4 Causes of a Sore Throat, and When to Worry

It's winter time, and infection is certainly a cause of a sore throat. But what else can cause throat discomfort? What signs and symptoms should you be worried about? And when should you see your doctor?

Sanaz Majd, MD
Episode #250
a man and woman with sore throats

3. Allergies

One of the more chronic or intermittent causes of sore throat is allergies. Allergic stimuli in the air, such as pollen or dust, trigger our immune system to combat these foreign invaders when breathed in. Then, as an inflammatory response, our nasal passages produce fluid. Once built up, the fluid has to go somewhere. Either it drips down our nostrils and out of our face, or down the back of the throat (or often both). This drip in the back of the throat is called “postnasal drip.” Yes, this means you are swallowing your snot. Unpleasant thought, but nevertheless a reality for many of us. The same phenomenon also occurs in the common cold.

Postnasal drip can irritate the back of the throat, hence causing a sore throat. If the allergies come and go, your sore throat can also come and go. It is usually milder than more acute causes, such as with viruses and strep. But it can linger much longer. It can also cause “clearing of the throat” or even a persistent cough.

Postnasal drip can irritate the back of the throat, hence causing a sore throat.

Learn how to treat postnasal drip so it doesn't cause too much irritation.

4. Acid reflux

Postnasal drip drips from the top down into the throat, but contents from below can also regurgitate in the opposite direction (upward) to irritate that same region. Acid reflux is another cause of a chronic or intermittent sore throat.

The stomach is connected to the throat via a long tube called the “esophagus.” A special muscle called the “lower esophageal sphincter,” or LES, wraps around the lower part of the esophagus where it joins the stomach. Certain foods (citrus, caffeine, spicy foods, mint, blueberries, tomatoes, soda, greasy foods, etc.) and irritants (such as cigarette smoke) relax this sphincter more than they should, and food contents easily escape the stomach upward.

Acid reflux can erode and irritate the throat, causing pain and discomfort. Like postnasal drip, it can also cause a chronic, annoying cough in addition to the sore throat. Follow these 5 tips to help combat acid reflux.

When to Worry About A Sore Throat

As seemingly benign as most of the causes for sore throat may be, there are signs and symptoms that you really don’t want to ignore. Here’s when you should be seen, and sometimes right away:

  • Fever lasting more than seven days
  • Sore throat lasting more than seven days
  • Trouble breathing
  • Drooling
  • Difficulty speaking or opening the mouth
  • Enlarged or swollen throat or tongue
  • Stiff neck
  • Rash
  • If the sore throat becomes chronic or comes and goes
  • And of course, as always, if the sore throat is particularly worrisome to you in any way.

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Please note that all content here is strictly for informational purposes only.  This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider.  Please always seek a licensed physician in your area regarding all health related questions and issues.

Image of sore throats © Shutterstock


About the Author

Sanaz Majd, MD
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