To Your Health

Sore throat can mean many things

  Dr. Roger Hicks 

As temperatures cool down and activities move indoors, more and more people get sore throats. It is one of the most common reasons for going to an urgent care clinic in the colder months.


There are many causes of a sore throat, but most are caused by viral or bacterial infections. Viruses that cause colds and upper respiratory infections are by far the most common cause. The first sign of a cold is often a sore throat, usually followed by a runny nose, congestion and a cough. Typically, the sore throat from a cold gets better or goes away in the first few days, before the other symptoms. Antibiotics are useless against viruses, of course, and may cause harmful side effects.


Mono is another viral infection that causes a sore throat and fever, but unlike a cold, it can take a few weeks to resolve, rather than a few days. 


Although there is no specific treatment for mono, it is important to know if you have it because there are potential complications to be aware of and things you should and should not do. Spread the same way as a cold or strep throat, mono is common in teenagers and young adults. Most adults have had it and developed resistance even if was never diagnosed, making mono rare in people over 30. 


An influenza-caused sore throat usually comes with a fever, muscle aches and pains, and a dry cough. Influenza is one of the few viral illnesses for which there is a specific treatment but to be effective, it must be started in the first few days of symptoms. There is a rapid test in-office test for influenza, so if you think you have the flu, consider seeing a doctor right away.


When a sore throat is from a bacterial infection, antibiotics are needed. The most common bacterial cause is strep throat, which also can be diagnosed with a rapid office test. Strep throat may cause a fever and sore lymph nodes in the neck, but typically not a cough, nasal congestion or a runny nose. Strep throat can result in heart or kidney disease if not treated. Scarlet fever is strep throat with a rash and is caused by certain strains of the streptococcal bacteria.


Epiglottitis, though uncommon, is the most dangerous throat infection. It causes swelling of the epiglottis that can result in sudden blockage of the airway and require emergency intervention. Often not seen by just looking in the mouth, warning signs include muffled speech and swallowing that is so painful it causes drooling.


Throat pain that is consistently on just one side may be from a bacterial infection under a tonsil. It is also often accompanied by extremely painful swallowing and a muffled voice, and when severe, can cause blockage of the airway.


Sometimes a sore throat is caused by inflammation, not an infection. Examples include irritation from post nasal drip, allergies, dry air, mouth breathing, or acid reflux. In rare cases, a tumor is the cause.


Waking up with a scratchy or sore throat can happen any time of year, but the likelihood increases as fall turns to winter. Take precautions such as limiting your exposure to those who already are ill, staying well hydrated, washing your hands often and getting plenty of rest. 


At the first sign of a sore throat, try resting first (including your voice), increase your liquids, drink warm tea with honey, use a personal humidifier, gargle with saltwater (1/4 teaspoon salt to ½ cup water), suck on throat lozenges and avoid throat irritants such as cigarette smoke.


When should you or your child see a doctor? If you have a severe or prolonged sore throat, a fever over 101 that lasts more than a day, trouble swallowing or opening your mouth, any difficulty breathing, pain on only one side, a rash, or swelling of your face or neck, you should make a trip to your doctor or local urgent care center. 


A director of the Urgent Care Association of America from 2011 to 2017, Dr. Roger Hicks served as the Association’s treasurer and then secretary. He is a founder and current board member of the Urgent Care Assurance Company, a malpractice company specializing in urgent care. He is the founding President of the California Urgent Care Association. He is also the founding president of the South Yuba River Citizens League and served on SYRCL’s Board of Directors for 30 years.