My throat is swollen and hurts to swallow

A sore throat is one of the symptoms of COVID-19. Even if your symptoms are mild, get tested for COVID-19 immediately — use the colds and flu Symptom Checker if you're not sure what to do.

What is sore throat?

A sore throat, or pharyngitis, is when the throat is red, swollen and painful, especially when you swallow. It happens when the back of the throat, called the pharynx, is inflamed.

Usually, sore throats go away without treatment within 3 to 4 days. Seek medical attention if:

• you have trouble breathing or swallowing (or if your baby is drooling)
• you have a stiff or swollen neck
• you have a high fever
• you have a rash
• you feel very unwell or the sore throat is getting worse

What are the symptoms of a sore throat?

If the sore throat is caused by a cold, you may also have a runny nose, cough, possibly fever and feel very tired.

If it’s a strep throat, other symptoms may include:

• swollen glands in the neck
• swollen red tonsils
• rash
• fever
• tummy pain
• vomiting

What causes a sore throat?

The most common cause of a sore throat is a virus like a cold or the flu, COVID-19 or glandular fever.

Less than 1 in 3 sore throats is caused by a bacterial infection. Some sore throats are caused by the bacteria Strepococcus pyogenes. This is sometimes called a strep throat. If bacteria are the cause, you tend to become very unwell and your infection seems to get much worse. If the sore throat is caused by bacteria, you may benefit from antibiotics.

Sometimes a sore throat can be caused by tonsillitis (the tonsils will be swollen), mouth ulcers or allergies.

Sore throats and children

Sore throats are very common in children. They are usually caused by a virus. The child will normally also have a runny rose, cough, sore ears, a fever, be tired and be off their food.

It is more likely to be strep throat if the child is older than 3 years and if they have swollen glands in the neck, swollen, red tonsils with white spots, a rash and vomiting.

If you’re not sure about your child’s symptoms, or you are worried, see your doctor.

CHECK YOUR SYMPTOMS — Use the colds and flu Symptom Checker and find out if you need to seek medical help.

How is a sore throat diagnosed?

If you or child has a sore throat and you are worried about the symptoms, see your doctor.

They will look at the throat with a torch and feel the neck for swollen glands. They may take a swab from the throat to determine the cause of infection. Swabs can test for a range of viruses and bacteria.

How is a sore throat treated?

There is no way to cure a sore throat that is caused by a virus. The sore throat should clear up in 5 to 7 days. In the meantime, you can ease the symptoms by taking pain relief medication. Adults and children older than 1 month can take paracetamol, and adults and children older than 3 months can take ibuprofen. Do not give aspirin to children under 16.

If the sore throat is caused by bacteria, you may benefit from antibiotics.

The Australian Commission on Safety and Quality in Health Care (the Commission) has developed a guide which can be used with your doctor to help you decide whether to use antibiotics when you or your child has a sore throat.

Sore throat remedies and self-care

Over-the-counter medications might help, such as lozenges or throat gargles that contain local anaesthetic. If you are pregnant or breastfeeding, avoid products that contain iodine (such as Betadine®). Your pharmacist can give you more information.

Eating soft foods such as ice cream, ice blocks or jelly, can help.

To ease a scratchy throat, try gargling with warm, salty water or drinking hot water with honey and lemon. Warm or iced drinks and ice blocks may be soothing.

Avoid foods that cause pain when you swallow. Try eating soft foods such as yoghurt, soup or ice cream.

It is important to stay well hydrated so drink plenty of water. If you have an existing medical condition, check with your doctor about how much water is right for you.

Keep the room at a comfortable temperature and rest and avoid heavy activity until symptoms go away.

Smoking or breathing in other people’s smoke can make symptoms worse. Try to avoid being around people who are smoking. If you are a smoker, try to cut down or quit. For advice on quitting smoking, visit the Quit Now website.

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Shulman ST, Bisno AL, Clegg HW, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012;55(10):e86-e102. PMID: 22965026www.ncbi.nlm.nih.gov/pubmed/22965026/.

Tanz RR. Acute pharyngitis. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 409.

van Driel ML, De Sutter AI, Habraken H, Thorning S, Christiaens T. Different antibiotic treatments for group A streptococcal pharyngitis. Cochrane Database Syst Rev. 2016;9:CD004406. PMID: 27614728www.ncbi.nlm.nih.gov/pubmed/27614728/.

Last reviewed on: 7/19/2021

Reviewed by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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