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According to Affinity Health, a leading provider of high-quality healthcare, most sore throats are harmless, but severe symptoms can make breathing difficult.

Everyone gets sore throats; for the most part, they are just a nuisance that passes in a few days. However, sore throats can sometimes indicate a serious infection that necessitates antibiotic treatment. And now and then, they may have an extremely unlikely cause.

“A viral infection is the most common cause of sore throat. It is frequently accompanied by typical cold symptoms such as coughing, sneezing, and fatigue,” says Murray Hewlett, CEO of Affinity Health.

“However, while viral infections are often to blame, there are many other conditions that could be responsible for a sore throat, so I recommend seeing your doctor for a throat swab, especially if a high fever or pus accompanies a sore throat on the tonsils.”

Affinity Health explores the main causes of a sore throat and when it’s time to see a doctor.


It can be challenging to determine if a sore throat is a COVID symptom. Both the common cold and the virus that causes COVID-19 are types of viruses known as coronaviruses, and they can cause similar symptoms.

A fever is one of the first signs of COVID. However, due to the spread of different strains of COVID, it is possible to have a COVID sore throat but no fever or other symptoms.

However, if you have COVID, you are more likely to have other symptoms in addition to a sore throat.

“Only 5-10% of COVID-19 patients will have a sore throat. They usually have a slight fever, loss of taste and smell, and difficulty breathing,” adds Hewlett.

“With cold symptoms, we have to be vigilant. We used to dismiss cold symptoms as a society, but we can’t anymore. If you only have a sore throat and no other symptoms, COVID-19 is less likely to be the cause. However, if you have other symptoms, you may have COVID. I’d be concerned about COVID if I had a sore throat, cough, or fever.”

How long does COVID cause sore throat? COVID symptoms typically last between five days and two weeks, according to the Centers for Disease Control and Prevention (CDC). However, if it lasts longer than five days, it could be something else, and it is worth getting checked out by your provider.


Tonsillitis, or inflammation of the tonsils at the back of the throat, is also caused by a virus infection. The sore throat lasts two to three days before subsiding over the course of a week or so. It can, however, be caused by a bacterial infection (usually one called streptococcus). Strep throat is most common in children, teenagers, and young adults, but it can also affect older people.

Specific key characteristics can help you determine whether you need to see a doctor about antibiotics. If you have at least three of the following symptoms, you should see your doctor or pharmacist:


  • No cough, but a sore throat
  • A fever
  • Tender, swollen glands in the front of your neck
  • White pus on the back of your throat
  • Difficulty breathing
  • Difficulty swallowing
  • Severe pain on one side of your throat

Those who get strep throat several times a year may be candidates for tonsillectomy. According to the Academy of Otolaryngology-Head and Neck Surgery, if a person has strep throat seven times in one year, five times in two years, or three times in three years, they should consider having their tonsils removed.

Glandular fever

Glandular fever is also more common in teenagers and young adults. The condition is typically accompanied by swollen, tender glands, particularly in your neck, and can leave you feeling completely exhausted. If your doctor suspects glandular fever, they will order a blood test to confirm the diagnosis.


The majority of us associate thrush with a vaginal fungal infection. However, thrush can develop in your mouth and throat. Oral thrush is relatively common in infants but far less common in adults.

Thrush usually causes small white patches in the mouth that do not rub off easily with your finger, in addition to a sore mouth and throat. The lining of the mouth may also appear inflamed and redder than usual.

The condition is likely if you use steroid inhalers or if your immune system is suppressed by conditions like cancer or medicines that work by dampening down your immune system.

Acid reflux

Acid reflux can cause heartburn; if the acid reaches the throat, it can also lead to throat discomfort.

Common signs of acid reflux include:

  • A burning sensation in your chest (heartburn), usually after eating, which might be worse at night or while lying down
  • Backwash (regurgitation) of food or sour liquid
  • Upper abdominal or chest pain
  • Trouble swallowing (dysphagia)
  • The sensation of a lump in your throat

Treatment for a sore throat

While a sore throat can be painful, the good news is that most sore throats go away on their own after about a week, depending on the cause. According to National Institute for Health and Care Excellence (NICE) s, 85% of sore throats will resolve within a week, and 40% within three days.

If a bacterial infection causes a sore throat, antibiotics may be necessary, while sore throats caused by a viral infection usually do not require medical attention.

Acetaminophen or mild pain relievers may help with pain and fever; paediatric versions of these medications are available. A pharmacist can advise you on which ones to use and the proper dosages. It is critical to always follow the directions on any medication and only take what is recommended.

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