Patient information from BMJ

Sore throat

Last published:Mar 03, 2021

A sore throat can be painful. But it usually clears up on its own after three or four days. While you're recovering, there are things you can do to make yourself feel more comfortable.

You can use our information to talk to your pharmacist or doctor about which treatments are best for you.

What is a sore throat?

You can get a sore throat if your throat is infected with bacteria or a virus. Sore throats are common and are often part of another illness, such as a cold. You might also hear a sore throat called pharyngitis. 'Pharynx' is another word for the throat.

Viruses are the most common cause of a sore throat. Some viruses can cause very severe sore throats. For example, glandular fever (also called infectious mononucleosis) is caused by a virus.

A sore throat caused by bacteria is sometimes called strep throat. This is short for Streptococcus, the most common bacteria to cause a sore throat.

Other infections that can cause sore throats include gonorrhoea and oral thrush (infection with a type of fungus called Candida). However, these are less common. Here, we look at sore throats caused by colds and other common infections.

What are the symptoms?

The pain is usually at the back of your throat and probably feels worse when you swallow. You may also have redness in your throat or white patches at the back of your throat. Some people get a headache or a fever.

Young children sometimes have trouble describing where their pain is coming from. They may point to the part of their body that is hurting.

Most sore throats aren't serious. But you should call your doctor if you or your child has:

• difficulty swallowing or breathing

• a temperature of more than 38°C (about 101°F)

• very tender or swollen glands in the neck

• painful sinuses, or

• a cough with mucus. 

What treatments work?

Most sore throats get better in a few days without any treatment. In the meantime there are things you can try to help you feel more comfortable.

However, if you have strep throat, your doctor will probably recommend antibiotics. Antibiotics kill bacteria. They don't work against viruses, which are the most common cause of sore throats. 

Ways to relieve your sore throat

There are some simple things you can do to help soothe a sore throat, including:

• drinking warm tea with honey. But don't give honey to children under a year old, as there is a chance they could develop a serious illness called botulism

• gargling with salt water

• sucking throat lozenges or hard sweets. But don't give hard sweets or lozenges to young children, because they could choke on them.

Over-the-counter painkillers such as paracetamol and ibuprofen can also help with the pain of a sore throat. These medicines come as tablets you swallow and as chewable tablets and syrups, which are easier for children to take.

Aspirin is another option. But don't give aspirin to children or teenagers. It can very occasionally cause a condition called Reye's syndrome, which affects the brain and liver. 

Aspirin and ibuprofen can irritate the stomach. They can also cause ulcers and bleeding in some people.

Paracetamol doesn't irritate the stomach in the way that aspirin or ibuprofen may. But it's very important not to take too much, because an overdose can damage your liver.

Many cold and flu remedies contain paracetamol, so be careful if you or your child is taking more than one treatment at a time. It's a good idea to talk to your pharmacist if you have any questions or concerns about what's safe. 

Antibiotics

Doctors often prescribe antibiotics for strep throat.

To find out whether someone has strep throat, doctors use a test called a rapid antigen test. This involves having a cotton swab rubbed on the back of your throat to collect a sample of fluid. This sample is then tested for signs of the bacteria that cause strep.

The test is fast, giving results in minutes. But it doesn't catch all cases of strep. If this test is negative for strep, your doctor may do another test called a throat culture. It can take a day or two to get the results from a throat culture. 

If you test positive for strep (either through the rapid antigen test or throat culture) your doctor will probably prescribe antibiotics.

Your doctor may also give you a prescription for antibiotics if you have had a throat culture and are waiting for the results. That way, if your throat culture comes back positive for strep, you can fill the prescription and start taking the antibiotics straight away.

Taking antibiotics for strep can help stop the infection spreading to someone else and will often make you feel better within 24 hours. It can also prevent the infection from causing an ear infection, a throat abscess, and rare problems such as rheumatic fever.

Antibiotics can cause side effects such as an upset stomach, diarrhoea, and a rash.

What will happen to me?

Sore throats usually clear up on their own in a few days. But sometimes the infection that causes a sore throat can lead to other problems. If this happens, you may become hoarse or lose your voice, get an ear infection, or get a sinus infection. If you think you have an ear or sinus infection, see your doctor.