Sore Throat

A sore throat can arise from many different causes and is often the first sign of illness. Sore throats have a variety of causes, such as:

  • viruses (such as colds or mono)
  • bacteria (such as strep)
  • smoking
  • polluted air
  • dry indoor air
  • mouth breathing
  • muscle strain from yelling
  • stomach acid

Sore throat can also be a symptom of hay fever and other allergies.

Strep throat vs. viral sore throat

Strep throat is caused by a type of bacteria called group A strep (GABHS). The pain of strep throat often feels the same as sore throats caused by other bacteria or by viruses. The important difference is that strep infections caused by GABHS may cause rare but serious complications such as heart damage or rheumatic (scarlet) fever.

The vast majority of throat infections are viral and therefore not strep. Approximately 5 to 15 percent of throat infections are caused by strep bacteria. Some bacterial infections require antibiotics, whereas the best treatment for viral sore throat is rest and liquids.


Symptoms of sore throat may include:

  • swollen, red tonsils, often with a white or light-colored coating
  • swollen lymph nodes
  • body aches
  • fever
  • headache

Cold symptoms such as a runny nose or cough may also occur.


If symptoms associated with a bacterial infection are present, a strep throat culture may be performed. In this procedure, a clinician swabs the tonsils and sends the sample to a laboratory where it is tested for GABHS bacteria. Test results are usually available within one to two days. If symptoms are consistent with those for a viral infection, a throat culture is not needed.

If a throat culture is positive for GABHS, you will be contacted by a clinician.

Other kinds of strep bacteria may also be present in culture, but these do not necessarily need antibiotics. Depending on the severity of illness, the clinician may want to further discuss symptoms and appropriate treatment.


Regardless of the cause of the sore throat, observe the following treatment guidelines:

  • Drink plenty of liquids
  • Gargle with warm salt water (one teaspoon salt in one cup of hot water) every few hours to help with pain
  • Cough drops, or hard candy can moisten a dry, irritated throat
  • Sore throat lozenges or sprays to numb the throat
  • Use a vaporizer or hot shower steam to breathe in moist heat
  • Take ibuprofen or acetaminophen for pain as directed. Avoid using aspirin if you are under 20 years old
  • Avoid smoking and smoky areas

Seek medical attention if you…

  • are having trouble breathing or swallowing
  • have white or yellow patches on your tonsils
  • have a sore throat lasts more than 7 days
  • had close physical contact with someone diagnosed with strep recently
  • have a skin rash and a sore throat
  • have enlarged lymph nodes that last for more than 7 days

Safe use of antibiotics

Antibiotics should be avoided if use of them is unnecessary and taken only when prescribed. Overuse of antibiotics can give rise to bacterial strains that are resistant to antibiotics and therefore more difficult to treat. Antibiotics can also lead to other problems such as yeast infections or diarrhea. Rarely, people experience allergic reactions to antibiotics. When taking antibiotics, remember to:

  • Inform the clinician of any allergies and all medications currently being taken.
  • Take antibiotics according to the instructions and for the full time specified, even if symptoms subside before treatment is completed. Patients who stop earlier are more likely to relapse or develop complications.
  • Contact a clinician if any side effects occur during treatment.


To avoid catching or passing illnesses that can lead to a sore throat, follow these health measures:

  • Wash hands often.
  • Avoid touching the eyes, nose, and mouth.
  • Cough or sneeze into a tissue and then throw it away.
  • Eat healthily and stay well-rested.
  • Avoid close contact with people who are sick.
  • Don’t smoke and avoid exposure to secondhand smoke.
  • Stay indoors as much as possible on high pollution days.