View source for Sore throat

{{short description|Pain of the throat}}
{{for|the band|Sore Throat (band)}}
{{Infobox medical condition
| name = Sore throat
| synonyms = 
| image = Pharyngitis.jpg
| caption = [[Pharyngitis]]—inflammation of the back of the throat—caused by a virus is the most common cause of a sore throat.
| pronounce = 
| field = 
| symptoms = 
| complications = 
| onset = 
| duration = 
| types = 
| causes = 
| risks = 
| diagnosis = 
| differential = 
| prevention = 
| treatment = 
| medication = 
| prognosis = 
| frequency = 
| deaths = 
}}'''Sore throat''', also known as '''throat pain''', is pain or irritation of the [[throat]].<ref>{{Cite web |title=Sore throat - Symptoms and causes |url=https://www.mayoclinic.org/diseases-conditions/sore-throat/symptoms-causes/syc-20351635 |access-date=2022-04-24 |website=Mayo Clinic |language=en}}</ref> The majority of sore throats are caused by a virus, for which [[antibiotic]]s are not helpful.<ref name=":0" /> 

For sore throat caused by bacteria (GAS), treatment with antibiotics may help the person get better faster, reduce the risk that the bacterial infection spreads, prevent [[retropharyngeal abscess]]es and [[Peritonsillar abscess|quinsy]], and reduce the risk of other complications such as [[rheumatic fever]] and [[rheumatic heart disease]].<ref name=":0" /> In most [[developed countries]], post-streptococcal diseases have become far less common. For this reason, awareness and [[public health]] initiatives to promote minimizing the use of antibiotics for viral infections have become the focus.<ref name=":0" />

<!-- Epidemiology and prognosis -->
Approximately 35% of childhood sore throats and 5–25% of cases in adults are caused by a bacterial infection from group A streptococcus.<ref name=":0" /> Sore throats that are "non-group A streptococcus" are assumed to be caused by a viral infection. Sore throat is a common reason for people to visit their primary care doctors and the top reason for antibiotic prescriptions by primary care practitioners such as family doctors.<ref name=":0" /> In the United States, about 1% of all visits to the hospital emergency department, physician office and medical clinics, and outpatient clinics are for sore throat (over 7 million visits for adults and 7 million visits for children per year).<ref name=":0" />

==Causes==
Causes of sore throat include:<ref>{{cite web |date=17 April 2024 |title=Sore Throat Basics |url=https://www.cdc.gov/sore-throat/about/index.html |publisher=Centers for Disease Control and Prevention |access-date=11 September 2025}}</ref>
* [[Viral disease|viral infections]]
* [[group A streptococcal infection]] (GAS) bacterial infection<ref name=":0">{{Cite journal|last1=Cohen|first1=Jérémie F.|last2=Pauchard|first2=Jean-Yves|last3=Hjelm|first3=Nils|last4=Cohen|first4=Robert|last5=Chalumeau|first5=Martin|date=June 2020|title=Efficacy and safety of rapid tests to guide antibiotic prescriptions for sore throat|journal=The Cochrane Database of Systematic Reviews|volume=2020|issue=6 |article-number=CD012431|doi=10.1002/14651858.CD012431.pub2|issn=1469-493X|pmc=7271976|pmid=32497279}}</ref>
* [[allergies]]
* [[smoking]] or exposure to [[secondhand smoke]]

==Definition==
A sore throat is pain felt anywhere in the throat.<ref name=Rosen2010>{{cite book |title=Rosen's emergency medicine: concepts and clinical practice |edition=7th |last=Marx |first=John |year=2010 |publisher=Mosby/Elsevier |location=Philadelphia, PA |isbn=978-0-323-05472-0 |page=Chapter 30 }}</ref>

==Symptoms==
Symptoms of sore throat include:
* a scratchy sensation<ref name="goodrx"/>
* pain during swallowing
* discomfort while speaking
* burning sensation
* swelling in the neck<ref name="goodrx">{{Cite web|last1=Hovav|first1=K.|last2=Pinto-Garcia|first2=P.|date=13 October 2021|title=Sore Throat Causes, Home Remedies, and When to Seek Care|url=https://www.goodrx.com/conditions/cold-symptoms/causes-of-sore-throat#:~:text=You%20can%20experience%20sore%20throat%20differently,%20based%20on%20what%E2%80%99s%20causing%20it%20and%20how%20severe%20the%20symptoms%20are.%20A%20sore%20throat%20can%20feel%20like:|url-status=live|archive-url=https://web.archive.org/web/20220127192730/https://www.goodrx.com/conditions/cold-symptoms/causes-of-sore-throat|archive-date=27 January 2022|access-date=19 February 2022|website=GoodRx|language=en}}</ref>

==Diagnosis==
The most common cause (80%) is [[Acute (medicine)|acute]] [[Virus|viral]] pharyngitis, a viral [[infection]] of the throat.<ref name=Rosen2010/>  Other causes include other bacterial infections (such as group A streptococcus or [[streptococcal pharyngitis]]), trauma, and [[tumor]]s.<ref name=Rosen2010/> [[Gastroesophageal reflux disease|Gastroesophageal (acid) reflux disease]] can cause [[stomach acid]] to back up into the throat and also cause the throat to become sore.<ref>{{cite web|url=http://www.webmd.com/cold-and-flu/tc/sore-throat-topic-overview|title=Sore Throat and Other Throat Problems-Topic Overview}}</ref> In children, streptococcal pharyngitis is the cause of 35–37% of sore throats.<ref>{{cite journal |vauthors=Shaikh N, Leonard E, Martin JM |title=Prevalence of streptococcal pharyngitis and streptococcal carriage in children: a meta-analysis |journal=Pediatrics |volume=126 |issue=3 |pages=e557–64 |date=September 2010 |pmid=20696723 |doi=10.1542/peds.2009-2648 |s2cid=8625679 }}</ref><ref name=":0" />

The symptoms of a viral infection and a bacterial infection may be very similar. Some clinical guidelines suggest that the cause of a sore throat is confirmed prior to prescribing antibiotic therapy and only recommend antibiotics for children who are at high risk of non-[[suppurative]] complications.<ref>{{Cite web|date=2019-04-19|title=Group A Strep {{!}} Strep Throat {{!}} For Clinicians {{!}} GAS {{!}} CDC|url=https://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html|access-date=2020-09-18|website=www.cdc.gov|language=en-us}}</ref><ref>{{Cite web|title=Clinical Practice Guidelines : Sore throat|url=https://www.rch.org.au/clinicalguide/guideline_index/Sore_throat/|access-date=2020-09-18|website=www.rch.org.au}}</ref> A group A streptococcus infection can be diagnosed by [[throat culture]] or a rapid test:
* In order to perform a throat culture, a sample from the throat (obtained by swabbing) is cultured (grown) on a blood agar plate to confirm the presence of group A streptococcus.<ref name=":0" /> Throat cultures are effective for people who have a low bacterial count (high sensitivity), however, throat cultures usually take about 48 hours to obtain the results.<ref name=":0" />
* Rapid tests to detect GAS (bacteria) give a positive or negative result that is usually based on a colour change on a test strip that contains a [[throat swab]] (sample). Test strips detect a cell wall carbohydrate that is specific to GAS by using an [[Immunological defense|immunologic]] reaction.<ref name=":0" /> Rapid testing can be performed in the doctor's office and usually takes 5–10 minutes for the test strip to indicate the result. [[Specificity (statistics)|Specificity]] for most rapid tests is approximately 95%, however [[Sensitivity and specificity|sensitivity]] is about 85%.<ref name=":0" /> Although the use of rapid testing has been linked with an overall reduction in antibiotic prescriptions, further research is necessary to understand other outcomes such as safety, and when the person starts to feel better.<ref name=":0" />

Clinicians often also make treatment decisions based on the person's signs and symptoms alone. In the US, approximately two-thirds of adults and half of children with sore throat are diagnosed based on symptoms and do not have testing for the presence of GAS to confirm a bacterial infection.<ref name=":0" />

Numerous clinical scoring systems ([[decision tool]]s) have also been developed to support clinical decisions. Scoring systems that have been proposed include [[Centor criteria|Centor's]], McIsaac's, and the feverPAIN.<ref name=":0" /> A clinical scoring system is often used along with a rapid test.<ref name=":0" /> The scoring systems use observed signs and symptoms in order to determine the likelihood of a bacterial infection.<ref name=":0" />

==Management==
Sore or [[Throat irritation|scratchy]] throat can temporarily be relieved by [[gargling]] a solution of 1/4 to 1/2 teaspoon (1.3 to 2.5 milliliters) [[Sodium chloride|salt]] dissolved in an {{convert|8|USfloz|ml|adj=on}} glass of water.<ref>{{cite web |title=Does Gargling Wlth Salt Water Ease a Sore Throat? |url=https://www.webmd.com/cold-and-flu/features/does-gargling-wlth-salt-water-ease-a-sore-throat |website=WebMD |language=en}}</ref>

Pain medications such as [[non-steroidal anti-inflammatory drug]]s (NSAIDs) and [[paracetamol]] (acetaminophen) help in the [[Pain management|management of pain]].<ref name=Review00>{{cite journal |vauthors=Thomas M, Del Mar C, Glasziou P |title=How effective are treatments other than antibiotics for acute sore throat? |journal=Br J Gen Pract |volume=50 |issue=459 |pages=817–20 |date=October 2000 |pmid=11127175 |pmc=1313826 }}</ref><ref name=":1">{{Cite journal|last1=de Cassan|first1=Simone|last2=Thompson|first2=Matthew J.|last3=Perera|first3=Rafael|last4=Glasziou|first4=Paul P.|last5=Del Mar|first5=Chris B.|last6=Heneghan|first6=Carl J.|last7=Hayward|first7=Gail|date=1 May 2020|title=Corticosteroids as standalone or add-on treatment for sore throat|journal=The Cochrane Database of Systematic Reviews|volume=2020|issue=5|article-number=CD008268|doi=10.1002/14651858.CD008268.pub3|issn=1469-493X|pmc=7193118|pmid=32356360}}</ref> The use of [[corticosteroid]]s seems to increase slightly the likelihood of resolution and the reduction of pain, but more analysis is necessary to ensure that  this minimal benefit outweighs the risks.<ref name=":1" /><ref>{{cite journal|last1=Sadeghirad|first1=Behnam|last2=Siemieniuk|first2=Reed A C|last3=Brignardello-Petersen|first3=Romina|last4=Papola|first4=Davide|last5=Lytvyn|first5=Lyubov|last6=Vandvik|first6=Per Olav|last7=Merglen|first7=Arnaud|last8=Guyatt|first8=Gordon H|last9=Agoritsas|first9=Thomas|title=Corticosteroids for treatment of sore throat: systematic review and meta-analysis of randomised trials|journal=BMJ|date=20 September 2017|article-number=j3887|doi=10.1136/bmj.j3887|pmid=28931508|volume=358|pmc=5605780}}</ref> Antibiotics probably reduce pain, diminish headaches and could prevent some sore throat complications, but as these effects are small they must be balanced with the threat of antimicrobial resistance.<ref>{{Cite journal |vauthors=Spinks A, Glasziou PP, Del Mar CB |date=Dec 9, 2021 |title=Antibiotics for treatment of sore throat in children and adults |journal=Cochrane Database Syst Rev |volume=2021 |issue=12 |article-number=CD000023 |doi=10.1002/14651858.CD000023.pub5 |pmid=34881426|pmc=8655103 }}</ref>  It is not known whether antibiotics are effective for preventing [[Relapse|recurrent]] sore throat.<ref>{{Cite journal|last1=Ng|first1=Gareth JY|last2=Tan|first2=Stephanie|last3=Vu|first3=Anh N|last4=Del Mar|first4=Chris B|last5=van Driel|first5=Mieke L|date=2015-07-14|editor-last=Cochrane ENT Group|title=Antibiotics for preventing recurrent sore throat|journal=Cochrane Database of Systematic Reviews|volume=2015 |issue=7|article-number=CD008911|language=en|doi=10.1002/14651858.CD008911.pub2|pmid=26171901|pmc=8860619 }}</ref>

There is only limited evidence that a hot drink can help alleviate a sore throat, and other [[common cold]] and [[influenza]] symptoms.<ref name=owt>{{cite web |publisher=National Health Service |title=Hot drinks ease cold and flu |date=10 December 2008 |url=https://www.nhs.uk/news/food-and-diet/hot-drinks-ease-cold-and-flu/ |access-date=15 February 2019 |archive-date=8 August 2020 |archive-url=https://web.archive.org/web/20200808151408/https://www.nhs.uk/news/food-and-diet/hot-drinks-ease-cold-and-flu/ |url-status=dead }}</ref> If the sore throat is unrelated to a cold and is caused by, for example, [[tonsillitis]], a cold drink may be helpful.<ref name=bathala>{{cite journal |vauthors=Bathala S, Eccles R |title=A review on the mechanism of sore throat in tonsillitis |journal=J Laryngol Otol |volume=127 |issue=3 |pages=227–32 |date=March 2013 |pmid=23317998 |doi=10.1017/S0022215112003003 |s2cid=20563591 |type=Review}}</ref>

There are also other medications such as [[Throat lozenge|lozenges]] which can help soothe irritated tissues of the throat.

Without active treatment, symptoms usually last two to seven days in children.<ref>{{cite journal|last=Thompson|first=M|author2=Vodicka, TA |author3=Blair, PS |author4=Buckley, DI |author5=Heneghan, C |author6=Hay, AD |author7= TARGET Programme, Team |title=Duration of symptoms of respiratory tract infections in children: systematic review.|journal=BMJ (Clinical Research Ed.)|date=Dec 11, 2013|volume=347|article-number=f7027|pmid=24335668|doi=10.1136/bmj.f7027 |pmc=3898587}}</ref>

==Statistics==
In the United States, there are about 2.4 million [[emergency department]] visits with throat-related complaints per year.<ref name=Rosen2010/>

==References==
{{Reflist}}

== External links ==
{{Medical resources
|   DiseasesDB     = 24580
|   ICD10          = {{ICD10|J|02||j|00}}, {{ICD10|J|31|2|j|30}}
|   ICD9           = {{ICD9|472.1}}
|   ICDO           =
|   OMIM           =
|   MedlinePlus    = 000655
|   eMedicineSubj  = emerg
|   eMedicineTopic = 419
|   MeshID         = D010612
}}
{{Pain}}

{{DEFAULTSORT:Sore Throat}}
[[Category:Symptoms and signs: Respiratory system]]
[[Category:Pain]]
[[Category:Laryngology]]
[[Category:Otorhinolaryngology]]