Long time sore throat: When to worry about sore throat

24.07.202311.06.2023 by alexxlab

When to worry about sore throat

July 20, 2022 | by
City of Hope

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A sore throat may get better in a day or two or linger for a while. The key is to know when this common symptom may require for a trip to the doctor.

Most everyone has had a sore throat at some point. Maybe it was caused by a virus, seasonal allergies or cheering on your favorite team. In most cases, a sore throat gets better in a day or two. Sometimes, it may linger for a while. The key is to know when this common symptom may require for a trip to the doctor, especially when it may be caused by a serious disease, including cancer.

In this article, we’ll explain:

Common causes of a sore throat
When you should consult a doctor
Tests used to find the cause of a sore throat
What cancers may be associated with a sore throat

If you’ve been diagnosed with throat cancer and would like to learn more about treatment options we offer, or if you’re interested in a second opinion on your diagnosis and treatment plan, call us or chat online with a member of our team.

Common causes for a sore throat

Viral infections are the primary reason for most sore throats. As the name implies, their most common cause is the common cold. Adults have an average of two to three colds per year, and children have even more of these uncomfortable, but benign viral infections, according to the U.S. Centers for Disease Control and Prevention (CDC). Influenzais another frequent cause of a sore throat, and, like a cold, is a viral infection that usually clears up in about a week to 10 days. COVID-19, an unfortunately familiar virus these days, may also cause a sore throat, sometimes for a prolonged period.

Other possible causes of a sore throat include:

Viral illnesses, such as mononucleosis, chicken pox, measles and croup
Overuse of your voice
Environmental factors like exposure to molds, bad air quality, pollution or chemical vapors
Allergens like pollen that may cause nasal drainage
Acid reflux
Laryngitis, an inflammation of the voice box
A persistent dry cough or hoarseness
An irritated epiglottis, the flap of tissue at the base of the tongue
Tonsillitis, or an inflammation of the tonsils in the back of the throat or tonsil stones, caused by food debris getting caught in the tonsil folds
Strep throat and other bacterial infections like streptococcus pyogenes (group A streptococcus)

Those with repeated bacterial throat infections like strep or tonsillitis may undergo a tonsillectomy to remove the tonsils, which may reduce the frequency of the infections. (This is especially true for those who get more strep more than seven times in a year, according the Mayo Clinic.)

“Sore throat is very common,” says Beomjune Kim, DMD, MD, Head and Neck Surgeon at CTCA® Atlanta. “The only time you have to be really worried is if it persists over several weeks, despite adequate treatment.”

When should you be concerned and consult a doctor?

You should call your doctor if your sore throat:

Is accompanied by a high fever (101 degrees or more)
Persists despite treatment
Is painful when swallowing to the point you can’t sleep
If a rash appears
If the pain intensifies
Unusual bad breath or a foul taste in your mouth
Ear or jaw pain
A persistent hoarse, raspy or breathy voice
Swelling in the face or neck
A sore in the mouth or throat, especially if you’re a smoker, use tobacco or frequently drink alcohol
Unexplained weight loss

“If it’s chronic, over three or four weeks, then you have to be worried,” Dr. Kim says. “Difficulty breathing, coughing up or vomiting up blood are worrisome signs.”

Tests used to find the cause of your sore throat

To help find the cause of sore throat, the doctor will likely perform a thorough physical exam and perhaps a blood test and swab the throat to rule out strep or a bacterial infection. The exam may also help to rule out symptoms due to other viral infections, like prolonged COVID-19.

If a more serious condition is suspected, the doctor may perform a flexible endoscopic exam, in which a long, flexible tube with a tiny camera and light attached to the end is inserted to see the inside of the throat more clearly. Depending on what this exam reveals, the doctor may order a biopsy of the tonsil or a lymph node.

Benign and malignant tumors may grow in the tissue that lines the throat, the tongue and the larynx (voice box). Both cancerous and non-cancerous tumors or lesions may cause throat pain and other symptoms.

The physician may also order an imaging study of the chest and abdomen to help learn whether cancer is present and whether it has spread to other parts of the body.

Cancers that may be associated with a sore throat?

While a persistent sore throat is the most common early warning sign for throat cancer, many patients are asymptomatic in early stages of the disease.

Throat cancers are often discovered by a dentist or doctor treating another condition. Still, an ongoing sore throat accompanied by a cough, difficulty swallowing, swelling or a lump in the mouth, throat or neck and other persistent symptoms, may indicate throat cancer and require medical attention.

There are three main types of throat cancer:

Laryngeal cancer affects the tissues of the larynx or voice box and may include the vocal cords and the areas above and below them.

Pharyngeal cancers may affect the area behind the nose, the throat behind the mouth and the bottom part of the throat just above the larynx or the hypopharynx near the opening to the.

Oropharyngeal cancers are known as oral cavity cancers, and may affect the lips, inside of the cheeks, gums, the tongue and the hard palate or the roof of the mouth.

Most throat cancers, like 90 percent of all head and neck cancers, are squamous cell carcinoma, which forms in the thin, flat cells that line much of the throat. Cancers other than throat cancers may also cause a sore throat, cough, hoarseness, difficulty or pain when swallowing and swollen lymph nodes in the neck. These cancer types include:

Lung cancer
Esophageal cancer
Thyroid cancer
Oral cancer
Salivary gland cancer
Lymphoma

More than 70 percent of oropharyngeal cancers are caused by the human papillomavirus (HPV). In fact, HPV is a more common risk factor for throat cancer than tobacco or alcohol use. The positive impact of the HPV vaccine in preventing throat cancers may not be seen for many years, says Dr. Kim, who urges those eligible to get the vaccine. The CDC recommends the vaccine for 11- to 26-year-olds, and, if recommended by a doctor, for patients up to age 45.

“I want to tell people to reduce their chance of developing cancer by avoiding smoking, chewing tobacco or excessive alcohol use and following safe sexual practices,” Dr. Kim said. “Prevention is the key.”

No Fever, Cough, Causes, STD

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Allergies

When you have an allergy, your immune system is hyper-reactive to certain substances that are normally harmless. These substances are called allergens.

Common allergens include foods, certain plants, pet dander, dust, and pollen. You’re particularly susceptible to a persistent sore throat if you have allergies associated with things you breathe in (pollen, dust, synthetic fragrances, mold, and so forth).

The most frequent symptoms associated with these types of airborne allergies include:

runny nose
coughing
sneezing
itchy eyes
watery eyes

The postnasal drip from a runny nose and inflamed sinuses is the most likely cause of a sore throat due to allergies.

Postnasal drip

When you have postnasal drip, excess mucus drains from your sinuses into the back of your throat. This can lead to a persistent raw, sore, or scratchy throat. Postnasal drip can be triggered by weather changes, some medicines, spicy foods, a deviated septum, allergies, dry air, and more.

Besides sore throat, some of the symptoms of postnasal drip include:

no fever
bad breath
a sensation of needing to swallow or clear your throat all the time
coughing that worsens at night
nausea from the excess mucus in your stomach

Mouth breathing

If you breathe through your mouth chronically, particularly when you’re asleep, this can lead to a recurring sore throat. Most likely, you’ll experience it first thing in the morning when you wake up, and the soreness is likely to be relieved once you take a drink.

The symptoms of nighttime mouth breathing include:

dry mouth
scratchy or dry throat
hoarseness
fatigue and irritability upon waking
bad breath
dark circles under your eyes
brain fog

Most of the time, mouth breathing is due to some kind of nasal obstruction that prevents you from breathing properly through your nose. This can include nasal congestion, sleep apnea, and enlarged adenoids or tonsils.

Acid reflux

Acid reflux, also known as heartburn, occurs when the lower esophageal sphincter (LES) has weakened and becomes unable to close tightly. Stomach contents then flow backward and up into the esophagus. Sometimes acid reflux can lead to a sore throat. If you’re having symptoms daily, it’s possible for them to cause persistent soreness.

Over time, the acid from your stomach can damage the lining of the esophagus and your throat.

Common symptoms of acid reflux include:

sore throat
heartburn
regurgitation
sour taste in your mouth
burning and discomfort (upper middle stomach area)
trouble swallowing

Tonsillitis

If you’re experiencing a prolonged sore throat and are unable to find relief, it’s possible you may have an infection like tonsillitis. Most often, tonsillitis is diagnosed in children, but people can get it at any age. Tonsillitis can be caused by bacterial infections or viruses.

Tonsillitis may recur (reappearing multiple times per year) and requires treatment with prescription antibiotics. Because there are multiple types of tonsillitis, symptoms are widely varied and can include:

difficulty swallowing or painful swallowing
a voice that sounds scratchy or hoarse
a severe sore throat
stiff neck
jaw and neck tenderness due to swollen lymph nodes
tonsils that appear red and swollen
tonsils that have white or yellow spots
bad breath
fever
chills
headaches

Mono

Another cause of sore throat and tonsillitis, mononucleosis (or mono for short) results from an infection by the Epstein-Barr virus (EBV). While mono can last up to two months, in most cases it’s mild and can be resolved with minimal treatment. Mono feels like having the flu, and its symptoms include:

sore throat
swollen tonsils
fever
swollen glands (armpits and neck)
headache
fatigue
muscle weakness
night sweats

It’s possible a person with mono might experience a persistent sore throat for the duration of the active infection.

Gonorrhea

Gonorrhea is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. You might think of an STI as something that only affects your genitals, but a gonorrhea infection in the throat can occur from unprotected oral sex.

When gonorrhea affects the throat, it typically only results in a red and persistently sore throat.

Environmental pollution

If you live in an area like a large city, it’s possible you could have a persistent sore throat from smog, a conglomeration of airborne pollutants. Especially on hot days, it can be dangerous to breathe smog. In addition to an irritated, sore throat, breathing smog can cause:

worsening of asthma symptoms
coughing
chest irritation
difficulty breathing
lung damage

Tonsil abscess

A peritonsillar abscess is a serious bacterial infection in the tonsil that can cause a persistent, severe sore throat. It can occur when tonsillitis haven’t been properly treated. A pus-filled pocket forms near one of the tonsils when infection breaks out of the tonsil and spreads to the surrounding tissue.

You may be able to see the abscess at the back of your throat, but it’s possible that it could be hidden behind one of your tonsils. Symptoms are usually similar to those of tonsillitis, though more severe. They include:

sore throat (usually worse on one side)
tender, painful, swollen glands in the throat and jaw
ear pain on the side of the sore throat
infection in one or both tonsils
difficulty opening the mouth fully
difficulty swallowing
difficulty swallowing saliva (drooling)
swelling of the face or neck
difficulty turning the head from side to side
difficulty tilting the head down (moving the chin to the chest)
difficulty tilting the head up
headache
muffled voice
fever or chills
bad breath

Smoking

Smoking and exposure to secondhand smoke can cause a scratchy or sore throat, along with worsened asthma, bronchitis, emphysema, and more.

In mild cases, the exposure to toxins in cigarette smoke leads to the sore throat. But smoking is also a risk factor of throat cancer, which can result in throat pain as well.

If your sore throat lasts longer than two days, contact your doctor for an examination. Reasons for a sore throat are easily diagnosed, and most are easily treated. But see a doctor or seek emergency treatment immediately if you experience:

severe pain that impairs eating, talking, or sleeping
high fever over 101˚F (38˚C)
intense, severe pain on one side of your throat, along with swollen glands
trouble turning your head

If you don’t already have a primary care doctor, you can browse doctors in your area through the Healthline FindCare tool.

If you have a persistent sore throat that isn’t due to an infection, it’s possible to treat your symptoms at home. Here are some things to try to relieve symptoms of a sore throat:

Suck on a lozenge or piece of hard candy. Here’s a selection to choose from.
Drink plenty of water.
Eat popsicles or chipped ice.
Run a humidifier if the air in your house is dry. Purchase a humidifier online.
Irrigate your nasal passages with a neti pot or bulb syringe. Shop for neti pots or bulb syringes.
Give yourself a steam treatment (breathing steam from a bowl of hot water or in the shower).
Sip warm broth or tea.
Add honey and lemon to warm tea or water. Shop for honey.
Sip juice with a small amount of diluted apple cider vinegar. Find apple cider vinegar online.
Take a pain reliever like acetaminophen (Tylenol), ibuprofen (Advil), or naproxen (Alleve). Purchase pain relievers here.
Gargle with salt water.
Limit exposure or remove allergens from your environment.
Take over-the-counter allergy or cold medication. Shop for allergy medications or cold medications.
Stop smoking.

In some cases, your doctor will need to intervene with treatment solutions to help you find relief:

If your sore throat is due to acid reflux, your doctor might prescribe antacid medication to relieve your symptoms.
Your doctor could prescribe a prescription allergy medicine, allergy shots, or nasal spray if seasonal allergies are causing your sore throat.
For tonsillitis, your doctor will prescribe a course of antibiotics to treat the infection.
Your doctor might prescribe steroid medication to relieve the swelling and pain of an EBV infection if you have mono.

For more severe conditions like an advanced infection or peritonsillar abscess, you may have to be hospitalized to receive antibiotics through a vein (intravenously). In some cases, an abscessed tonsil requires surgery. Chronically swollen tonsils that impair breathing or sleeping may need to be surgically removed.

Most of the time, a persistent sore throat can go away on its own within a few days to a week, depending on its cause and treatment. Throat infection symptoms may persist for up to seven days, even with treatment. People with mono might experience a sore throat for up to two months.

If you require tonsillectomy surgery or surgery to treat an abscess, you should expect to experience some pain in your throat during the recovery period.

Read this article in Spanish.

Sore throat without fever: causes, treatment

05/29/2023

190 958

2 minutes

Author, editor and medical expert – Klimovich Elina Valerievna.

Editor and medical expert – Harutyunyan Mariam Harutyunovna.

Contents:

Causes
Diagnosis
How to treat a sore throat
Preventive measures

A sore throat can bother an adult several times a year ¹ . Most often, it is one of the symptoms of acute respiratory viral infections (ARVI) ² and is usually accompanied by fever ³ . However, sore throat can occur without fever. When does this happen and what can be done to alleviate the condition?

Causes

Sore throat can be felt in different ways. For some, it is strong, “cold” or “cutting” ⁵ , others complain not so much about pain, but about tingling, dryness, itching, feeling of a “lump” in the throat ⁴ . All these complaints may be associated with infectious and non-infectious processes occurring in the body ⁵ . Let’s examine each reason in more detail.

Colds

Infectious and inflammatory processes in the upper respiratory tract are in the first place among the causes of sore throat ¹ . The most common cause of the typical cold is rhinoviruses ⁹ . They account for 30-50% of ARVI cases. A rhinovirus infection usually occurs without fever, but causes sore throat, runny nose, sneezing, nasal congestion, and cough ⁹ .

Pharyngitis

Chronic pharyngitis, or inflammation of the pharynx, in adults often occurs without fever ⁸ , and sore throat is mild and feels like itching or soreness ⁸ . The acute form can be associated with both viral and bacterial infection ¹¹ , while exacerbation of chronic pharyngitis, as a rule, provokes group A beta-hemolytic streptococcus or an association of several bacteria ¹¹ .

Tonsillopharyngitis

The term “tonsillopharyngitis” is used to refer to combined inflammation of the mucous membrane of the pharynx (pharyngitis) and tonsils (tonsillitis) ⁶ . In 90% of cases, the causative agents of the disease are respiratory viruses ³ . In 5-15% of adults, the disease is caused by pathogenic bacteria (group A beta-hemolytic streptococcus), and even more rarely by fungi ³ .

With tonsillopharyngitis, the thermometer also does not always rise above the norm ⁶ . Even inflammation caused by group A beta-hemolytic streptococcus sometimes proceeds without a significant increase in temperature ⁶ . But the pain in the throat can be severe, sharp, especially when swallowing ⁶ . If you examine the throat, you will notice that the inflamed tissues differ from the healthy ones in red color, often on the tonsils and the back wall of the pharynx there is a plaque ⁶ .

Absence of fever should not be considered “mild disease” ⁶ . Even with unexpressed complaints, streptococcal pharyngitis and tonsillopharyngitis can lead to the development of serious complications from the heart, blood vessels, kidneys and joints ¹⁰ .

If you start treatment in time and strictly follow the doctor’s recommendations, complications in most cases can be avoided ⁵ .

Laryngitis

Acute sore throat without fever, dry “barking” ⁴ cough and hoarseness may be symptoms of a mild form of laryngitis, when the inflammatory process is limited to the mucous membrane of the larynx ⁷ . In this case, the body temperature sometimes remains normal ⁷ . Fever usually joins with the progression of the disease, for example, if the inflammation becomes purulent and captures the deeper layers of tissues ⁷ .

Laryngitis can occur with influenza, parainfluenza, adenovirus infection, but sometimes it is associated with non-infectious causes ⁷ .

Non-infectious causes of sore throat without fever

Inflammation of the pharynx and larynx can be caused not only by infection, but also by other factors. So, the cause of sore throat without fever can be:

laryngopharyngeal reflux — a disorder in which the acidic contents of the stomach are thrown into the pharynx and larynx ² and cause inflammation ¹¹ ;
postnasal drip syndrome — runoff of inflammatory fluid along the pharyngeal wall in diseases of the nasal cavity and paranasal sinuses ^11.12 ;
allergy – to cold, food, wool, mold, pollen ⁴ ;
injuries – mechanical damage to the mucosa by foreign bodies ^4.11 or irritation of the pharynx by chemicals (acids, alkalis, exhaust gases) when they are swallowed or inhaled ^11.13 ;
smoking – not only active but also passive ¹³ .

Sore throat without fever often occurs in violation of nasal breathing, forced breathing through the mouth and abuse of vasoconstrictor drops ¹³ . The latter are able to get from the nasal cavity into the pharynx and disrupt blood circulation in the mucous membrane ¹³ .

Inflammation of the pharynx, as well as its manifestation – sore throat – can become a chronic problem in people with diabetes, hypovitaminosis, as well as heart and kidney diseases ¹³ . Therefore, if you often have a sore throat, be sure to make an appointment with your doctor.

Diagnosis

Only a doctor can determine the cause of a sore throat. First you need to visit a therapist. Having compared the examination data with the patient’s complaints, after conducting additional studies, the doctor will either immediately prescribe treatment or refer him for a consultation to another specialist.

In case of diseases of the nose and paranasal sinuses, lesions of the tonsils, other structures of the pharynx and larynx, the help of an ENT doctor is needed.

Since the problem can be caused by non-infectious processes, sometimes consultation with a gastroenterologist, allergist, dentist, neurologist, psychotherapist, endocrinologist is required. It is important not to hesitate to visit a doctor in order to detect the cause of complaints as soon as possible and begin the necessary treatment.

How to treat a sore throat

Treatment of sore throat with or without fever is based on the cause of the disease ⁵ . So, with infectious and inflammatory processes in the throat, it is necessary to fight the causative agents of the infection – bacteria, viruses and fungi. Therefore, the doctor may prescribe antiviral, antibacterial and antifungal drugs ⁵ .

Sore throat caused by viruses requires symptomatic treatment – the use of drugs to relieve unpleasant symptoms ⁵ . Local treatment allows you to act directly on the focus of inflammation, creating a concentration of active substances in it ⁵ , and the onset of action is reduced ⁵ .

For local treatment of infectious and inflammatory diseases of the pharynx, antiseptics are intended that act on viruses, bacteria and fungi, such as HEXORAL ^® .

HEXORAL ^® Spray approved for use by adults and children over 3 years of age ¹⁵ . As an active ingredient, it contains hexetidine ¹⁵ , which is active against influenza A viruses, respiratory syncytial virus (RS virus) and herpes simplex virus type 1, affecting the respiratory tract ¹⁵ , destroying up to 99% of viruses causing SARS ¹⁴ . The drug also fights bacteria and fungi ¹⁵ and helps to relieve sore throat from the first application.

HEXORAL ^®solution is indicated for adults and children from 3 years of age. It contains hexetidine and essential oils of anise, eucalyptus, cloves and peppermint. The solution can be used for classic throat gargling ¹⁶ . It does not need to be diluted in a glass, it is completely ready for use and therefore convenient to use.

HEXORAL ^® TABS are approved for use in adults and children over 4 years of age ¹⁸ . The lozenges have a mint flavor and give a slight “chill” sensation in the throat ¹⁸ . The antiseptic chlorhexidine dihydrochloride, which is part of the preparation, helps fight infection, and the anesthetic benzocaine helps to reduce sore throat ¹⁸ .

HEXORAL ^® TABS CLASSIC are suitable for adults and children over 6 years of age. The line includes lozenges with orange, lemon, honey-lemon and blackcurrant flavors. The preparation contains a combination of antiseptics (amylmetacresol, dichlorobenzyl alcohol) acting on bacteria and fungi, as well as essential oils ¹⁷ .

HEXORAL ^® TABS EXTRA is intended for adults and children from 12 years of age. In addition to antiseptics, the drug contains the anesthetic lidocaine ¹⁹ and has a dual effect – it fights infection and helps fight even severe sore throats ¹⁹ .

Preventive measures

To prevent a sore throat, it is necessary to eliminate, if possible, factors that can cause diseases of the pharynx:

give up cigarettes and alcohol ⁷ ;
avoid drinks that are too hot or too cold ⁷ ;
avoid hypothermia and avoid contact with irritants ¹⁰ ;
treat diseases of the nose and paranasal sinuses ^7.10 ;
do not abuse the use of vasoconstrictor drops ¹³ .

Sore throat without fever is not just an unpleasant symptom. Even if it occurs against the background of a cold, do not expect everything to go away on its own. Pay attention to the signals of your body, consult a doctor to find out the cause of unpleasant symptoms and get the necessary medical attention.

The information in this article is for reference only and does not replace professional medical advice. For diagnosis and treatment, contact a qualified specialist.

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Sore throat at night: causes and treatment

Sore throat at night can interfere with your sleep without giving you a proper rest. Fortunately, in most cases it does not require treatment and goes away on its own in about a week. There are many ways to help you reduce discomfort during this period in order to get a good night’s sleep.

Causes of sore throat at night

According to experts , most cases of sore throat are associated with bacterial and viral infections. Nighttime sore throats can also be caused by allergies, dry or polluted air in the bedroom, or smoking.

In some cases, sore throat at night is caused by infection with bacteria from the group of pyogenic streptococci, which cause streptococcal pharyngitis. In addition to a sore throat, symptoms of streptococcal pharyngitis include redness and swelling tonsils , small red spots in the back of the mouth, fever, nausea, vomiting, enlarged cervical lymph nodes, headache, body aches and rash. In adults, sore throat at night is associated with pharyngitis in only 5-15% of cases, while in children this figure is 20-30 percent.

Otolaryngologists name some other causes of nocturnal sore throat:

Acid reflux, in which the contents of the stomach are thrown into the larynx, causing pain and irritation.
Mononucleosis is a viral disease that affects many human organs.
Tension of the muscles of the larynx.
Tonsilloliths, or tonsil stones, that is, pieces of mineralized matter that accumulate in the caverns of the tonsils and cause tissue inflammation and discomfort.

Home Treatment

If you suffer from sore throats at night, pay attention to the quality of the air in your bedroom. For relief of symptoms Doctors recommend using a humidifier. Also try increasing your fluid intake by drinking warm tea with honey and gargling with salted water. To prepare the rinse, dissolve a quarter teaspoon of salt in half a glass of warm water. Perform the procedure several times a day until the symptoms disappear.

When to Seek Medical Care

Although a sore throat often resolves on its own, in some cases it can be a symptom of a more serious condition.