Sore throats

Written by: 
Dr Roger Henderson

What causes a sore throat?

Sore throats are one of the most common reasons for people to consult their doctor, but in most cases medication is not needed and 90 per cent of people recover within a week.[1]

In most people with sore throat, the soreness originates primarily in the area around the tonsils, and can be caused by either a viral or a bacterial infectionInvasion by organisms that may be harmful, for example bacteria or parasites. - this distinction is important because it affects whether treatment is required.

Not only can a sore throat be a problem in itself, but it may also be an effect of other illnesses such as flu or glandular fever.

Sore throats tend to be seen most frequently in children and young people [2], but they can occur at any age and the usual symptoms are throat pain and trouble swallowing.

Infection is most frequently caused by a virusA microbe that is only able to multiply within living cells., often the same virusA microbe that is only able to multiply within living cells. that causes colds, but it may also be due to the Epstein-Barr virusA microbe that is only able to multiply within living cells. that causes glandular fever. Such viral infections are spread via airborne droplets and poor hygiene, such as unwashed hands or contaminated surfaces that carry the infectionInvasion by organisms that may be harmful, for example bacteria or parasites. from person to person.

In sore throats caused by bacteriaA group of organisms too small to be seen with the naked eye, which are usually made up of just a single cell., the Streptococcus group A (so-called 'strep throat') is the most common culprit. The incubation period between contracting the infectionInvasion by organisms that may be harmful, for example bacteria or parasites. and the symptoms beginning is usually 2-4 days, but can be less.

What are the symptoms of a sore throat?

Features of a sore throat include pain in the throat (that may spread to the ears) and difficulty in swallowing. The throat looks more red than usual, the tonsils may be swollen and have white spots on them, and the person often has a high temperature and bad breath. Swollen lymph nodesSmall swellings along the lymphatic system that filter lymph, a fluid derived from the blood, and produce antibodies and a type of white blood cells, lymphocytes. under the jaw and neck are common (which is why your doctor feels your neck if infectionInvasion by organisms that may be harmful, for example bacteria or parasites. is suspected).

If the sore throat is due to a viral infectionInvasion by organisms that may be harmful, for example bacteria or parasites., the symptoms are usually milder and similar to those that may occur with the common cold. Occasionally, small blisters may develop on the tonsils and in the soft palate, and are followed by a scab that may be very painful.

A doctor will usually make a diagnosisThe process of determining which condition a patient may have. based on the patient's symptoms and an examination of the throat. However sometimes a swab of the throat and bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. tests are required to identify the cause, as, for example, in cases of glandular fever.

Occasional complications following sore throat include a secondary infectionInvasion by organisms that may be harmful, for example bacteria or parasites. in the ear or sinusesMay describe the air spaces within a bone, or wide channels within the body that contain blood (usually venous blood)., a rash, or an abscessInfection resulting in a collection of pus walled off by inflamed tissues. in the area of the tonsils that usually occurs only on one side (known as a quinsy). In very rare cases, diseases such as rheumatic fever or a kidney disease called glomerulonephritis may develop.

What treatments are available for sore throats?

Fortunately, the vast majority of sore throats caused by viral infections need to be treated only with analgesicsAnother term for painkillers. (painkillers) that bring the person's temperature down as well as easing the symptoms.

The symptoms of a viral sore throat can also be relieved with medicines available from a pharmacist, such as sprays containing antiseptics and anaesthetics to numb the sore area, or antiseptic gargles. These can be bought without a prescription and your pharmacist will be able to advise you about them. Gargling with warm salt water may also help.

In the few people with sore throats caused by bacteriaA group of organisms too small to be seen with the naked eye, which are usually made up of just a single cell., antibioticsMedication to treat infections caused by microbes (organisms that can't be seen with the naked eye), such as bacteria. such as penicillin - or erythromycin in cases of penicillin allergy - may be prescribed.

General tips to help treat sore throats include:

  • If symptoms of a sore throat persist for more than a few days or are severe, with marked difficulty in swallowing, high fever or vomiting, it's advisable to see a doctor
  • Warm drinks and soft food may ease swallowing problems
  • Try to drink plenty of fluids. Regular sips of honey and lemon juice in warm water may be very soothing
  • Gargling with a warm soluble aspirin or warm salt water solution is also a good way to ease throat discomfort (note that aspirin should not be taken by children)
  • Manuka honey has antibacterial properties. Taking one to four teaspoons daily may both reduce throat soreness and speed healing
References: 
  1. 'Oxford Handbook of General Practice'. Oxford University Press. 2nd edition, 2002
  2. 'Sore Throat'. NHS Choices website. Link. Last accessed 17 January 2010.