Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2006;74(7):1185-1186

What causes a sore throat?

Sore throats can be caused by many things. Viruses and bacteria can cause a sore throat, and so can smoking, breathing dirty air, drinking alcohol, and hay fever and other allergies.

What is tonsillitis?

Tonsillitis (tawn-sill-EYE-tuss) is when your tonsils (at the back of your mouth on each side of your throat) get swollen. This can cause a sore throat. Strep throat and tonsillitis can feel the same. Tonsillitis is usually caused by bacteria, but sometimes a virus may be the cause.

Symptoms of tonsillitis or strep throat

  • Sore throat

  • Fever

  • Headache

  • Vomiting

  • White patches in your throat or on your tonsils

  • Pain when you swallow

  • Swollen, red tonsils

  • Sore glands in your jaw and throat

Do I need surgery for tonsillitis?

Most people who have tonsillitis don’t need to have surgery. You might need surgery if you get very bad tonsillitis a lot or if your tonsils are too large and cause problems with your breathing. Your doctor can tell you if you need surgery.

What is strep throat?

Strep throat is caused by a certain kind of bacteria. Strep throat can feel like sore throats caused by other bacteria or by viruses. If strep throat is not treated, it can lead to heart problems.

What is mononucleosis?

Mononucleosis (mono) is an infection caused by a virus. Mono can cause a sore throat that lasts for up to four weeks. It also can cause fever and chills, headache, feeling tired, and swollen glands in your neck, armpits, and groin.

How can my doctor tell what is causing my sore throat?

Your doctor may do a rapid strep test, a throat culture, or both. A rapid strep test will give results within about 15 minutes. A throat culture takes about 24 hours, but it is more accurate than the rapid strep test. If your doctor thinks you may have mono, he or she will probably do a blood test.

What is the treatment for a sore throat?

If your sore throat is caused by bacteria, your doctor will probably give you an antibiotic. Antibiotics do not work against viruses. Sore throats caused by viruses usually just have to run their course. Most sore throats caused by a cold virus go away in about 10 days.

If you have mono, your doctor will probably tell you to get plenty of rest and not to exercise too hard. You can take acetaminophen (one brand: Tylenol), ibuprofen (one brand: Motrin), or naproxen (one brand: Aleve) for the headache and other aches.

Easing the pain of a sore throat

  • Take an over-the-counter pain medicine.

  • Gargle with warm salt water (one teaspoon of salt stirred into a glass of water).

  • Suck on throat lozenges or hard candy.

  • Suck on flavored frozen desserts (such as ice pops).

  • Use a humidifier in your bedroom or other rooms you spend a lot of time in.

  • Drink plenty of liquids.

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