Throat, sore

Alternative names:

burning in the throat; pain in the throat; sore throat

Home care:

Time is the most important healer for sore throat pain. If the sore throat is caused by a virus, it will clear up on its own.

Cold liquids and over-the-counter pain medications are effective in treating the pain. Aspirin should be avoided in children under 15 years old (because of the risk of Reye's syndrome). Home remedies such as gargling salt water, or drinking honey or lemon tea may help. Analgesic sprays and lozenges may be administered; however, they may make the pain of strep throat worse instead of better.

Call your health care provider if:

• there is severe difficulty in swallowing, difficulty in breathing, or excessive drooling in a young child.
• there is a temperature of 101 degrees Fahrenheit or greater.
• there are tender or swollen lymph glands in the neck.
• there is pus in the back of the throat.
• there is a fever, a red rash that feels rough, and increased redness in the skin folds.

What to expect at your health care provider's office:

The medical history will be obtained and a physical examination performed.

Medical history questions documenting sore throat in detail may include:

• time pattern
  • How long has the sore throat been present?
  • Have you had a sore throat before?
  • What was the cause?
  • Have other family members had recent sore throats?

• quality
  • Is the pain increasing, staying the same, or decreasing?
  • Are you able to swallow saliva, fluids, and food?
  • Is there excessive drooling (infants)?
  • Is the person able to talk?
  • Is the person hoarse?
  • Is the person able to sleep?

• aggravating factors
  • Worse at night?
  • Breathing through mouth?

• relieving factors
  • Is the soreness better in the morning?
  • Is the soreness better with moist air or mist?
  • Is the soreness better with medications?

• other
  • What other symptoms are also present?
    • noisy breathing
    • fever
    • wheezing
    • recent choking
    • allergies
    • rash

  • Has there been a recent injury?
  • Has there been a recent surgery?
  • Are there swollen lymph glands in the neck?
  • Are there sores or pus in back of throat?
  • Is there a sensation of gagging?
  • What medications are being taken?
  • What is the typical daily diet?

Diagnostic tests that may be performed include:

• complete blood count
• monospot test (to rule out mononucleosis)
• throat culture or rapid strep test

Intervention:
Usually, treatment will be delayed until the culture results are known. Doctors will often begin treatment of a sore throat immediately if there is a family history of rheumatic fever, if the patient has scarlet fever, if rheumatic fever is commonly occurring in the community at the time, or if a rapid strep test is positive.

If one child in a family has a strep throat, the chances are very good that other family members will also have a strep throat. Therefore, it is common for doctors to take cultures from brothers and sisters. If strep throat is diagnosed, it is important to complete the entire course of antibiotics as directed, even after symptoms improve.

For sore throat caused by infectious mononucleosis, rest and home treatment is recommended.

For sore throat caused by tonsillitis, antibiotic treatment may be recommended. Some tonsillitis is viral and will clear up without treatment. (Surgery is rarely necessary.)

After seeing your health care provider:
You may want to add a diagnosis related to sore throat to your personal medical record.