What causes a sore throat with no other symptoms

Having a sore throat can be uncomfortable, or worse. In many cases, sore throats are caused by viral infections but an expert at Baylor College of Medicine says that although this may be the most common cause; multiple health conditions may play a role in having an itchy, irritated and painful throat.

“The most common reason for someone to develop a sore throat would be a virus, and this is often accompanied by a runny nose, cough or malaise,” said Dr. Julina Ongkasuwan, assistant professor of otolaryngology at Baylor.

A severe sore throat may be an indication of possible strep throat, a bacterial infection. Individuals who develop strep throat often have high fevers or pus on the tonsils; however, Ongkasuwan said many other viral infections may be associated with high fevers so she recommends visiting your doctor for a throat swab.

“For most people experiencing a sore throat, I generally recommend rest and hydration. If you are highly concerned then you should get a strep swab, and you really shouldn’t take antibiotics unless the strep swab is positive,” she said.

Those who experience strep throat multiple times a year may be a candidate for tonsillectomy. “According to the Academy of Otolaryngology Head and Neck Surgery, if an individual has documented strep throat seven times in one year, five times per year for two consecutive years, or three times per year for three consecutive years, they can consider having their tonsils removed,” Ongkasuwan said.

Other health conditions that can cause sore throat are reflux, tonsil stones, muscle tension, and mononucleosis, also known as mono. Acid reflux can cause heartburn and if the acid reaches the throat it can also lead to throat discomfort. Tonsil stones refer to food debris that get stuck in the tonsils resulting in inflammation and irritation.

For throat pain that persists beyond three weeks and is accompanied by difficulty swallowing or weight loss, Ongkasuwan recommends visiting a doctor to rule out any severe health conditions.

There are ways to sooth a sore throat without having to take antibiotics, such as non-caffeinated warm tea or hot water with honey.

“Sore throats are very common. While viral infections are the most common cause, severe or persistent pain may be indicative of a more serious problem. If your throat pain lasts longer than 3 weeks or if you are concerned, visit your local doctor.”

Sore throats are not usually serious and often pass in three to seven days. There are some treatments you can use at home to relieve your symptoms.

Painkillers

For treating sore throats, over-the-counter painkillers, such as paracetamol, are usually recommended. These may also help reduce a high temperature (fever).

You should not take aspirin or ibuprofen if you have:

• asthma
• current or past stomach problems, such as a stomach ulcer
• current or past liver or kidney problems

Children under the age of 16 should never be given aspirin.

Take painkillers as necessary to relieve your pain. Always read the manufacturer’s instructions so you do not exceed the recommended or prescribed dose.

Self-care tips

If you or someone in your family has a sore throat, the tips below may help relieve the symptoms:

• avoid food or drink that is too hot, as this could irritate the throat
• eat cool, soft food and drink cool or warm liquids
• adults and older children can suck lozenges, hard sweets, ice cubes or ice lollies
• avoid smoking and smoky environments
• regularly gargling with a mouthwash of warm, salty water may help reduce swelling or pain
• drink enough fluids, especially if you have a fever

Steam inhalation is not recommended, as it's unlikely to help a sore throat and there is a risk of scalding.

Antibiotics

The use of antibiotics is not usually recommended for treating sore throats. This is because most sore throats are not caused by bacteria.

Even if your sore throat is caused by bacteria, antibiotics have very little effect on the severity of the symptoms and how long they last, and may cause unpleasant side effects.

Overusing antibiotics to treat minor ailments can also make them less effective in the treatment of life-threatening conditions. This is known as antibiotic resistance.

Antibiotics are usually only prescribed if:

• your sore throat is particularly severe
• you are at increased risk of a severe infection – for example because you have a weakened immune system due to HIV or diabetes(a long-term condition caused by too much glucose in the blood)
• you are at risk of having a weakened immune system – there are some medications that can cause this, such as carbimazole (to treat an overactive thyroid gland)
• you have a history of rheumatic fever (a condition that can cause widespread inflammation throughout the body)
• you have valvular heart disease (a disease affecting the valves in your heart, which control blood flow)
• you experience repeated infections caused by the group A streptococcus bacteria

Delayed antibiotics prescription

If your pharmacist thinks you might need antibiotics, they may recommend you see your GP who might issue a prescription but ask you to wait up to three days for symptoms to improve.

If your sore throat gets worse, or has not improved after three days, you should have instructions to either:

• take your prescription slip to a pharmacy
• return to the GP surgery after three days to collect your medication

Recent studies show that complications of a sore throat are uncommon and usually not serious. A delayed antibiotic prescription seems to be as effective as an immediate prescription in reducing complications.

Using a delayed prescription provides similar benefits to an immediate prescription. Most importantly, this helps you to avoid taking antibiotics when they're not needed and helps prevent antibiotic resistance.

Tonsillectomy

A tonsillectomy is a surgical procedure to remove the tonsils (the two lumps of tissue on either side of your throat). If your child has repeated infections of the tonsils (tonsillitis), a tonsillectomy may be considered.

Read more about treating tonsillitis.

Glandular fever

If you are 15-25 years of age with a persistent sore throat, you may have glandular fever(also known as infectious mononucleosis, or mono). This is a type of viral infection with symptoms that can last up to six weeks.

Cancer

A persistent sore throat can also be a symptom of some types of cancer, such as throat cancer. This type of cancer is rare and mainly affects people over the age of 50. In the UK every year, 5,300 people are diagnosed with cancer of the oropharynx (the area at the back of your throat) or mouth.

Read more about mouth cancer

Non-infectious causes

In some cases, a sore throat may be caused by substances that irritate the throat. Sources can include:

• alcohol
• cigarette smoke
• an allergy– such as hay fever
• gastro-oesophageal reflux disease (GORD)– when stomach acid leaks out of the stomach and into the gullet

You may find that avoiding these substances, or seeking treatment for an allergy or GORD, can help to reduce symptoms of a sore throat.

Giving up smoking

If you smoke, giving up will reduce irritation to your throat and strengthen your defences against infection.

The Quit Your Way Scotland service can offer you advice and encouragement to help you quit smoking. Phone Quit Your Way Scotland free on 0800 84 84 84 (8.00am to 10.00pm, every day).

Your GP or pharmacist will also be able to give you help and advice about giving up smoking, or you can read more about quitting smoking.

Preventing a sore throat

As sore throats are caused by bacterial or viral infections, they can be difficult to prevent.

If you have a sore throat caused by an infection, you can help prevent the infection spreading by practising good hygiene, such as washing your hands regularly and keeping surfaces clean and free of germs.

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