Pharyngitis: Top 2 Reasons Your Throat Hurts

What is pharyngitis?

Pharyngitis, or sore throat, is the inflammation of the throat area located at the back of the mouth and nasal passages. It happens when your body responds to an infection caused by a virus or bacteria. The usual cause of sore throat is the "cold" virus, which typically gets better on its own within a few days. However, streptococcus bacteria can also cause sore throat or "strep throat." If your sore throat is due to bacterial infection, antibiotics will be prescribed as treatment.

Pharyngitis Symptoms

Pharyngitis typically causes mild to severe throat pain, making it hard to swallow, eat, or talk. Your throat may feel dry, scratchy, or itchy, and you may develop a hoarse voice. Additionally, you may have a dry cough that's painful. In some cases, pharyngitis causes a fever and headache.

If the pharyngitis is caused by a virus, like the common cold or flu, you might experience other symptoms like a runny nose and stuffy nose. Pharyngitis may also be associated with irritation of the eyes (conjunctivitis) or ears (otitis). If the sore throat is caused by bacteria, such as streptococcus, you will most likely have additional symptoms, such as fever, and need antibiotics to treat it.

Main symptoms

• Throat pain, from mild to severe
• Pain with swallowing

Other possible symptoms

• Dry, painful cough
• Fever
• Headache
• Runny nose
• Congestion
• Ear pain
• Red eyes

Pharyngitis causes

Most cases of pharyngitis are viral infections. Many different viruses can cause a sore throat. Adenovirus and rhinovirus all cause the “common cold.” So does coronavirus—the common cold virus, not the COVID-19 virus. Influenza is another virus that can also cause pharyngitis.

When a bacteria causes pharyngitis, it is most often Group A streptococcus, which leads to strep throat.

Typically, infections are passed from one person to another. A sneeze or cough can spread the virus or bacteria. Or touching shared surfaces and objects, like doorknobs, especially if you then touch your eyes, mouth, or nose.

Chronic pharyngitis—lasting longer than a few weeks—is less common. When this happens, it is probably not caused by an infection. Your throat may be reacting to environmental irritants like dry air, dust, smoke, or pollution. Allergies or acid reflux (GERD) might also be to blame.

Pharyngitis treatment

A viral sore throat always gets better on its own, usually within a few days. But warm tea, honey, and throat lozenges or sprays can be soothing. Look for over-the-counter pain remedies that have an “active ingredient” like menthol and benzocaine. These are known as analgesics or anesthetics—pain reducers or numbing medications. Over-the-counter pain relievers such as acetaminophen and ibuprofen can help too.

You may have strep throat if you have two or more of the following symptoms. Call your doctor if you think you or your child has strep throat. The doctor will do a throat culture to test for strep, and if positive, will prescribe antibiotics.

• Fever
• No cough
• White spots or streaks on tonsils or back of throat
• Swollen lymph nodes (painful lumps under chin and jaw)

Also contact your doctor if:

• Symptoms don’t improve after a few days.
• Swallowing is so painful that you can’t eat or drink.
• Pain is on one side of the neck.
• The pain is so bad that you cannot do your daily activities (work, sleep, etc).
• Coughing with lots of phlegm (thick fluid) or phlegm with blood.
• You can see white spots or streaks on your throat or tonsils.
• You have additional concerning symptoms (rash, joint swelling, weight loss, ulcers in the mouth).

Pharyngitis in children

Children often get pharyngitis. Similar to adults, most sore throats are from a virus and will go away on their own. But kids are more likely to develop the bacterial strep throat than adults. If strep throat is untreated, it can lead to heart problems and other long-term issues.

Infants and toddlers are often infected by viruses that may cause a sore throat and difficulty breathing. Antibiotics don’t help, but other treatments can be life-saving in very serious cases. If your child has a sore throat and trouble breathing or is drooling a lot, take them to the ER right away. Call your pediatrician if your child is not eating or drinking, losing weight, or if the sore throat lasts more than a few days.

What makes you more likely to get pharyngitis?

Your immune system fights off infections. When your immune system is weak, you may be more susceptible to sore throats. Uncontrolled diabetes, HIV, and drug use and significant alcohol use interfere with the body’s ability to fight off illness.

• Children get pharyngitis more frequently than adults. They are slightly more likely to have strep throat than adults.
• Viruses are more active from late winter through early spring.
• Sick family members or coworkers make it more likely that you’ll get infected.

Preventative tips

A sore throat is most often from the common cold, which is hard to prevent. You can try to prevent pharyngitis the way you would prevent any other infection.

• Wash hands before eating and try not to touch your face—eyes, nose, mouth.
• Wash hands after using the restroom or whenever you’ve been outside or around other people.
• Avoid close contact with people who are sick. And don’t share food or drinks.
• Although there aren’t any vaccines for common cold viruses, there is a vaccine for the flu, which also causes a sore throat. Make sure you and your family are up to date on your vaccines.