A sore throat is one of the most common reasons people visit an ENT clinic. Most of the time it is part of a cold and goes away on its own within 5-7 days. During that time, what helps most is gargling with salt water, honey, plenty of warm fluids and a humid room. Antibiotics are only needed for a bacterial infection; they do not speed up recovery from a viral sore throat. If there is severe pain on one side, difficulty opening the mouth, shortness of breath or symptoms lasting more than a week, waiting is not the right choice.
What helps a sore throat?
Whatever the cause, a few simple things done at home noticeably ease a sore throat. They will not end the illness in a day, but they make swallowing easier and help you get through the recovery period more comfortably.
Gargling with salt water
Stir half a teaspoon of salt into a glass of warm water. Gargle for about 30 seconds and spit the water out; you can repeat this 3-4 times a day. Salt water reduces swelling in the throat and clears away accumulated secretions. Make sure the water is not too hot, because tissue that is already irritated is bothered even more by heat.
Honey
A dessertspoon of honey can be taken on its own or stirred into a warm herbal tea. Honey coats the surface of the throat and reduces irritation. It is especially soothing for a sore throat that comes with a night-time cough. Honey must not be given to babies under one year of age.
Plenty of fluids and humid air
The drier the throat, the worse the pain. Drink fluids such as warm water, linden tea, chamomile tea or soup frequently through the day. People who sleep in a dry, centrally heated room notice that their sore throat is worse in the morning. In that case, placing a humidifier in the room or laying a damp towel over the radiator helps.
Lozenges and throat sprays
Lozenges and sprays sold in pharmacies soothe the throat for a short time, but they do not treat the underlying cause. Sprays containing a local anesthetic should not be used in young children or for long periods without consulting a doctor.
Resting the voice
If hoarseness accompanies the sore throat, talking less for a day or two speeds up recovery. Contrary to popular belief, whispering strains the vocal cords more; speaking little, in a normal tone, is the better approach. During this period, avoid smoking and smoky environments.
How do you get rid of a sore throat?
How a sore throat goes away depends on whether the cause is a virus or bacteria. Treatment is completely different depending on that distinction.
In adults, the great majority of sore throats are viral. A sore throat that starts together with a runny nose, sneezing, cough and hoarseness is usually caused by a virus. Antibiotics are of no benefit in this situation. The body overcomes the infection itself and the pain goes away within 5-7 days.
The most common cause of bacterial throat infection is group A streptococcus (strep throat), and it is seen more often in children than in adults. The absence of a cough, high fever, white spots of pus on the tonsils and swollen, tender lymph nodes in the neck suggest a bacterial infection. The diagnosis is made with a rapid test or culture from a throat swab. If antibiotics have been started, the prescribed course should be completed even if symptoms improve in 2-3 days. Treatment that is stopped halfway can lead to the illness returning and, rarely, to acute rheumatic fever, which affects the joints and the heart.
How long does a sore throat last?
A viral sore throat usually goes away within 3-7 days. The pain is generally worst in the first 2-3 days and then eases a little each day. In a strep infection, there is clear relief 24-48 hours after the appropriate antibiotic is started.
A sore throat that lasts more than a week, gets better and then worse again, or continues at the same intensity every day should not be regarded as a simple cold. For a sore throat that has been going on for two or three weeks, chronic causes such as reflux, postnasal drip and sinusitis are investigated.
What causes a sore throat?
The most common cause is upper respiratory tract infection. Apart from that, the causes I see most often in examinations are:
- Reflux. Stomach acid reaching the throat at night causes a burning type of pain, particularly in the morning. A feeling of something stuck in the throat is also common with reflux.
- Postnasal drip. Discharge trickling from the back of the nose into the throat because of sinusitis or allergic rhinitis constantly irritates the throat.
- Sleeping with the mouth open. A person with a blocked nose spends the night breathing through the mouth and wakes up with a dried-out throat.
- Dry air, smoking and cigarette smoke.
- Using the voice for long periods or shouting.
- Swollen tonsils and tonsillitis.
Why do I have a sore throat in the morning?
A sore throat that clears up during the day but starts again every morning points to something happening overnight rather than to an infection. Some of these patients spend years interpreting it as "I get sick a lot".
The most common cause is sleeping with the mouth open. A person with a deviated septum, enlarged turbinates or chronic nasal congestion breathes through the mouth during sleep without realizing it. The nose works like a filter that warms and humidifies the air we breathe. When breathing is through the mouth, this filter is bypassed and the throat dries out until morning. These people usually also snore and wake with a dry mouth.
In this situation, lozenges or gargling give temporary relief, but the complaint comes back every morning. The lasting solution is to open the nasal airway. For the structural causes, see the pages on deviated septum surgery (septoplasty) and turbinate (concha) reduction.
The second most common cause of a morning sore throat is reflux. Eating late in the evening and having tea, coffee or alcohol before bed make the complaint worse. Raising the head of the bed slightly and having the last meal at least 2-3 hours before lying down help in this case.
What causes a sore throat on one side when swallowing?
A sore throat on one side usually comes from inflammation of the tonsil or a swollen lymph node on that side, and it clears up with simple treatment. However, if one-sided pain is getting worse day by day, caution is needed.
An abscess developing around the tonsil (peritonsillar abscess) causes one-sided, very severe pain that radiates to the ear. The patient has difficulty opening the mouth, cannot swallow saliva, and the voice becomes muffled as if there were something hot in the mouth. This does not get better at home. The abscess needs to be drained, and an ENT examination should take place the same day.
Why is my sore throat not going away with antibiotics?
The most common reason a sore throat does not go away despite antibiotics is that the pain was viral in the first place. Antibiotics have no effect on viruses, and taking them does not speed up recovery.
Other reasons include stopping the antibiotic halfway, an abscess developing, fungal infection, reflux and postnasal drip. A fungal infection of the throat can occur in people who use steroid asthma inhalers for a long time; rinsing the mouth with water after using the inhaler prevents this. In adults who smoke and have had hoarseness for more than three weeks, the larynx needs to be examined.
What helps a sore throat in children?
The basic approach is the same in children: plenty of fluids, warm and soft foods, and a humid room. Children old enough to gargle can gargle with salt water. Honey can be given to children over one year of age.
Because strep infection is more common in children, a child with a sore throat accompanied by high fever and no cough should always be examined. If there is frequently recurring tonsillitis, snoring and sleeping with the mouth open, adenoid and tonsil size are assessed together.
When should you see a doctor for a sore throat?
Most sore throats clear up at home. In the following situations, however, you should be examined without waiting:
- Difficulty breathing or noisy breathing,
- Being unable to swallow saliva, drooling,
- Difficulty opening the mouth and severe pain on one side that keeps increasing,
- Fever above 38.5°C (101.3°F) lasting more than 2-3 days,
- Swelling in the neck or a lump that can be felt,
- A sore throat lasting longer than one week,
- Hoarseness lasting longer than three weeks,
- Blood in saliva or phlegm.
The first two situations are emergencies; with these symptoms, go to the nearest emergency department.
For a sore throat that does not go away or keeps coming back, especially together with nasal congestion and snoring, you can contact Op. Dr. Ümit Küçüktepe in Antalya, Turkey. This article has been prepared for information purposes and does not replace an examination.
Frequently Asked Questions
Both can be soothing, and which one works better varies from person to person. Warm drinks soften the throat and thin secretions. Cold water or ice cream makes swallowing easier through a short-lived numbing effect. What should be avoided is very hot drinks, because they irritate the inflamed tissue even more.
Honey coats the surface of the throat, reduces irritation and is particularly soothing for a sore throat that comes with a cough. About a dessertspoon can be taken on its own or added to a warm herbal tea. Honey must not be given to babies under one year of age.
Adding a few drops of lemon to warm water or tea is soothing for most people. However, in people with reflux, acidic drinks such as lemon can increase the burning. For a burning type of sore throat that occurs in the morning, it is better to cut down on lemon.
A sore throat caused by a virus or bacteria is contagious; it spreads through coughing, sneezing and shared items. In strep infection, contagiousness falls considerably about 24 hours after antibiotics are started. A sore throat caused by reflux, dry air or sleeping with the mouth open is not contagious.
The throat and the ear receive sensation from the same nerves. This is why ear pain can be felt when swallowing even though there is nothing wrong with the ear. If severe one-sided throat pain radiates to the ear and there is difficulty opening the mouth, an abscess may have developed around the tonsil, and the examination should not be delayed.
Most sore throats do not need antibiotics, because the cause is a virus. Antibiotics are decided on only when a bacterial infection such as strep is suspected, based on an examination and a throat test if necessary. Taking leftover antibiotics at home on your own does not help and leads to antibiotic resistance.
During pregnancy, gargling with salt water, honey, plenty of warm fluids and a humid room can be used safely. A doctor should be consulted first for any medication, including lozenges, sprays and fever reducers. A sore throat accompanied by high fever should be examined without delay.
For a short-lived sore throat that comes with a cold, a family doctor is sufficient. For a sore throat that is recurrent, lasts more than a week, is one-sided or occurs together with hoarseness and nasal congestion, see an Ear, Nose and Throat (ENT) specialist. For children, the first visit can be to a pediatrician.
