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Sore throat

A sore throat does not usually require treatment and tends to resolve itself within a week. It’s usually caused by a viral infection such as the rhinovirus or influenza virus. Sore throats are very common, and aren’t typically an indication of a serious condition.

  • Can be painful and irritating, leading to coughing
  • Often caused by the common cold and other viral infections
  • Usually do not require treatment but antibiotics may be necessary

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Possible causes

What causes a sore throat?

The sensation of a sore throat will usually develop quickly and subside over the course of a week, although it can persist. A sore throat is caused by inflammation in one of the following four areas of the throat: the pharynx, tonsils, larynx or epiglottis.

Common causes

  • Viruses such as cold or flu 
  • Tonsillitis - inflammation of the tonsils; it’s characterised by white spots on the tonsils and pain when swallowing.
  • Strep Throat - a bacterial infection where the glands in the neck become swollen.
  • Glandular fever - a viral infection leading to swollen glands in the neck.
  • Laryngitis - irritation of the vocal cords, resulting in hoarseness.

Other causes (rare)

  • Quinsy - a complication of tonsillitis, consisting of a build up of pus at the back of the throat which can be severely painful, and lead to difficulty swallowing.
  • Epiglottitis - when tissue at the back of the throat becomes inflamed.

Diagnosing the cause of a sore throat

A doctor will look to establish if there are other symptoms accompanying a sore throat. For example, if there is a headache or fever present, which would suggest an upper respiratory tract infection. If the voice is hoarse, it could be due to an issue with the larynx.

Clarity on how long you have had the sore throat for and the severity of the pain, or how irritating it’s been, will also be sought. A doctor will make sure that no other symptoms of a systemic illness are present, such as a rash, and will ask you about what medication you have recently been taking, if any.

Having determined a patient’s history, a doctor is likely to examine the throat for signs of redness in the tonsils and pharynx, and if there is any swelling. They will also check for signs of exudate, which is a fluid that often seeps out of the throat when it’s inflamed or infected.

A bright red rash on the body can be indicative of scarlet fever, which may in turn suggest that a streptococcus infection, or strep throat, is present. If a sore throat is accompanied by enlarged lymph nodes then a doctor may also suspect glandular fever.

It’s unlikely that a doctor will need to perform any tests, as patient history and an examination should be sufficient for a diagnosis. There is some disagreement amongst practices across the world regarding tests for a suspected bacterial sore throat. On the one hand it’s considered important not to prescribe antibiotics unnecessarily, while on the other the time between collecting a swab and getting the results can be significant. 

This does not apply to prolonged or recurring symptoms, as further investigation is recommended in these cases.

In the UK, throat swabs are not generally advised for routine tests but can be helpful for a potential high risk group. If glandular fever is suspected, a doctor may decide to get a full blood count. A rapid antigen test may be recommended and is a common test for a suspected case of bacterial pharyngitis.

If you would like to speak to one of our GPhC-registered clinicians online about getting a sore throat diagnosed, you can use our video consultation service, which is available between 9.30am and 4.30pm, from Monday to Friday. Our clinicians can issue referrals to specialists or prescriptions where appropriate, as well as provide advice about your symptoms and treatment options. 

Page last reviewed:  11/06/2020
Types of Treatment

What you can do to help a sore throat

It’s important to drink enough fluids to avoid dehydration, and some people find that taking lozenges and hard boiled sweets can help to soothe the throat. 

There is no evidence that using a saline solution such as Benzydamine has any effect. It is also advisable not to drink alcohol with a sore throat as it can lead to further irritation.

What treatments are there for a sore throat?

In most cases, treatment for a sore throat focuses on alleviating the pain with practical measures, and taking over-the-counter medications such as paracetamol and ibuprofen.  A doctor will usually determine that a sore throat is a result of a self-limiting underlying condition that will pass. 

For sore throats with a bacterial cause, you should note the following three methods on how best to proceed with antibiotics:

  1. Don’t take any and instead allow the immune system to tackle the infection, as antibiotics are unlikely to have an effect on symptoms.
  2. Refrain from using antibiotics initially. If the situation changes however (for example, if the sore throat persists for more than a week) consider taking them.
  3. Antibiotics should be prescribed immediately for people who are immunocompromised or showing indications of a system illness.

According to the National Institute for Health and Care Excellence (NICE) guidelines, the recommended course of antibiotics for bacterial causes of sore throats is phenoxymethylpenicillin for 10 days, or erythromycin or clarithromycin for five days. A doctor is likely to provide you with an urgent referral if the sore throat is accompanied by breathing difficulties, or if there is a clear systemic illness or severe dehydration apparent.

A sore throat is usually a self-limiting condition, and it can also be painful and irritating. If you are worried about your sore throat, one of our GMC-registered clinicians may be able to help. They can advise you on whether your symptoms warrant further investigation or if your sore throat is unlikely to persist. They are available for consultations between 9.30am and 4.30pm, five days a week.

Page last reviewed:  11/06/2020
Questions and Answers

How long is it normal to have a sore throat for?

A sore throat usually lasts for no longer than a week. This is because the most common causes are minor illnesses such as a cold or flu.

However, it is possible for a sore throat to persist. This doesn’t necessarily mean that it’s serious, as it could simply stem from a seasonal allergy, but some accompanying symptoms can be indicative of a more severe condition.

Is a sore throat serious?

A sore throat is not usually reflective of a serious condition. 

In some cases, a stiff neck with a sore throat can be symptomatic of meningitis, which is an infection of the membranes that surround the brain. 

Symptoms such as drooling can be serious because it means there is difficulty swallowing; it’s an indication of epiglottitis, which requires urgent hospital referral.

Can I get treatment for a sore throat?

Treatment for a sore throat usually takes the form of basic measures that can be conducted at home. Staying hydrated, sucking lozenges and avoiding alcohol can all help with a sore throat.

Antibiotics may also be prescribed in the event of a bacterial infection, if a doctor deems it necessary.

How can I prevent a sore throat?

It is not always possible to prevent a sore throat unless you are vaccinated against the flu virus, for example. However, there are some measures you can take, such as sucking on lozenges or taking paracetamol or ibuprofen.

Can I speak to a doctor about a sore throat?

If you’re concerned about a sore throat, you may wish to speak to one of our GPhC-registered clinicians. They are available to consult with via our online video consultation service, from 9.30am to 4.30pm, Monday to Friday. They can advise you on your symptoms and treatment, and issue prescriptions and referral to specialists, where suitable.

Page last reviewed:  11/06/2020

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