When Is a Sore Throat Considered Chronic?
Don’t ignore pain that persists on both sides or one side of your throat. It could be a sign of a serious problem — one that requires medical treatment ASAP.
When you wake up and notice that your throat hurts, just like it did before you went to sleep, you may be tempted to grab some soothing lozenges and hope for the best.
But that approach could backfire: If you have a sore throat every morning, your body might be trying to tell you that something is wrong. Ignoring it could lead to a serious health issue.
A sore throat (medically known as pharyngitis) can take many forms and have many different causes, says Lyndsay Leigh Madden, DO, an otolaryngologist at Atrium Health Wake Forest Baptist in Winston-Salem, North Carolina.
Viral infections are typically the cause, Dr. Madden says, but bacterial infections can also result in sore throat. Plus, there are a number of other explanations for sore throat. All may cause pain on one side of your throat or both sides.
Causes of sore throat include the following.
Tonsillitis This inflammation and swelling of the tonsils is usually caused by a viral infection, according to MedlinePlus. Besides sore throat, symptoms include red and swollen tonsils; trouble swallowing; a white or yellow coating on the tonsils; swollen glands in the neck; fever; and bad breath.
COVID-19 Sore throat is among the most common symptoms of COVID-19, caused by a coronavirus, according to UC Davis Health. Other symptoms include congestion or runny nose and cough.
Flu A case of flu (infection with the influenza virus) can range from mild to life-threatening, and symptoms can come on suddenly. Sore throat is a classic sign of flu, as are cough, runny or stuffy nose, fever (often but not always), and body aches.
Mononucleosis Also known as mono, mononucleosis is usually caused by the Epstein-Barr virus, and can result in a sore throat, fever, and extreme fatigue.
Strep Throat Caused by a type of bacteria called Streptococcus pyogenes (Group A strep), this illness is very contagious. According to the Centers for Disease Control and Prevention (CDC), common symptoms include sore throat that can start very quickly and may look red; fever; pain when swallowing; red and swollen tonsils; white patches or streaks of pus on the tonsils; tiny red spots on the roof of the mouth; and swollen lymph nodes in the front of the neck.
Peritonsillar Abscess Usually a complication of tonsillitis, it is often caused by the same bacteria that cause strep throat. The abscess is a swollen pus-filled pocket that typically forms near one of the tonsils and may cause persistent pain on one side, according to the Icahn School of Medicine at Mount Sinai.
Sexually Transmitted Diseases Sore throat can be a symptom of sexually transmitted diseases such as gonorrhea and chlamydia (bacterial infections) or genital herpes (a viral infection), says Penn Medicine.
Candidiasis Pain when swallowing and difficulty swallowing can occur when a yeast called Candida infects the esophagus (the tube connecting the throat and the stomach). Most people who get esophageal candidiasis have weakened immune systems, such as those living with HIV/AIDS, according to the CDC.
Gastroesophageal Reflux Disease (GERD) GERD can cause chronic sore throat in some people, says Ghassan Samara, MD, otolaryngologist at Stony Brook Medicine in New York. GERD is caused by irritation from stomach acid flowing up into the esophagus, he says.
Allergies Exposure to irritants in the environment (allergens) can cause a person with allergies to experience cold-like symptoms, including sore throat and runny nose, according to the American Academy of Allergy, Asthma & Immunology.
Smoking Smoking or secondhand smoke can lead to painful inflammation in the throat, says the CDC.
Air Pollution Pollutants in the air enter the body through the nose and mouth, causing throat pain and other symptoms and worsening sore throat from viral or bacterial infections, per Penn Medicine.
Other causes of throat pain include lumps, growths, or masses in the throat or the neck, says Madden.
Plus, “There are muscle conditions that can cause patients to have throat pain and even issues with the cervical spine can cause pain, but those are much less common than infectious causes,” she says.
“If your sore throat is severe or lasts longer than a week and is accompanied by difficulty swallowing, breathing, or opening the mouth, you should see a medical provider, according to the American Academy of Otolaryngology guidelines,” says Madden.
Pain in the jaw joint or neck pain, a lump in the neck, or hoarseness that lasts longer than a week should also be checked out, she says. An untreated sore throat that persists for 12 weeks or more should definitely be evaluated, says Madden.
“We want to make sure we’re not missing a cancerous growth. Though it’s not common, it can be a potential — and serious — cause of throat pain,” she says.
The first step to successfully treating a sore throat is identifying the cause.
Viral Infections These days, if you have a sore throat, it’s a good idea to take a COVID-19 test as soon as possible, says Dr. Samara. “If you test positive, you can talk with your doctor to see if they recommend an antiviral treatment,” he says.
COVID-19 — and flu as well — may be treated with antiviral medication if you are at high risk for complications, but most cases do not require any treatment at all, according to the CDC.
Bacterial Infections Strep throat and other bacterial infections require treatment with antibiotics, per the CDC. Your doctor might take a throat culture to verify a strep throat diagnosis and conduct a physical exam as well, says Samara. “When we look in the throat, there are things we can see that point toward a bacterial infection, such as white patches on the tonsils,” he says.
It’s crucial that you receive treatment for strep. This bacterial infection can lead to rheumatic fever, which can cause permanent heart damage, according to the CDC. A simple course of antibiotics (remember to take them all!) can keep strep throat from becoming a serious problem.
GERD Throat pain caused by GERD can be treated by lifestyle changes, surgery, and over-the-counter and prescription medications such as antacids, H2 blockers, or proton pump inhibitors (PPIs), according to the National Institute of Diabetes and Digestive and Kidney Diseases.
Allergies If your allergies are causing postnasal drip, resulting in chronic sore throat, your doctor may prescribe a medication to control allergy symptoms, such as nasal corticosteroids like Flonase (fluticasone). You can also find ways to avoid allergens (often things like mold, pet dander, or pollen) to prevent throat pain and other symptoms.
Other If your sore throat is caused by something other than an infection or allergies, in addition to any medications, treatment may require a procedure or surgery.
Whether or not you’re taking medication, there are steps you can take at home to soothe an itchy, scratchy, painful throat. The CDC offers these tips to relieve throat pain:
It can be hard to pinpoint the cause of a persistent sore throat, but if it doesn’t get any better, you can be sure something’s going on. See your doctor, figure out the cause, and decide on treatments and remedies that best fit your diagnosis.
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