Sore Throat: Causes and When to See a Doctor Skip to content

Sore Throat: Causes and When to See a Doctor

A sore throat is most often caused by a virus, but strep throat and rarer causes exist. Here is what pain on swallowing, without a fever, in a child and on one side can mean, and when you need a doctor urgently.

Ear, nose and throat

When to see a doctor urgently

  • Trouble breathing or a high-pitched noisy sound when breathing in
  • You cannot swallow, and saliva runs out of the mouth
  • Severe pain on one side, hard to open the mouth, a nasal voice
  • Swelling of the neck, face, tongue or throat that grows fast
Show all signs (8)
  • A thick gray-white coating on the tonsils that does not wipe off in an unvaccinated person
  • A very high fever with chills
  • Sore throat that lasts more than a week or keeps coming back
  • Sore throat with a bright fine rash and a fever

If you have any of these signs, call 112 or go to emergency care.

Possible Causes

This is not a diagnosis: a doctor will determine the cause.

Diphtheria
Influenza

What a sore throat is and how it varies

A sore throat is pain, scratchiness or burning in the throat and around the tonsils, usually most noticeable when you swallow. Most often the cause is a virus: a cold or the flu. Less often a bacterium such as strep is to blame, and more rarely other conditions. The pain usually goes away within a few days. A text alone cannot tell the causes apart, but the accompanying signs show how urgent a doctor visit is.

Sore throat with a cold or the flu

If a sore throat comes with a runny nose, a cough, sneezing, a mild fever and aches, it looks like a viral cold. More on Runny nose and Cough. A sudden start with a high fever, body aches and weakness is more often influenza. Antibiotics do not treat a viral sore throat.

Tonsillitis and strep throat

Severe pain on swallowing, a high fever, white or yellow patches on the tonsils, tender swollen glands in the neck and no cough point toward tonsillitis. Only a doctor can confirm it: the doctor examines the throat and, if needed, does a rapid test or a swab. Antibiotics are prescribed only when there are signs of a bacterial infection. For swollen glands, see Swollen lymph nodes.

Sore throat without a fever

Without a fever the throat can hurt from dry air, smoking, shouting or straining the voice, allergy, and a runny nose with mucus dripping down the back of the throat. Scratchiness and a lump-in-the-throat feeling happen with reflux, when stomach acid comes back up the food pipe: see Heartburn. If the pain lasts more than a week, see a doctor.

Sore throat in a child

In children a sore throat is most often viral, and fluids and rest are enough. But if a child refuses to drink or swallow, drools, breathes noisily or stretches the neck forward, urgent help is needed. A gray-white thick coating that does not wipe off, a swollen neck and a hoarse voice can be signs of diphtheria: the disease is rare but dangerous, and unvaccinated people are especially at risk. A bright fine rash together with a sore throat and a fever is a reason to see a doctor the same day. See a pediatrician.

Sore throat on one side and in the ear

Pain on one side that is much worse than usual, especially if it is hard to open the mouth, the voice sounds nasal and the fever is high, can be a sign of an abscess next to the tonsil. This is an emergency. A sore throat often radiates to the ear, but if the ear hurts on its own, read Ear pain.

What you can do before the visit

  • Drink more fluids, warm or cool, whichever is more comfortable, and rest more.
  • Gargle with warm salty water. Do not suggest it to small children who cannot gargle yet.
  • Eat soft or cool food if hard food irritates the throat.
  • Do not smoke, and avoid smoke and dry air.
  • Do not ask for an antibiotic "just in case": it will not help a viral sore throat, and only a doctor prescribes it.
  • If warning signs appear, do not wait: call 112 or go to the emergency department.

How a doctor finds the cause of a sore throat

The doctor asks how the pain began, about fever, cough and contacts, examines the throat, tonsils and neck, and feels the lymph nodes. If strep is suspected, the doctor does a rapid test or takes a swab and, if needed, orders a blood test. If diphtheria is suspected, a swab is taken urgently. Treatment depends on the cause: for a viral infection the doctor eases symptoms and watches, for a bacterial one prescribes treatment, and an abscess is drained.

Frequently asked questions

Which doctor should I see for a sore throat?
A general practitioner or an ear, nose and throat doctor; for a child, a pediatrician. If breathing or swallowing is hard, do not book a visit: call 112.
Do I need antibiotics for a sore throat?
Usually not: the cause is most often viral, and antibiotics do not ease it. Only a doctor prescribes them, when there are signs of a bacterial infection such as strep throat.
How long can a sore throat last?
With a cold the pain usually goes away in a few days. If it has not improved in a week, comes with a high fever or keeps returning, see a doctor.
How can I tell strep throat from a viral sore throat?
Strep throat more often comes with a high fever, patches on the tonsils, tender glands in the neck and no cough. Only a doctor can tell them apart reliably, so do not wait if you have these signs.