You may not recognise the term pharyngitis, but you are likely to know what we’re talking about when we say sore throat.1,2 It may not be easy to forget the pain and discomfort associated with a sore throat, especially if it is affecting your day or even how well you sleep.1,3

There are a number of causes of a sore throat, which we will go through. This list is not exhaustive, but some examples are:1,4

  • Infections caused by viruses or bacteria
  • Exposure to irritants like smoke or dust
  • Allergies
  • Other causes might include mouth breathing or snoring or certain medications.

So let’s look more closely at what a normal throat versus a sore throat might be, as well as some causes of a sore throat.

Disclaimer

This list is not exhaustive and is not meant to replace the professional opinion of your healthcare provider.

Healthy Throat vs Sore Throat

Compared with a normal throat, a sore throat is usually painful due to inflammation of the lining of the throat, including the tonsils.5 Most causes of a sore throat are infection, which usually get better on their own and can be managed at home.4,5 If a sore throat lasts longer than a few days, you should see a doctor to rule out other causes of a sore throat.1,4

Common Causes of a Sore Throat

We briefly touched on what is likely to cause a sore throat and what it feels like compared with a normal throat. Let us now look at some of the causes of a sore throat in more detail.

It important to remember that if a sore throat or other symptoms are getting worse, new symptoms are appearing or symptoms including the sore throat are lasting longer than a few days, then it’s important to see a doctor.1,4

Viral Infections

Did you know that viral infections are the most common causes of a sore throat, and can affect all age groups?1,5 There are many different types of viruses that can infect and cause sore throat symptoms, including respiratory syncytial virus, rhinovirus, adenovirus, influenza virus and parainfluenza virus.1 Only a doctor can test and diagnose a viral sore throat. If a virus is the culprit, it’s most often a rhinovirus, which also happens to be one of the viruses responsible for the common cold.1,6 Symptoms of the common cold include a sore throat, runny or stuffy nose.1,6 There can be more serious viral infections which can cause a severe sore throat, with other symptoms such as fever, nausea, rash and fatigue.1

Bacterial Infections

Bacterial infections can also cause a sore throat, but are usually less common than viral sore throat infections.1 A sore throat caused by bacteria is more commonly found in school-aged children and adolescents, but can occur in younger kids and adults as well.1 A common bacterial culprit are the Streptococcus group of bacteria, and typical symptoms can include fever above 38°C, sore lymph nodes around the neck and head area, fluid being excreted from the tonsils or even sinus congestion.1 To determine a bacterial or viral infection, a doctor will usually need to take a swab and send it off for testing. Bacterial infections may be treated with antibiotics , while viral infections should not be.1

Dry Air

Dry air has been known to be a cause of a sore throat for some people.1 Where someone may be predominately breathing through their mouth or snoring at night, any dry air contacting the nose and throat areas can cause irritation and soreness.7 If you are getting a sore throat at home, and think it could be due to dry air, you should speak with your doctor for further advice.

Irritants

There are a range of irritants which can either contribute or cause a sore throat, including pollution, medications, cigarette smoke and even gases from volcano eruptions!1,7 Cigarette smoking can give you a sore throat. Quitting smoking is a good way to help prevent sore throat and a range of other medical health issues. Not smoking near others in the home will also help prevent passive smoking induced sore throat.7 If you think your sore throat is connected to smoking or other environmental factors, speak with your doctor about quitting or what other options are available.

Overusing Your Voice

Another cause of a sore throat is from overusing your voice, shouting or excessive talking.7 For those who work in roles where there is constant talking, shouting or singing, there can also be a risk of developing laryngitis (inflammation of the larynx resulting in voice hoarseness or dry cough). For fans at a concert or big sporting event, the excitement and thrill of getting involved and shouting or screaming may also cause damage and inflammation in the throat area.7,8 So whilst the excitement of a big game or other event may get the better of us, not shouting too much might ensure we don’t get a sore throat in this way.

Sore Throat Risk Factors

We’ve touched on some of the more common causes of sore throat, let's also have a look at some of the risk factors.

Tobacco Smoke

It is possible to get a sore throat from smoking by breathing in or passively smoking tobacco smoke from others around us.7 In the home setting, other family members such as kids could be at risk, especially if the smoker in the family is smoking inside the range where passive smoking is possible.7 Quitting smoking is the most effective solution to remove this sore throat cause, speak with your doctor to find out more.

Age

Age can also be a factor in some of the following ways:1,5

  • Children, school age and younger tend to be exposed to infections and may have inadequate hand hygiene that promotes the spread of germs
  • Teenagers and young adults can be susceptible to infections passed through direct person-to-person contact
  • Teenagers, adults and even older people can put themselves at risk of sore throat if excessively using their voice for extended periods
  • The most common cause of sore throat, viral infections, can occur across all age groups.

People with weakened immune systems

For people who have a weakened immune system, there may be a heightened risk of acquiring infections that can cause a sore throat.9-11 Most people who have a weakened immune system will likely know they do so, but it’s important to take precautions to prevent unnecessary exposure to infections.

Being in a Crowd

Many of the infectious causes of sore throat can be spread easily through close contact and crowded conditions.12 For instance, some germs are spread via air droplets, direct contact or touching contaminated surfaces in places like shopping centres, playgrounds, or school classrooms.12,13 Being in proximity to people who are sick with germs that infect the upper airways can increase the chance of getting sick.12,14 Taking precautions such as wearing face masks, hand washing and social distancing are important to help protect oneself.12,14

When to see a doctor

You should seek medical advice if you or someone in your family experience any of the following:1

  • snoring-type sound when breathing
  • wheezing
  • muffled voice
  • difficulty moving your jaw
  • neck swelling
  • drooling
  • neck pain
  • throat pain on one side only
  • severe neck pain
  • breathing difficulty
  • any other signs or symptoms that concern you.
References
  1. Algorithm for assessing and managing acute sore throat. In: Therapeutic Guidelines [digital]. Melbourne: Therapeutic Guidelines Limited; May 2022 [cited Oct 2022]. Access from: https://www.tg.org.au

  2. Renner B & Mueller CA. Inflamm. Res. 2012: 61; 1041–52

  3. Robinson CH, et al. Fam Pract. 2021;38(6):802-10

  4. Krueger K, et al. Dtsch Arztebl Int. 2021;118(11):188-94

  5. National Library of medicine. StatPearls Publishing LLC [Internet]. Laryngitis: Treasure island (FL). Last Updated: May. 2022 [Accessed Oct. 2022]. Access from: https://www.ncbi.nlm.nih.gov

  6. Eccles R. Lancet Infect Dis 2005; 5: 718–25

  7. Renner B & Christian AM. Inflamm. Res. 2012: 61;1041–52

  8. National Library of medicine. StatPearls Publishing LLC [Internet]. Acute Pharyngitis: Treasure island (FL). Last Updated: Sept. 2022 [Accessed Oct. 2022]. Access from: https://www.ncbi.nlm.nih.gov

  9. National Library of medicine. StatPearls Publishing LLC [Internet]. Upper Respiratory Tract Infection:Treasure island (FL). Last Updated: June. 2022 [Accessed Oct. 2022]. Access from: https://www.ncbi.nlm.nih.gov

  10. Vallalta M, et al. Rev Esp Quimioter. 2006;19(4):367-75

  11. Cohen JI. Curr Top Microbiol Immunol. 2015; 390(Pt 1): 241–65

  12. Leung N.H.L. Nat. Rev. Mic 2021. 19: 528–45

  13. Tanz RR National Library of Medicine. Nelson Pediatric Symptom-Based Diagnosis [internet]. Sore Throat. Elsevier Public health Emergency Collection. Last Update May 2017 [cited Oct 2022]. Access from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7152117/

  14. U.S. Department of Health & Human Services. Centers for Disease Control and Prevention. Common Colds: Protect Yourself and Others. Last updated November 29, 2021 [Cited Aug 2022]. Access from: https://www.cdc.gov/features/rhinoviruses/index.html

This article is for general information only and not intended as a substitute for medical advice.

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