“Sore throats are very common with a viral infection and do not necessarily mean you need antibiotics,” says Stacey L. Silvers, MD, a board-certified otolaryngologist at Beth Israel Medical Center in New York City. “With congestion from a cold, nasal breathing can dry out the throat, worsening throat discomfort.” Although it’s less common, a sore throat can be due to other causes that sometimes require a trip to the doctor. Learn the possible reasons for a prolonged or severe sore throat and the appropriate plan of action. Here are the most likely culprits: The Common Cold (Viral Pharyngitis) Given we’re surrounded by viruses on trains and buses, at the mall, and in the office, no matter how often we wash our hands we can still get sick. “Symptoms of the common cold include sore throat, nasal congestion, postnasal drip, and cough,” says Cristina Cabrera Muffly, MD, a board-certified otolaryngologist at the Cleveland Clinic’s Head & Neck Institute. Most colds last three to seven days, she says. Generally speaking, colds resolve themselves on their own and don’t merit a visit to the doctor. Strep Throat Unlike the common cold, strep throat is caused by the streptococcus bacteria and needs a doctor’s treatment, usually in the form of antibiotics. Strep throat symptoms can feel similar to those of a cold, but they also include fever and swollen tonsils. Strep throat is the cause of about 25 percent of sore throats in children and 10 percent in adults. If your doctor suspects you have strep throat, he or she will probably do a throat culture to confirm the diagnosis before prescribing antibiotics. Allergies Another sore throat culprit, allergies cause nasal stuffiness, which can lead to mouth breathing and a dry mouth and throat. Postnasal drainage can also contribute to your cough and sore throat. Although the symptoms of a sore throat caused by allergies and a sore throat caused by a cold are similar, there are some clues that can help you distinguish between the two. “The difference between the common cold and allergies is that allergies are usually present seasonally for several weeks at a time and are due to the body’s reaction to allergens, not viruses,” says Dr. Muffly. “Allergens can also cause itchy, watery eyes and rashes.” A Climate With Overly Dry Air Some people may experience sore throats from breathing air that’s too dry, like when you travel to a particularly dry climate or when indoor humidity falls too low during dry winter months. Generally speaking, however, this won’t bother you if you tend to breathe through your nose, as the nose moisturizes incoming air. Acid Reflux In some cases, a lingering sore throat may be the result of something totally unexpected — acid reflux. “A sore throat can come from inflammation from acid refluxing from the esophagus into the upper region of the throat,” says Lisa A. Liberatore, MD, a board-certified ear, nose, and throat specialist at Lenox Hill Hospital in New York City. “This can be detected on the ear, nose, and throat exam through the use of a flexible scope.” Sore Throat Relief Regardless of the cause, the same simple remedies can help soothe a sore throat. Using a humidifier, drinking tea with honey and lemon, and gargling with salt water may offer temporary relief. Staying well-hydrated, avoiding smoky environments, taking over-the-counter pain relievers or antihistamines, and using cough drops are more long-term home remedies. Ultimately, common sense is the key to caring for a sore throat. Your achy throat will usually resolves itself, but if it is accompanied by a fever or swollen glands, seek medical care for a strep-throat culture and possibly antibiotics. Keep in mind that if your sore throat lasts longer than a week or you have additional unusual or severe symptoms (such as difficulty swallowing or breathing) you should see a doctor to rule out anything serious.
