Sore, Scratchy Throat?

Soothing Pain From Illness or Allergy

It’s a familiar sensation as the days grow shorter and colder: a scratchy, painful feeling when you swallow, talk, or even just breathe. Sometimes, a sore throat is little more than a nuisance. But it can also be a sign of serious infection. So how do you know which is which? And what can you do to soothe a sore throat?

Many things can trigger a sore throat, explains Dr. Alison Han, an infectious disease expert at the NIH Clinical Center. “It can be an allergenSubstance that produces an allergic reaction when a person comes in contact with them, like pollen or dust.. It can be an infection, like a virus or bacteria. Sometimes, it’s even just dry air,” she says.

So, when should you call your health care provider? That depends on how bad the sore throat is and what symptoms come with it, Han explains. “If it’s a mild sore throat and a runny nose, some congestion, that’s probably a typical cold,” she says. But severe pain plus symptoms like a high fever and a loss of interest in eating or drinking may be serious.

How long a sore throat lasts also matters. “If it’s been more than three days, then you might want to seek medical advice,” Han says. “But at any time, it’s always reasonable to call your doctor and get an opinion.”

A very contagious bacterial infection called strep can cause a sore throat, high fever, and swollen glands. Children may also have nausea, vomiting, or stomach pain. Strep can cause other serious health problems. So it’s important to see a doctor as soon as possible if you think someone in your household has strep.

If test results confirm strep, your doctor will prescribe antibiotics. Even if you feel better after a few days, it’s important to finish the entire prescription. Most causes of a sore throat, though, don’t need antibiotics. These include allergies as well as colds, flu, COVID-19, and RSV, which are all caused by viruses. Antibiotics only work against bacteria. Doctors can sometimes prescribe antiviral medication for certain viruses, like flu or COVID-19.

There is no treatment for the common cold, but over-the-counter products for symptom relief may help. For example, acetaminophen, ibuprofen, or aspirin (not for kids) can reduce pain. Mild allergies can be treated using over-the-counter antihistamines, decongestants, or nasal sprays. But you may need prescription medication or allergy shots for severe allergies.

A sore throat is a common symptom for the current variants of COVID-19. “If you have a sore throat and some other cold-like symptoms, it’s reasonable to do a COVID-19 test,” Han says. This can help you stop spreading the disease to others.

For most causes of a sore throat, time is the best healer. Lozenges, lollipops, or other hard candies can help soothe your throat. Experts now recommend that children under the age of 4 don’t use any over-the-counter cold and cough medications.

For young kids who might choke on candy, cold liquids or popsicles can help numb the pain. See the Wise Choices box for other tips.

The best way to prevent a sore throat is to avoid the germs that cause them. Wash your hands or use hand sanitizer often. Steer clear of other people who are sick. And stay up to date with the vaccines recommended for your age group, including flu, COVID-19, and RSV. “These shots can help protect ourselves and our loved ones,” Han says.