Is your throat scratchy or is it painful to swallow? If you have a sore throat, you’ll likely wonder what’s causing your discomfort and what you can do about it. A sore throat is a common condition that can have many causes.
What causes a sore throat?
Pharyngitis, commonly known as a sore throat, is an inflammation of your pharynx (back of the throat), characterized by painful swallowing and scratchiness.
Pharyngitis is most commonly caused by viruses, accounting for up to 45% of sore throats. The most common viruses causing pharyngitis are adenovirus, rhinovirus, and coronavirus. Other culprits include enteroviruses, influenza A and B, parainfluenza viruses, and respiratory syncytial virus (RSV).
Viral pharyngitis can be accompanied by symptoms of an upper respiratory infection such as cough and nasal congestion. Other clues that a virus is the cause of a sore throat include pinkeye, sneezing, mouth ulcers, and body aches. Fevers may be seen with viral pharyngitis, most often with flu viruses and SARS-CoV-2 (the virus that causes COVID-19).
Bacteria can also cause sore throats. Bacterial causes account for an estimated 5–15% of cases of pharyngitis in adults, with the most common bacterial cause being Group A Streptococcus (GAS) Pharyngitis caused by GAS is commonly referred to as strep throat. Signs and symptoms that may indicate a bacterial cause include a fever of greater than 101o F, white patches on the throat, sudden onset of symptoms, rash, and tender lymph nodes.
There are many other causes of sore throats. Some additional common causes of sore throats include allergies, irritants (such as pollution or secondhand smoke), sinus infections, cold air, and acid reflux. A sore throat is also a symptom of mononucleosis, caused by the Epstein-Barr virus.
Is pharyngitis contagious?
Yes—both viral and bacterial forms of pharyngitis are contagious. Germs that cause pharyngitis live in the nose and throat and are spread by breathing in tiny droplets when an infected person coughs or sneezes. These germs are also passed on when someone shares utensils or touches a contaminated object and then touches their face.
What is the treatment for pharyngitis?
Your healthcare provider will examine you to determine the cause of your pharyngitis. Your healthcare provider will recommend treatment options based on your diagnosis. The most common causes of a sore throat are viruses. Your healthcare provider will need to determine the cause of pharyngitis and rule out other infections, such as COVID-19 infection.
Most sore throats, except for strep throat, do not need antibiotics. Using an antibiotic when it is not indicated places you at risk for unwanted antibiotic side effects and increases the risk of resistant bacteria. Common side effects that arise with antibiotic use affect the GI tract and include nausea, diarrhea, loss of appetite, abdominal pain, and cramping.
Viral pharyngitis is treated with self-care for symptom control—this includes staying hydrated, getting plenty of rest, taking over-the-counter pain relievers (acetaminophen, ibuprofen), topical treatments (lozenges, throat spray, warm tea/soup, honey, popsicles), avoiding tobacco smoke, and using a humidifier to moisten the air. You may also consider gargling warm salt water to alleviate discomfort—use ½ teaspoon of salt mixed with a warm glass of water.
If a bacterial cause is suspected, your healthcare provider may order a lab test to help diagnose strep throat. Your healthcare provider may recommend the same supportive care as viral pharyngitis but may also prescribe antibiotics. Your symptoms are likely to improve within a few days of treatment; however, you should take the entire course of antibiotics to prevent complications and reinfection.
As causes of pharyngitis may vary, it is important you talk to your healthcare provider about the best treatment options for you.
Anthony W. Chow, Shira Doron, “Evaluation of acute pharyngitis in adults,” UpToDate, September 21, 2020.
Jamie Eske, “What is pharyngitis?,” MedicalNewsToday, January 10, 2019, https://www.medicalnewstoday.com/articles/324144
MedlinePlus, “Pharyngitis – viral,” https://medlineplus.gov/ency/article/001392.htm
Michael E. Pichichero, “Treatment and prevention of streptococcal pharyngitis in adults and children,” UptoDate, January 16, 2020.
University of Illinois, “Side Effects of Antibiotics: What They Are and How to Manage Them,” Healthline, April 19, 2019, https://www.healthline.com/health/infection/antibiotic-side-effects
Valencia Higuera, “Everything You Need to Know About Strep Throat,” Healthline, August 30, 2019, https://www.healthline.com/health/strep-throat
Valencia Higuera, “How to deal with a sore throat,” MedicalNewsToday, February 27, 2019, https://www.medicalnewstoday.com/articles/311449
Wendy Stead, “Symptomatic treatment of acute pharyngitis in adults,” UpToDate, July 12, 2020.