How to Know When to See a Doctor for a Sore Throat

Every day, thousands of people in the U.S. wake up with a sore throat. In the U.S., there are an estimated 12 million visits a year to see a healthcare professional for a sore throat. And for good reason: A sore throat can be pretty uncomfortable and can make it painful to swallow. 

But do you have to go to see a healthcare professional every time you or your child has a sore throat? There are cases when you can save yourself the time and money and take care of your symptoms at home. Let’s take a look at how you can tell the difference.

What causes a sore throat?

A sore throat can have several different causes. The most common causes are:

• Infection: Both viruses and bacteria can infect the back of the throat. This can happen as part of an upper respiratory tract infection, like with the flu or common cold. Or the infection may only affect the throat, as is the case with strep throat. (More detail on this below.) 

• Allergies: Seasonal allergies or allergic rhinitis can also cause a sore throat. This happens when drainage from the back of the nose drips into the throat. This can cause inflammation in the throat that feels similar to an infection. 

• Acid reflux: Sometimes the stomach acid that causes heartburn can also affect the throat. If the acid travels far enough up the esophagus, it can irritate the back of the throat.

How to tell the difference between viral vs. bacterial throat infection

Many viruses can cause a sore throat. This is a symptom that often goes along with the common cold, the flu, and COVID-19. A virus also causes mono, another infection that’s associated with a sore throat. 

When your sore throat is due to a virus, there’s a good chance you might also have:

• Cough

• Runny nose

• Eye drainage or redness

• Fever

• Swollen lymph nodes in the neck

• Hoarse voice

If you have a sore throat, a bacterial infection is less likely to be the cause. 

But when bacteria do cause a sore throat, the culprit is likely Group A streptococcus. The resulting infection is known as strep throat. It accounts for about 10% of sore throats in adults and 30% in children. It can be hard to know if you have strep throat based on symptoms alone. 

When your sore throat is due to bacteria, you’re more likely to have:

• Sore throat that starts suddenly

• Red, swollen tonsils 

• Pus on the tonsils 

• Red spots on the roof of the mouth or back of throat

• Fever 

• Abdominal pain

• Headache

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• Best foods for a sore throat: Soft foods — like yogurt, oatmeal, and eggs — can be soothing. Learn about the best and worst foods to eat when your throat hurts.

• Over-the-counter (OTC) remedies for sore throat: Whether you pick cough drops or throat sprays, you have plenty of options to help ease throat pain. Learn about OTC and at-home treatments for sore throat. 

• Strep throat and its spread: Strep throat is very contagious. Learn about how long it takes to stop being contagious, with and without treatment.

When to see a doctor for your sore throat

Not every sore throat has to be evaluated by a healthcare professional. A virus causes most sore throats, and there’s no specific treatment that’ll cure the infection. 

But it’s a good idea to get evaluated if you have these symptoms:

• A sore throat that gets worse, rather than better, after 2 to 3 days 

• A fever over 101°F

• Trouble breathing

• Trouble swallowing or drooling

• Any type of rash, especially if it covers a large part of the body

• Swelling in the neck or jaw

All of these can be signs of a bacterial infection, and antibiotics can help shorten the length of time you're sick. Antibiotics can also help treat or prevent a complication from a bacterial infection. Some examples include: 

• A peritonsillar abscess: This is a collection of pus near the tonsils. Sometimes it needs to be drained. 

• A blood infection: If the bacteria gets into your blood, it can make your whole body sick. This is more likely in people with a weaker immune system.

• Rheumatic fever: Thanks to antibiotics, this is now a very rare complication of strep throat. Rheumatic fever can cause swelling in your joints, brain, skin, and heart. It’s more common in children than adults. 

• Epiglottitis: This is also rare these days. This is a throat infection that can sometimes spread to the epiglottis (a flap of tissue that covers your airway). And when it gets infected, it can make it difficult to breathe. 

What will your doctor do for a sore throat?

When you see a healthcare professional for a sore throat, the first thing they’ll do is look in the back of your throat and examine your neck. Many times, they can figure out what’s causing your sore throat from your symptoms and a physical exam.

For diagnosis, you may also receive: 

• A throat swab: A rapid test can check for strep bacteria and get results within 15 minutes. The swab may also be sent for a culture, which takes 1 to 3 days.

• A nasal swab: This can help figure out if COVID-19 or flu is causing your symptoms.

• Blood tests: If your provider suspects mono, you may need a blood test to diagnose this. 

• Imaging: It’s rare that someone needs an X-ray or CT scan for a sore throat. But these tests can be used to diagnose deeper or more serious infections that the naked eye can’t see.

For treatment, a healthcare professional may recommend:

• Antibiotics: If you do have strep throat, antibiotics can help shorten the time you have symptoms and prevent complications. Also, after 24 hours of starting antibiotics, you’re a lot less contagious.

• Fluids: Some people can get dehydrated if their sore throat prevents them from eating or drinking. 

What can you do at home for a sore throat?

Since most sore throats are from a virus, there’s no specific medication that’ll make it go away. You just need to give your body time to fight off the infection. 

But there are still several home treatments for a sore throat that’ll help you feel better:

• Lozenges: Throat lozenges and even hard candies can help soothe a sore throat. Don’t use these in children younger than 5 years of age, since lozenges and hard candies can be a choking hazard.

• Cold or iced drinks: Drinking cold fluids can soothe your throat and help you stay hydrated. When you have a sore throat, cold drinks are also easier to swallow. Avoid carbonated or acidic drinks, since these can make your throat hurt more. 

• Popsicles: These are a great alternative to cold drinks. An average ice pop equals about 1 oz of fluid.

• Over-the-counter (OTC) pain medications: Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help with the discomfort. 

• Throat sprays: Chloraseptic sprays can help numb a sore throat. But they aren’t recommended for children under 3 years of age. 

• Honey and lemon: This home remedy is used widely across cultures. There’s even scientific evidence that both honey and lemon can prevent bacteria growth. Though there haven’t been studies to prove honey and lemon works to cure a sore throat, at the least, it may feel soothing.

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Written by:

Jill L. Jaimes, MD

Jill L. Jaimes, MD, is a board-certified pediatric emergency medicine physician with over 20 years of clinical experience. She received her medical degree from Baylor College of Medicine and completed her residency and fellowship training at Texas Children’s Hospital.

Edited by:

Katie E. Golden, MD

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

Reviewed 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.

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