Causes for a Sore Throat : What Causes a Sore Throat?

Causes for a Sore Throat : What Causes a Sore Throat?

There are a few different causes for a sore throat and my aim is to investigate and document these as thoroughly as I can on this page.

Causes for a sore throat

Causes for a sore throat – illustration of the inflammatory diseases of the throat

1. Tonsillitis

Tonsillitis can be caused by a bacterial infection or a virus and is usually transmitted by another person who is already infected. The infection or virus can be spread via tiny droplets of fluid which are emitted by an infected individual during coughing, sneezing, kissing or even speaking (or any other close contact).

Bacterial tonsillitis is a bacterial infection of the throat and tonsils usually caused by Group A Beta-Hemolytic Streptococcus bacteria (which causes Strep Throat). There are other species of strep bacteria that can cause tonsillitis however and these include :

  • Chlamydia pneumoniae (chlamydia)
  • Staphylococcus aureus (MRSA)
  • Neisseria gonorrhoeae (gonorrhea)

It is estimated that around 10-30% of tonsillitis is caused by a bacterial infection.

Viral Tonsillitis – viruses are the major cause of sore throats and the less serious ones (such as the common cold) will generally resolve on their own. The following viruses can cause sore throats :

  • The common cold transmitted by airborne droplets and caused by a over 200 different viruses e.g. Coronavirus or Rhinovirus.
  • Influenza Virus – types A & B of the flu virus.
  • Measles Virus – spread through infected mucus and saliva which also causes a rash and fever.
  • Parainfluenza virus – a group of four viruses which cause different symptoms and illnesses. HPIV-1 causes croup which in turn can cause a sore throat.
  • Epstein-Barr virus causes mononucleosis (aka ‘mono’ or glandular fever) – an infectious disease transmitted via saliva.
  • Herpes simplex virus type 1 (is also known for causing cold sores)
  • HIV – one of the early symptoms of HIV may be a sore throat.
  • Chickenpox – an infection that causes a fever and an itchy, bumpy rash.
  • Mumps, an infection that causes swelling of the salivary glands in the neck.
  • Herpangina caused by the Coxsackie A virus.
  • Adenovirus – this can also cause conjunctivitis (aka pinkeye – an infection of the eyes).

2. Dry Air

If you are looking for causes for a sore throat then the air seems an unlikely culprit but when the air is dry, especially in winter, you will find you may get a sore throat more often.  That is because the dry air will absorb moisture from your body and will dry your mouth, nose and throat out leaving your throat feeling sore, rough and scratchy. Lack of moisture in our living environment may also cause other problems such as headaches and nose bleeds. In winter the air tends to be a lot drier generally than in the summer months and additionally we tend to heat our houses which dries out our environment even more. Due to this you may find that you get more sore throats in the cold winter months. The air on aircraft is also very dry so you may find that flying also gives you sore throat symptoms. Another causes for a sore throat culprit may be sleeping with your mouth open at night, which may happen if you have a blocked nose, as this will dry the saliva out from your throat and leave it feeling dry and scratchy. It’s best to drink plenty of water at this time and additionally think about getting a humidifier to replenish moisture back into the air.

3. Allergies

Allergies may be caused by triggers such as pollen (hay-fever), pet dander, dust mites or grass and can cause a reaction called ‘postnasal drip’. This is mucus congestion in the sinuses which drains down the back of your throat and may be one of your causes for a sore throat. This mucus can irritate and result in a scratchy, sore and tickly throat as well as coughing. Over the counter antihistamines may help to alleviate some of the symptoms.

4. Injury

A sore throat may also be caused by various injuries including muscle strain and strains to the vocal cords caused by excessive yelling, screaming, shouting or singing for prolonged periods. These activities can strain and irritate your throat and larynx and may result in the temporary loss of your voice. Performers, teachers and fitness instructors are especially susceptible to this type of throat injury as these duties are usually part of their jobs.

If you are interested in causes for a sore throat then a sore throat may also be caused by physical injuries to the throat and neck area such as getting hit or cut in the neck and even getting food lodged in the throat, such as a bone, which can lead to irritation.

5. Toxins and Irritants such as smoke and chemicals

There are various irritants that can cause a sore throat. These include :

  • Smoke – Smoke from a wood burning fire, a bonfire, cigarette and other tobacco smoke. The heat from cigars, cigarettes and pipes dries out your throat and may cause it to become sore and irritated.
  • Air Pollution – high air pollution levels may cause a dry, tickly and sore throat
  • Chemicals such as cleaning sprays which can be accidentally inhaled may irritate throat tissue. Very acidic or alkaline substances inhaled or swallowed can also lead to an inflamed throat.
  • Airborne Chemicals can cause a sore throat among other symptoms. These include ozone gas (ozone generators sold as air cleaners emit ozone gas) can cause throat irritation and fumes from new carpeting and paint.

6. GERD – Gastroesophageal reflux disease

GERD is a digestive disorder which affects the lower esophageal sphincter – the ring of muscle between the esophagus and the stomach – and occurs when it becomes weak or opens when it shouldn’t causing stomach acid to leak up into the esophagus (gullet).  The acid can enter the throat and even voice box and burn it causing symptoms like heartburn, acid reflux as well as a sore throat and hoarseness. GERD is quite common in pregnancy and more common as people get older.

7. Tonsil Stones – Causes for a sore throat

Tonsil Stones, also called Tonsilloliths, are formed when debris such as dead cells, bacteria and mucus become trapped in the crevices of the tonsils. Tonsil stones symptoms include difficulty in swallowing, bad breath, ear and throat pain. They tend to occur most often in people who have repeated bouts of tonsillitis. You can read more about tonsil stones on my Tonsil Stones page. 
If you are fed up of getting tonsil stones then there is actually a very quick and easy permanent cure for them.  Check out the tonsil stones remedy for more information!

8. A Peritonsillar Abscess (also known as Quinsy)

Although rare quinsy, which is a complication of tonsillitis or strep throat, may become potentially serious and causes a severe sore throat (usually on one side) and difficulty in swallowing, speaking and even breathing when severe. Quinsy is a bacterial infection which forms abscess (pus-filled pocket) that is created between one of the tonsils and wall of the throat when a bacterial infection spreads from the tonsil to the surrounding area.  It is important to get quinsy treated quickly by a doctor to stop the infection spreading and avoid problems caused by swelling, such as obstructed airways, infected lungs or spreading of the infection to the surrounding area of the throat, mouth, neck and chest.

9. A Retropharyngeal Abscess

This is a pocket of pus at the back of the throat caused by a bacterial infection which has spread from the tonsils, throat, adenoids, sinuses, nose, teeth or an injury to the throat. It causes a sore throat and difficulty, a stiff neck and pain when swallowing and can cause complications such as airway obstruction or sepsis so it is important to get treated quickly by a doctor.

10. Diptheria

Diptheria is a very serious and highly contagious bacterial infection which affects the throat and nose. It is spread very easily between people through coughs and sneezes or contact with objects that have the bacteria on them, however it is less and less prevalent, especially in the western world, due to the use of vaccines. It is still sadly common in some of the following areas : Asia, Carribean, parts of Eastern Europe, the Middle East and the South Pacific where immunization rates are low. The symptoms of diptheria include a sore throat, a thick grey-white coating at the back of the throat, a high temperature/fever, feeling sick, swollen glands in the neck, a cough, chills and general feeling of unwell. If you suspect symptoms of diptheria get urgent medical help immediately.

11. Throat Cancer

Throat cancer may cause a sore throat however it is quite rare in people under 40 and it is most common in people over 60. Other symptoms of throat cancer may include swollen glands in the neck or a lump/swelling in the neck, unexpected weight loss, a cough that won’t go away, earache, wheezing, a change in your voice and hoarseness and may also cause you to constantly clear your throat. Laryngeal cancer is a cancer where malignant cells grow in the larynx (voice box). It is four times more common in men than women and you are more at risk of getting it if you have unhealthy/poor nutrition, drink large amounts of alcohol regularly, smoke, have poor dental hygiene, have a family history of head or neck cancer or have had exposure to certain chemicals/substances such as asbestos, nickel, sulfuric acid fumes or coal dust. Sexually transmitted infection with HPV (human papilloma virus) also increases the risk of contracting mouth and throat cancer.

When to see a doctor – Causes for a sore throat

It is important to see a medical professional if you have any of the following symptoms :

  • difficulty in breathing / pain when you breathe
  • difficulty in opening your mouth
  • difficulty in swallowing and talking
  • a severely sore throat that won’t subside and even gets worse
  • a stiff or painful neck
  • you have white pus filled areas on the tonsils or at the back of the throat
  • you have any swelling inside your mouth and/or throat
  • if you have blood in your phlegm or saliva
  • severe symptoms such as a high fever (101°F (38°C)
  • sore joints
  • earache
  • It is also important to see a doctor/go to the emergency room if your symptoms last longer than four days, are not improving or are getting worse

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