What Causes a Sore Throat (Pharyngitis)? 10 Reasons Your Throat Might Hurt

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 what home remedies may be helpful.

Quiz: Do I have strep throat?

What are some main causes of a sore throat?

Sore throats can be caused by a variety of triggers, from infection to muscle strain. The most common reasons for a sore throat are listed below. 

1. Viral infection (like the common cold, flu, and COVID)

Most sore throats are caused by infections, and the majority of those are caused by viruses. Many different viruses can lead to sore throat. These include:

• Common cold viruses

• Influenza (flu)

• Mono (mononucleosis)

• COVID-19

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. 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 being in certain positions. Along with heartburn, you might also have voice hoarseness or a sensation of frequently needing to clear your throat. 

5. 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.

6. Irritants

Multiple types of environmental irritants have been shown to lead to sore throat, ranging from air pollution to tobacco smoke and chemical fumes. 

7. Muscle strain 

Overuse of the vocal cords — like yelling more than usual — can make you wake up the next day with a painful throat along with hoarseness. It can also make you lose your voice.

EXPERT PICKS: WHAT TO READ NEXT

• Viral vs. bacterial sore throat: Both viruses and bacteria can cause sore throats. And it affects your treatment. Learn how to tell the difference.

• Do you need antibiotics? Even if you have strep throat, do you always need antibiotics for it to go away? Our experts explain what you should know.

• 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 the home treatments that are most effective.

8. 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. 

9. 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 very rare. 

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. 

10. 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’s not 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. 

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 something like 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

• Gargling warm salt water

• 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), H-2 blockers such as famotidine, (Pepcid), and proton-pump inhibitors such as omeprazole (Prilosec). 

How can you prevent a sore throat?

To keep your chances of developing 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.

• Treat your allergies.

• 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.

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Written by:

Karen Hovav, MD, FAAP

Karen Hovav, MD, FAAP, has more than 15 years of experience as an attending pediatrician in a variety of clinical settings. She has worked in a large academic center in an urban city, a small community hospital, a private practice, and an urgent care clinic.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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