Why does my throat hurt? 10 Causes of Sore Throat

Viruses are the most common culprit of sore throats, and many conditions can cause sore throat, from infections to allergies to acid reflux and even tumors.

Pain is just one of the symptoms of what is commonly referred to as a sore throat. Other symptoms include a scratchy throat or difficulty swallowing. 

Here’s what we need to know about the health conditions that cause sore throats, risk factors, and how to prevent them.

Risk factors

Anyone can have a sore throat. But you may be more likely to experience a sore throat if you have any of the following risk factors:

• smoking
• snoring
• certain medications
• acid reflux

How to prevent sore throat

We cannot completely control viruses, allergies, or other causes of sore throats. But you can try the following to help prevent a sore throat: 

• Practice proper hand washing.
• Avoid touching eyes or mouth.
• Avoid sharing food, wine glasses or eating utensils with others.
• Avoid close contact with people who are sick.
• Avoid smoke exposure.

If you have symptoms of a sore throat, your doctor may test you for strep throat.

Please let us know if you experience any of the following symptoms: 

• Trouble breathing or swallowing
• Coughing up blood in saliva or sputum
• Drowning, which is usually more common in young children than in adults
• dehydration
• joint swelling or pain
• rash

10 Possible Causes of Sore Throat

Your sore throat will most likely go away within a few days without any real irritation, but if it persists, you could be in trouble. Here are ten reasons why you might have a sore throat.

Viral infection

Viruses are one of the most common causes of sore throats, says Alan Mensch, MD, senior vice president of medical affairs and medical director at Plainview Hospital in New York State:

Typically, a sore throat is a symptom of the common cold or flu. But the same viruses that cause mononucleosis, measles, chickenpox, and vomiting (famous in children for their barking coughs) can also cause sore throats. In addition, SARS-CoV-2, the virus that causes COVID-19, may cause sore throat.

• To treat a sore throat caused by a virus, try a few of the following: 
• Rinse your mouth with warm salt water.
• Try an over-the-counter (OTC) pain reliever such as Tylenol (acetaminophen) or Anvil (ibuprofen).
• Stay hydrated.
• Use a humidifier or steamer to relieve respiratory symptoms 

Most viral infections clear up within a week, except for mononucleosis, which may last for weeks or months

Wash your hands frequently to prevent viral infection. Don’t get too close to someone who is sick, and cover your coughs and sneezes.

Strep throat

In addition to viruses, bacteria are also common causes of sore throats, says Kathleen Tibbetts, MD, assistant professor of otolaryngology at the University of Texas Southwestern Medical Center in Dallas. Especially in children, strep throat (caused by strep bacteria) is a common culprit. Because it is not a viral infection, there is no possibility of immunity. After taking antibacterial drug treatment, the condition can be controlled quickly.

In addition to a sore throat, other symptoms of strep throat may include: 

• fever
• cold
• red spots or white patches on your tonsils
• swollen lymph nodes

A throat bacterial test will confirm whether you have an infection. If you do have strep throat, treatment is necessary.

“We’re worried about late complications from strep,” Dr. Mensch said. This can include damage to the kidneys and heart valves.

Antibiotics, such as penicillin and amoxicillin, can often clear up strep throat and other bacterial infections.

Tonsillitis

Tonsillitis is inflammation and swelling of the tonsils. A viral or, more commonly, bacterial infection often causes tonsillitis.

Tonsils are two growths in the back of the throat that form the front line of the body’s immune system. They check for bacteria that enter your body and often lead to infection.

Tonsillitis may cause a sore throat, as well as other symptoms such as: 

• Red and swollen tonsils
• White or yellow patches on your tonsils
• fever
• cold
• Headache
• ear pain
• pain when swallowing
• Jaw or throat pain

In severe cases, the tonsils can become large enough to block the nasal passages. If this happens, you may have difficulty breathing, swallowing, and sleeping.

Allergy

Approximately 50 million people in the United States have allergic reactions.  An allergic reaction occurs when your body has an excessive response to a specific foreign invader, such as.

• dust
• pollen
• pet dander
• Mold

These invaders trigger a cascade of symptoms, such as a sore throat. Other allergy symptoms include: 

• Runny or stuffy nose
• sneeze
• itching

What’s more, sore throats caused by allergies can be worsened by postnasal drip. Postnasal drip occurs when mucus normally produced by the glands in the nose begins to accumulate. Mucus then runs down the back of your throat.

Some people may confuse allergy-related sore throats with viral and bacterial sore throats. Still, there are ways to tell them apart.

“Allergies last longer and don’t cause fever,” explains Dr. Tibbetts. “You may have itchy eyes and a runny nose.”

Many allergy-related sore throats also only occur during certain seasons, such as fall or spring.

Irritants

Irritation is not the same as allergy. But they also react to certain external factors, such as air pollution  or cleaning products. 

“The mechanism of allergy is an immune response,” explains Dr. Tibbetts. “Irritation is not an immune response. It’s just irritation of the tissue — and we’re seeing more and more irritation in urban areas as people are exposed to pollution.”

Exposure to certain irritants can cause long-term pain in your throat. So, try to avoid them if you can.

Dry air

Both humidity and temperature affect the mucous membranes surrounding your throat. Hot, dry air (such as in heated buildings) can cause discomfort. Summer air conditioning can have a similarly painful effect on your throat. Regardless, the discomfort tends to get worse early in the morning.

“During the winter months you have the heating on a lot of the time, so you’re breathing dry air all night long,” Dr. Tibbetts said. “Use a humidifier in your room at night while you sleep.”

You can also heat a pot of water and inhale the soothing steam.

Muscle strain

Studies have found that aerobics instructors and teachers often report sore throats. Shouting and screaming can hurt your throat, but so can talking.

Gastroesophageal reflux disease (GERD)

You might not think of a sore throat as a common symptom of acid reflux. Still, it can be, especially when the reflux is chronic, as in gastroesophageal reflux disease (GERD), a digestive disorder. After all, the throat is part of the digestive system.

“Stomach acid passes into the esophagus and sometimes into the throat,” explains Dr. Tibbetts. “Often, people have other related symptoms, such as indigestion.”

Symptoms may worsen after a large meal. In addition to a sore throat, symptoms of GERD may include:

• Heartburn
• acid reflux
• chest pain
• nausea
• severe cough

There are many over-the-counter and prescription medications to combat GERD. But you can also control the condition by controlling your weight and eating low-fat, low-acid foods.

Human Immunodeficiency Virus (HIV)

Thanks to highly effective treatments, the number of new human immunodeficiency virus (HIV) cases in the United States has been declining steadily since the 1980s.

Even people who are HIV-positive are unlikely to actually get the disease. This is what it says. But a sore throat still sometimes appears in the cluster of HIV symptoms.

Some people with HIV develop flu-like symptoms two to four weeks after infection. In addition to a sore throat, early symptoms of HIV may include: 

• fever
• cold
• rash
• Night sweats
• Muscle pain
• fatigue
• swollen lymph nodes
• Oral ulcers

HIV-positive people may develop sore throats due to secondary infections such as oral thrush or cytomegalovirus (CMV)

Tumor

Throat cancer doesn’t need to be at the top of your list of worries when you have a sore throat, but it can happen.

“All parts of the throat can be affected, from the upper part, the tonsil area, the back of the tongue to the voice box and upper esophagus,” explains Dr. Tibbetts.

• In addition to sore throat, tumors may present with other symptoms, such as: 
• lump
• hard to swallow
• earache

Sore throats caused by tumors can also persist, Dr. Tibbetts said: “A viral or bacterial sore throat should get better within a few days to weeks, but if it persists for weeks to months, that’s concerning. ”

If you have any of these red flags, talk to your doctor promptly.

Summarize

While most sore throats are caused by viral infections, such as a cold or the flu, there are several other causes that can cause a sore throat.

If symptoms do not improve within a few days or worsen, talk to your doctor. Less common causes of sore throat may require treatment.