Why Does My Throat Hurt? 10 Common Causes

Of all the questions healthcare providers hear in their practices, "Why does my throat hurt?" must be near the top of the list. A wide array of conditions can cause a throat to hurt, from infections to allergies to acid reflux and even tumors.

Pain is just one symptom of what's typically known as a sore throat. Other symptoms include having a dry or scratchy feeling in your throat or trouble swallowing.

Here's what you need to know about the health conditions that might be causing your sore throat, risk factors, and how to prevent a short throat.

Causes

Chances are your sore throat will fade in a few days without any real prodding, but there could be trouble if it lingers. Here's a roadmap to what might be causing your throat to hurt.

Viral Infections

Viruses are one of the most common causes of sore throats, said Alan Mensch, MD, senior vice president of medical affairs and medical director at Plainview Hospital in New York State.

Often, sore throat is a symptom of the common cold or the flu. However, viruses that cause mononucleosis, measles, chickenpox, croup, and other diseases can also produce sore throats. Also, the SARS-CoV-2 virus that causes COVID-19 may be causing your sore throat.

To treat sore throats caused by viruses, try some of the following remedies:

• Gargle with warm salt water.
• Try over-the-counter (OTC) pain relievers, like Tylenol (acetaminophen) or Advil (ibuprofen).
• Stay hydrated.
• Use a humidifier or steamer to ease respiratory symptoms.

Most viral infections tend to go away in about a week—except for mononucleosis, which can drag on for weeks or months. 

Protect yourself from viral infections by washing your hands well and often. Don't get too close to people who are sick, and cover your coughs and sneezes.

Strep Throat

In addition to viruses, bacteria are a common cause of sore throats, said Kathleen Tibbetts, MD, assistant professor of otolaryngology at the University of Texas Southwestern Medical Center in Dallas. Especially in children, strep throat (caused by Streptococcus bacteria) is a common culprit.

In addition to a sore throat, other symptoms of strep throat may include:

• Fever
• Chills
• Red spots or white patches on the tonsils

A throat culture will tell you whether you have the infection. If you do have strep throat, it's essential to treat it.

"We worry about the late complications of strep," said Dr. Mensch. That can include damage to the kidneys and heart valves. Antibiotics, like penicillin and amoxicillin, usually clear strep throat.

Tonsillitis

Tonsillitis is inflamed and swollen tonsils. A viral or, more commonly, bacterial infection usually causes tonsillitis.

The tonsils are two growths at the back of your throat that form the frontline of your body's immune system. They check out germs entering your body.

Tonsillitis may cause a sore throat, as well as other symptoms like:

• Chills
• Ear pain
• Fever
• Headache
• Pain when you swallow
• Red, swollen tonsils
• Tender jaw or throat 
• White or yellow patches on the tonsils

Tonsils can become large enough to obstruct the nasal passages in severe cases. You may experience breathing, swallowing, and sleep difficulties if that happens.

Allergies

About 50 million people in the United States have allergies. Allergies happen when your body has an outsize reaction to specific foreign invaders, like:

• Dust
• Mold
• Pet dander
• Pollen

Those invaders set off a cascade of symptoms, like a sore throat. Other symptoms of allergies include sneezing and a stuffy nose.

Sore throats from allergies can be made worse by post-nasal drip. Post-nasal drip happens when excess mucus builds up and trickles down the back of your throat.

Some people may confuse allergy-related sore throats with viral and bacterial sore throats. Still, there are ways to tell them apart.

"Allergies are going to go on longer, and they're not going to have symptoms of fever," explained Dr. Tibbetts. "You may have itchy eyes and a runny nose."

Many allergy-related sore throats also only appear during certain seasons, like fall or spring.

Irritants

Irritants differ from allergies but also cause reactions to certain outside elements, like air pollution or cleaning products.

"The allergy mechanism is an immune response," explained Dr. Tibbetts. "An irritation is not an immune reaction. It's just irritating the tissue–and we're seeing more and more of it in urban areas as people are exposed to pollution."

Exposure to certain irritants can make your throat sore, so try to avoid them if you can.

Dry Air

Humidity and temperature can both affect the mucous membranes that line your throat.

Dry air can cause discomfort. Summer air conditioning can have a similarly painful effect on your throat. In any case, that discomfort tends to be worse first thing in the morning.

"A lot of time in the winter months, you have the heater going, so you're breathing dry air all night," said Dr. Tibbetts. "Use a humidifier in your room at night when you're sleeping." 

You can also heat a pot of water and inhale the soothing steam.

Muscle Strain

Studies have found aerobics instructors and teachers have more frequent sore throats. Yelling and screaming can hurt your throat, but so can talking.

Gastroesophageal Reflux Disease (GERD)

You may not think of a sore throat as a common symptom of acid reflux. Still, it can be, especially when the reflux is chronic, like in gastroesophageal reflux disease (GERD).

GERD is a digestive disorder, and your throat is, after all, part of your digestive apparatus.

"Stomach acid is coming up into your esophagus and then sometimes up into the throat," explained Dr. Tibbetts. "Typically, people will have other associated symptoms, like indigestion."

Symptoms can get worse after a big meal. In addition to a sore throat, symptoms of GERD may include:

• Acid reflux
• Chest pain
• Cough
• Heartburn
• Hoarseness
• Nausea

There are medications to counter GERD. However, you can also tame the condition by managing your weight and eating dinner two to three hours before bed.

Human Immunodeficiency Virus (HIV)

Sore throats can sometimes appear in the collection of HIV symptoms.

Many people with HIV have flu-like symptoms within two to four weeks of infection. In addition to a sore throat, early symptoms of HIV may include:

• Chills
• Fatigue
• Fever
• Mouth ulcers
• Muscle aches
• Night sweats
• Rash
• Swollen lymph nodes

HIV-positive people may also have sore throats due to secondary infections like oral thrush, cytomegalovirus (CMV), or HSV esophagitis. By receiving proper treatment, people with HIV can make secondary infections less likely.

Tumors

Throat cancer doesn't need to be at the top of your list of things to worry about when you have a sore throat, but it can happen.

"All sites of the throat can be affected from the upper part, the tonsil area, to the back of the tongue to the voice box and the upper part of the esophagus," explained Dr. Tibbetts.

In addition to a sore throat, a tumor can also manifest with other symptoms, like:

• Lump in the neck
• Trouble swallowing
• Ringing or pain in your ear

Throat pain from a tumor also tends to linger. 

"Viral or bacterial sore throats should get better in days to weeks, but if this is something that lasts weeks to months, that is concerning," said Dr. Tibbetts. 

If you have any of those red flags, see a healthcare provider.

Is a Sore Throat Hereditary?

Sore throat has several potential causes. Some of these may be more common among people with certain genetic factors.

For example, repeated bouts of strep throat and tonsillitis may run in families. The same is true for allergies and GERD.

Who Gets a Sore Throat?

Anybody can get a sore throat. Viral infections, the most common cause of sore throat, are generally more common in children. However, even adults have an average of two or three colds per year.

We cannot wholly keep viruses, allergies, or other causes of sore throats at bay, but you can help prevent sore throats by trying some of the following:

• Avoiding close contact with people who are sick
• Avoiding smoke exposure
• Not touching your eyes, nose, or mouth with unwashed hands
• Practicing proper handwashing
  

Risk Factors

You may be more likely to experience pain in your throat if you have any of the following risk factors:

• Acid reflux
• Allergies
• Recently being intubated
• Smoking
• Snoring
• Taking certain medications
• Weakened immune system

When To Reach Out to a Healthcare Provider

You should tell your healthcare provider if you have sore throat symptoms. Your provider may want to test you for strep throat or other health conditions. 

Visit a healthcare provider if you experience any of the following symptoms:

• Blood in saliva or phlegm
• Dehydration
• Difficulty breathing or swallowing
• Excessive drooling
• Skin rash
• Swollen or painful joints

You'll also want to visit a healthcare provider if your symptoms don't start to get better within a few days or if you have recurrent sore throats.

A healthcare provider should also see anyone with other severe or concerning symptoms. For example, some signs of upper airway obstruction include:

• Agitation
• Bluish color to the skin
• Choking
• Confusion
• Hoarseness
• Muffled or "hot potato" voice
• Respiratory distress (e.g. fast, shallow breathing)
• Unconsciousness or changes in consciousness
• Wheezing, whistling, or other unusual noises while breathing

Features that may suggest deep neck space infections include:

• Airway difficulty
• Crepitus
• Fever and chills
• Neck pain or swelling
• Stiff neck
• Toothache
• Trismus
• Trouble swallowing

People with any other severe or alarming symptoms should also see a healthcare provider.

A Quick Review

While most sore throats are caused by a viral infection, such as a cold or the flu, there are several other reasons you might have a sore throat.

Consult a healthcare provider if your symptoms don't improve within a few days or worsen. Less common causes of a sore throat might require treatment.