When to see a doctor for a sore throat

No one likes having a sore throat. It can affect your ability to eat, drink, talk — and be downright painful. But a sore throat is just a symptom, with many possible causes.

Most sore throats improve on their own, according to UCLA Health pediatrician Carlos F. Lerner, MD. But he adds that on some occasions, a sore throat can be a sign of something more serious. The challenge is knowing when it’s time to transition from home remedies to seeing a doctor.

Common sore throat causes

Viruses, such as the common cold or seasonal flu, are the root cause of most sore throats. But they aren’t the only reason throats become irritated. And different ailments may require different treatments, so it’s important to identify what’s causing this symptom.

Sore throats may be the result of:

  • Allergies
  • Bacteria
  • Dry air
  • Irritation caused by voice overuse, pollution, excessive dust or chemicals in the air
  • Smoking or exposure to second-hand smoke
  • Throat or mouth cancer, which affects approximately 1% of adults
  • Virus, or nasal drainage related to a viral infection

How a bacterial sore throat differs from a virus

Bacterial sore throats are typically caused by group A strep bacteria, which cause streptococcal pharyngitis — commonly known as strep throat.

Only 1 in 10 adults and 3 in 10 children with sore throats have strep throat. But an accurate diagnosis is important — unlike viral sore throats, bacterial infections respond to treatment with antibiotics.

The symptoms associated with viral and bacterial sore throats can be similar. But there are some differences. Consider how much it hurts, how long it lasts and what other symptoms you have.

Viral sore throats develop over a few days and may be accompanied by a cough, runny nose or hoarse voice. Strep throat tends to come on quickly and may include:

  • Fever over 100
  • Pain when swallowing
  • Rash, known as scarlet fever
  • Red and swollen tonsils, often with white patches or pus
  • Small, red spots on the roof of the mouth
  • Swollen lymph nodes

Sore throat symptoms that need medical attention

Viral sore throats typically show signs of improvement within five days. But if your symptoms don’t improve or you have a fever of 101 or higher that lasts for a few days, it may be time to see your primary care physician.

“If it’s going on too long, seems too severe or is associated with other worrisome symptoms, definitely seek care,” Dr. Lerner says. “Don’t just stick with home remedies.”

Concerning symptoms associated with sore throat include:

  • Blood in saliva or phlegm
  • Dehydration
  • Difficulty breathing
  • Excessive drooling, especially in young children
  • Joint pain or swelling
  • Symptoms associated with strep throat (listed above)

Sore throat in children

Kids are prone to sore throats because strep and viruses spread more easily among children, especially when they spend time indoors. But it’s not always easy to spot the signs in younger children who can’t verbalize their discomfort.

To spot a sore throat in a younger child, keep an eye out for:

  • Changes in food preference, such as only wanting soft foods
  • Decreased appetite
  • Excessive drooling, which may signal a swollen throat
  • Touching or pointing to the neck
  • Tugging at ears, since ear pain can accompany bacterial infections

“It’s true that viruses are the cause of sore throats in the majority of kids, but we’re also concerned about strep throat and other causes that might need specific treatment,” Dr. Lerner says. “It’s worth connecting with the child’s physician to see if further evaluation or other treatment is needed.”

If you’re concerned your sore throat may not be viral or could be a sign of something more serious, reach out to your primary care physician.