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Pharyngitis: Top 2 Reasons Your Throat Hurts

A sore throat can be mildly irritating or make it painful to even swallow. Here’s how to find relief.
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Written by
Sam Kelly, MD.
Medically reviewed by
Last updated March 9, 2022

Pharyngitis quiz

Take a quiz to find out if you have pharyngitis.

Care Plan

1

First steps to consider

  • Most viral sore throats will get better on their own with home care.
  • Treat with pain relievers like Tylenol and soothing throat lozenges and sprays.
2

When you may need a provider

  • You have fever, white spots or streaks on the back of your throat, or swollen lymph glands.
  • Your child is not eating or drinking, losing weight, or their sore throat lasts more than a few days.

Emergency Care

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Call 911 or go to the ER if you have any of the following symptoms:

  • Difficulty swallowing or breathing
  • Swelling at the back of your throat

Pharyngitis quiz

Take a quiz to find out if you have pharyngitis.

Take pharyngitis quiz

What is pharyngitis?

Pharyngitis is better known as a “sore throat.” The pharynx is what we think of as the throat—the area at the back of the mouth and back of the nasal passages. When the throat becomes inflamed, it’s called pharyngitis. It’s your body’s response to an infection.

Generally, pharyngitis is caused by a “cold” virus and gets better on its own within a few days. While less common, bacteria can also cause pharyngitis. The most common bacteria to cause sore throats is streptococcus, which causes “strep throat.” In this case, you will be treated with antibiotics.

Symptoms of pharyngitis

Dr. Rx

You should start feeling better within a few days. In the meantime, for symptoms try acetaminophen (Tylenol) or ibuprofen (Advil) and numbing lozenges and throat sprays. Hot drinks and frozen foods—tea and soup, popsicles and ice cream—can also help relieve pain. —Dr. Ben Ranard

Mild to severe throat pain is the most common symptom of pharyngitis. It can be painful and difficult to swallow, eat, or talk. Your throat may feel dry, scratchy, or itchy, and you may have a hoarse (rough-sounding) voice. You may also have a painful, dry cough. Sometimes, people get a fever and headache.

Depending on whether you have bacterial or viral pharyngitis, you might have other symptoms as well. Since viruses (like the common cold or the flu) are often the cause, you may have a runny nose and congestion (stuffy nose). Also possible is pain or irritation of the eyes (conjunctivitis) or ears (otitis).

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.

Pro Tip

Look out for symptoms that might indicate you or a child might have strep throat. These include lack of a cough, sudden onset sore throat with fever, swollen tonsils that have red or white patches, swollen lymph nodes in front of neck, or rash. —Dr. Ranard

Pharyngitis quiz

Take a quiz to find out if you have pharyngitis.

Take pharyngitis quiz

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).

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Pharyngitis in children

Pro Tip

A common misconception is that antibiotics will help all sore throats. But sore throats are usually from a virus—and go away on their own. Antibiotics don’t treat viruses. They can have bad side effects and should only be used when they will help. —Dr. Ranard

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.

Pharyngitis quiz

Take a quiz to find out if you have pharyngitis.

Take pharyngitis quiz

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.
Share your story
Dr. Ranard is a Pulmonary and Critical Care fellow at Columbia University Irving Medical Center / NewYork-Presbyterian Hospital. He received his undergraduate degree in Biological Sciences from Cornell University (2011) and his Doctor of Medicine and Masters of Science in Health Policy Research from the University of Pennsylvania Perelman School of Medicine (2016). In addition to pulmonology and c...
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