to irritate your throat, especially after meals or when you’re in certain positions. Along with heartburn, you might also have voice hoarseness or a sensation of frequently needing to clear your throat.
6. Dryness
Breathing in dry air can leave your throat feeling scratchy and uncomfortable. This is an especially common cause of sore throat in winter months, when many people have the heater on throughout the day and night. Using a humidifier can be very helpful.
7. Irritants
Multiple types of environmental irritants have been shown to lead to sore throat, ranging from air pollution to tobacco smoke and chemical fumes.
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The best home remedies for a sore throat: Most of the time, you don’t have to see a healthcare professional for a sore throat. So, it helps to know which home treatments are most effective.
8. Muscle strain
Overuse of the vocal cords — like yelling more than usual — can cause you to wake up the next day with a painful throat, along with hoarseness. It can also make you lose your voice.
9. Tonsil stones
Tonsil stones, or tonsilloliths, are small white or yellow pebbles that can form in the crevices of your tonsils. They’re caused by the buildup of small bits of food, minerals, or bacteria. They can cause bad breath along with sore throat, a sensation of something stuck in the back of your throat, and difficulty swallowing.
10. Uncommon infections
There are some uncommon infections that can lead to sore throat. Viruses, such as measles or chickenpox, can cause a sore throat. But, thanks to vaccinations, these infections are less common these days.
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Some sexually transmitted infections (STIs) can also cause sore throat, if you get the bacteria in your throat. Gonorrhea can cause a very severe sore throat. But getting a gonorrhea infection in your throat isn’t common.
11. Tumors
Tumors are a very rare cause of sore throat. They may lead to chronic sore throat (lasting over 2 weeks), along with ear or jaw pain. And they may be accompanied by general symptoms, such as headaches and unexplained weight loss.
What are the symptoms of a sore throat?
A sore throat doesn’t always feel the same. It depends on what’s causing the sore throat and how severe the symptoms are. For example, if you have an infection, you may also have other symptoms with your sore throat. These can include fever, cough, and muscle aches. But sometimes people have sore throats and no other symptoms.
A sore throat can feel like:
A scratchy sensation in your throat
Pain with swallowing
Discomfort with talking
A burning sensation
Swollen glands in your neck
How do you know if your sore throat is caused by a virus or bacteria?
It isn’t always easy to know if a sore throat is caused by a virus or bacteria. Some ways to tell the two apart is by looking at your other symptoms.
Viral sore throat | Bacterial sore throat | |
Hurts to swallow | X | X |
Burning, scratchiness, or pain in the throat | X | X |
Redness in the throat | X | X |
Symptoms can last 7-10 days | X | X |
Runny nose | X | |
Cough | X | |
Body aches | X | |
Hoarse voice | X | |
Mild fever | X | |
Fever higher than 101°F (38.3°C) | X | |
Swollen neck glands | X | |
Pus or white spots on the tonsils | X | |
Pinpoint red or maroon spots in the throat or palate | X | |
Age between 5 to 15 years | X | |
Recent exposure to someone with known strep throat | X |
The best way to know for sure if your sore throat is viral or bacterial is to see your primary care provider. If you’re not sure what’s causing your sore throat, you should see a healthcare professional to get checked for strep throat, flu, or COVID.
What is the treatment for a sore throat?
You might know that your sore throat was caused by an overuse injury. If so, then you may just need to give your throat a little rest and try other overuse treatments that can help you recover faster.
If you have allergies or reflux (heartburn or indigestion), treating that condition should help your sore throat symptoms get better. You can try over-the-counter (OTC) treatments for allergies or reflux. If those don’t seem to help, a healthcare professional can offer prescription-strength options.
You can also help your sore throat feel better by using simple home remedies, like good, old-fashioned honey (see below).
Home remedies
The best home remedies usually rely on things you have at home, such as:
Honey and lemon
Drinking tea (hot or cold, black or green)
Using a humidifier at night while you sleep
OTC treatments
There are a variety of OTC remedies that can help provide relief from your sore throat:
Pain relievers: Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) give temporary relief for a few hours.
Throat-numbing agents: These include numbing sprays and throat lozenges, like Cepacol or Halls.
Demulcents: Often found in cough syrups, demulcents relieve irritation of the mucus membranes in the mouth by forming a protective film.
Antihistamines: These help to stop or even prevent an itchy throat that’s caused by allergies. Common examples are diphenhydramine (Benadryl), loratadine (Claritin), cetirizine (Zyrtec), and fexofenadine (Allegra).
Reflux medications: If your sore throat is caused by reflux, reflux medications can help make your stomach content less acidic and less irritating to your throat. These include antacids, like calcium carbonate (Tums, Rolaids), H2 blockers (such as famotidine, or Pepcid), and proton-pump inhibitors, such as omeprazole (Prilosec).
Quiz: Do I have strep throat?
How can you prevent a sore throat?
To keep your chances of developing a sore throat as low as possible, you should:
Wash your hands frequently.
Use a humidifier at night when sleeping if you’re sensitive to dry air.
Avoid overuse of your vocal cords.
Avoid smoking or overexposure to secondhand smoke.
Wear a mask in public indoor spaces, if you live in a community with high rates of COVID.
Frequently asked questions
The term “sore throat” describes the symptoms of having a painful throat. Strep throat means that the sore throat is caused by a particular bacteria, known as group A Streptococcus. Most causes of sore throat will go away on their own. However, strep throat is treated with antibiotics (such as penicillin or amoxicillin) to prevent complications, like rheumatic fever.
If you have a sore throat but no other symptoms, this might be a sign that your sore throat isn’t a viral infection. Viruses tend to cause other symptoms, like a runny nose, cough, and fatigue. If you still have the sense you’re getting sick, but all your symptoms are in your throat, this could be a sign of a bacterial infection (sore throat).
If you don’t really feel sick at all and just have a sore throat, this could point towards allergies, acid reflux, dryness, or muscle strain — especially if your symptoms are worse in the morning.
There are several reasons your throat hurts more when you wake up. No matter the cause, a sore throat is often made worse by dry air and mouth breathing overnight. If your sore throat is related to postnasal drip (either from allergies or a cold), this also tends to worsen throughout the night as mucus drips into your throat. And acid reflux — another common cause of sore throats — gets worse when you have been laying down for an extended period of time.
Most sore throats are caused by viruses and will resolve on their own. But there are some reasons you should see a healthcare professional for a sore throat, rather than wait it out at home. These include:
Significant pain or difficulty swallowing
Drooling
Pain that gets in the way of eating or drinking
Neck pain or swelling
Fever over 101°F, especially if it lasts longer than a day
Symptoms that don’t get better after a week
And, if you think you may have strep throat based on the signs and symptoms outlined above, it’s a good idea to see your primary care provider to see if you need antibiotics.
The term “sore throat” describes the symptoms of having a painful throat. Strep throat means that the sore throat is caused by a particular bacteria, known as group A Streptococcus. Most causes of sore throat will go away on their own. However, strep throat is treated with antibiotics (such as penicillin or amoxicillin) to prevent complications, like rheumatic fever.
If you have a sore throat but no other symptoms, this might be a sign that your sore throat isn’t a viral infection. Viruses tend to cause other symptoms, like a runny nose, cough, and fatigue. If you still have the sense you’re getting sick, but all your symptoms are in your throat, this could be a sign of a bacterial infection (sore throat).
If you don’t really feel sick at all and just have a sore throat, this could point towards allergies, acid reflux, dryness, or muscle strain — especially if your symptoms are worse in the morning.
There are several reasons your throat hurts more when you wake up. No matter the cause, a sore throat is often made worse by dry air and mouth breathing overnight. If your sore throat is related to postnasal drip (either from allergies or a cold), this also tends to worsen throughout the night as mucus drips into your throat. And acid reflux — another common cause of sore throats — gets worse when you have been laying down for an extended period of time.
Most sore throats are caused by viruses and will resolve on their own. But there are some reasons you should see a healthcare professional for a sore throat, rather than wait it out at home. These include:
Significant pain or difficulty swallowing
Drooling
Pain that gets in the way of eating or drinking
Neck pain or swelling
Fever over 101°F, especially if it lasts longer than a day
Symptoms that don’t get better after a week
And, if you think you may have strep throat based on the signs and symptoms outlined above, it’s a good idea to see your primary care provider to see if you need antibiotics.
The bottom line
Though there are many reasons for sore throat, viral infection is the most common. Most causes of sore throat aren’t dangerous and will respond well to home-based remedies, such as honey, tea, fluids, or over-the-counter (OTC) medications. If your symptoms feel more severe or persistent, it’s important to see a healthcare professional. They can test you for conditions like a bacterial infection, strep throat, or COVID-19.
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References
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Cleveland Clinic. (2023). Laryngopharyngeal reflux (LPR).
Eccles, R., et al. (2017). Soothing properties of glycerol in cough syrups for acute cough due to common cold. Pharmacy.
Familydoctor.org. (2022). Allergic rhinitis (allergies).
Palm, J., et al. (2018). Efficacy and safety of a triple active sore throat lozenge in the treatment of patients with acute pharyngitis: Results of a multi-centre, randomized, placebo-controlled, double-blind, parallel-group trial (DoriPha). International Journal of Clinical Practice.
Penn Medicine. (2023). Pharyngitis - Sore throat.
Renner, B., et al. (2012). Environmental and non-infectious factors in the aetiology of pharyngitis (sore throat). Inflammation Research.
Reynolds, L. (2020). How to avoid overusing and abusing your voice. University Hospitals.
Vincent, M. T., et al. (2004). Pharyngitis. American Family Physician.
Worrall, G. J. (2007). Acute sore throat. Canadian Family Physician.
