Sore Throat - Common Symptoms and Solutions
A sore throat can be painful and irritating, even dangerous, if not properly diagnosed and treated. Determining what symptoms you have and diagnosing the underlying cause of a sore throat is key in getting effective treatment and relief. Depending on the severity, it may be time to see a doctor. Understanding the causes of a sore throat will help you find the appropriate solution. This guide should help assist you on the best next steps to recovery!
Common Symptoms Associated with a Sore Throat
There are a number of different symptoms associated with a sore throat, among the most common are:
- Spots or ulcerations in the mouth and throat
- Swollen and/or tender lymph nodes in the neck
- Systemic symptoms like fevers, chills, body aches, or rashes
What is Causing My Sore Throat?
Sore throats are almost always the result of an infection. It’s best to group the various infections into three buckets:
Bucket #1: Infections with disease treatment available
- Strep Throat
- The Flu
- Herpes virus
- HIV Infection
Bucket #2: Infections with only symptom treatment available
- Respiratory Viruses
Bucket #3: Infections or complications of infections that are serious and might require a trip to the hospital.
- Some cases of COVID-19 Infection
- Peritonsillar Abscess
- Retropharyngeal Abscess
- Complications of Untreated Strep Throat
It can be difficult to distinguish the exact cause of your particular sore throat, but it is much easier to distinguish into which of the three buckets above your sore throat falls into. Follow these simple steps to help determine which bucket your sore throat belongs in.
Step 1: Let’s make sure you are not in Bucket #3.
If you have any of the following symptoms it’s best to speak with a doctor right away to make sure you aren’t in Bucket #3 and needing to go to the hospital.
- If your throat pain and swelling is so severe that you are unable to swallow food or liquids.
- If you notice your uvula (the fleshy hanging structure at the back of your throat) is shifted entirely to one side and one side of your tonsils are in the middle of your throat.
- Difficulty breathing
- Dehydrated and urinating very little
Step 2: You should consider yourself in Bucket #2 if you feel that ALL of the following are TRUE:
- No Fevers
- The throat pain is more uncomfortable or scratchy as opposed to painful.
- No body aches or neck tenderness,
- No lesions present in the back of the throat
- Have NOT recently engaged in high risk sexual activity (new partner without the use of barrier protection).
Step 3: If you are currently in Bucket #1, then ANY of the following will move you into Bucket #2
- Conjunctivitis (Red eyes)
- Patient is under the age of 3
How Do I Get Rid of My Sore Throat?
At this point, you should have a good idea of what bucket you fall into. See below for the level of care you’ll need and the treatments associated with each.
If you fall into this bucket then you will need an antibiotic for curative treatment and to reduce or eliminate the risk of serious complications. A list of these complications can be found below. You will need to work with your doctor to find the specific diagnosis, here are the common diagnoses and their treatments in bucket #1:
Typically penicillins if possible otherwise azithromycin can be used. Naproxen or Ketorolac is a prescription strength anti-inflammatory pain medication that will help to provide more immediate symptom relief.
Tamiflu will reduce illness severity, complication rates, and the need for hospitalization but it’s most helpful when treated within 48 hours of symptom onset (the earlier the better) and it is more effective in patients with more severe symptoms.
Acyclovir or Valacyclovir are the medications that are most often prescribed. For those with herpes infections, they will need to discuss with doctor about the best strategy to prevent or treat future flare ups. For long term suppression, it is typically the same antiviral medication list but at a small, daily dose.
Penicillins are most commonly used. An important component to this treatment is making sure the partner is treated simultaneously to avoid the risk of re-exposure.
Less commonly, but HIV infections can present as a sore throat. If you have engaged in any high risk sexual activity (1 or more partners without the use of barrier protection) then it is recommended you be tested for HIV as well as given prophylactic HIV medications in some situations. This is best discussed with your doctor.
Do I Need to See a Doctor for This?
If you fall into Bucket #1 or Bucket #3, then the simple answer is yes. If you fall into Bucket #2, it might be more effective to just purchase over-the-counter medications like Tylenol Cold and Flu or an anti-inflammatory like Motrin or Advil.
Complications for Untreated Infections of Bucket #1 and Bucket #2. Antibiotics are recommended for two very important reasons. Failure to treat strep throat can result in serious complications:
Scarlet Fever/Rheumatic Fever
For most, this complication stirs up images of kids developing rashes along the Oregon Trail. Since we’ve begun treating strep throat infections with antibiotics we have seen a dramatic decline in scarlet fever, but the risk remains for those who don’t receive antibiotics and scarlet fever is still diagnosed all throughout the US every year. What makes this illness so dangerous is that it can develop into Rheumatic fever causing permanent and life-threatening damage to cardiac valves leading to progressive heart failure.
Kidney Disease (Poststreptococcal Glomerulonephritis)
This is a relatively rare complication of strep throat and is caused by very specific strains of beta hemolytic streptococcus bacteria. Symptoms are often red-ish or brown urine, swelling in the extremities, high blood pressure and potentially nausea, confusion and a sharp reduction in the amount of urine production.
This complication of acute pharyngitis infections is life threatening but thankfully with the advent of antibiotics is relatively rare. Certain bacteria can cause abscesses to form in the tissue at the back of the throat. This abscess causes bulging of tissue and inflammation into the airway. This swelling can be so profound that it can close off the airway all together.
This complication of acute pharyngitis infections is also life threatening. In a similar mechanism of action as the retropharyngeal abscess, the peritonsillar abscess causes upper airway obstruction from the abscess and inflammation extending into the airway itself.
The mastoid air cells are delicate structures that are contiguous with the middle ear chamber and help to regulate ear pressure and protect the important bones within the ear in case of trauma. These cells can become infected and will cause severe ear pain and fullness and cause the ear itself to shift into an abnormal position. Most patients are not in life-threatening danger, but will need IV antibiotics administered.
This is a fancy word for when the bacteria spreads into the bloodstream. Once this occurs then the bacteria is carried all throughout the body and causes infections and abscesses in dangerous locations like the heart, spinal cord, brain or other vital organs. The symptoms related to this complication will be high fever, very ill-appearing and often a cluster of symptoms related to where in the body another infection has taken hold. In general, what’s important to keep in mind is that patients with bacteremia are typically very ill and will often know it’s time to seek emergency care.
While this is a rare complication of strep throat, if you are experiencing fevers, chills or a worsening cough that is producing mucus, it will be important that you are seen and get an x-ray ordered to rule out pneumonia.