Patient Education: Sore Throat

ALSO KNOWN AS: Viral sore throat; Strep throat/tonsillitis; Infectious mononucleosis

NOTE: The information provided on these websites is not intended as a substitute for professional medical advice or emergency treatment. You should not use any information on these websites to diagnose or develop a treatment plan for a health problem or disease without consulting a qualified health care provider.

Easing the pain of a sore throat: Suck on a throat lozenge, hard candy or popsicle; take acetaminophen (Tylenol®) or ibuprofen (Advil®); gargle with warm salt water (1/4 tsp. salt per glass of water); drink plenty of liquids; and eat soft, bland foods. Throat sprays (Chloraseptic®) can also provide pain relief.

What is it?

A wide variety of organisms may be responsible for sore throats. Most, in fact 85-90%, are caused by viruses. A much smaller percentage of sore throats are caused by bacteria. It is important to determine whether the cause of your sore throat is viral or a bacterial streptococcal infection because of the potentially severe complications that can occur with untreated strep infection.

Viral sore throats resolve by themselves, usually within 3-5 days, though it may take 7 days for complete resolution. Respiratory viruses, the viruses causing common colds, are the most likely cause of these sore throats.

Strep throat accounts for 10-15% of all sore throats. Strep throat is caused by a type of bacterium called Streptococcus. The pain of strep throat often feels just like the pain of viral sore throats.

Infectious mononucleosis, also known as mono, is a viral illness that almost always starts with a sore throat. The sore throat may be severe or mild but persists for longer than a week. Mono is most often caused by the Epstein-Barr virus. This virus is usually in the body for 30-50 days before a person develops symptoms.

What are the symptoms and how do I treat it?

Note that not all symptoms are present in every case.


  • Coughs
  • Fever
  • Mucous production
  • Runny nose
  • Watery eyes
  • Fatigue

There may also be:

  • A red appearance to the throat
  • White patches on the tonsils
  • Swelling, tenderness of the lymph nodes (neck)


Antibiotics are no help in treating viral sore throats, since they treat bacterial infections, not viruses. If you have a viral sore throat, nothing will help you recover faster than the time-tested remedies of rest and plenty of fluids along with generic acetaminophen (Tylenol®) or ibuprofen (Motrin® or Advil®) to control fevers and pain.

If you see a health care provider for your sore throat, a Rapid Strep Test may be recommended. These tests are 80-95% sensitive and reasonably priced. If your test is negative for strep, your sore throat is presumed viral and antibiotics are not recommended.



  • Sudden onset of throat pain and difficulty swallowing
  • Fevers over 101°F
  • Headaches
  • Body aches
  • Nausea
  • Vomiting
  • Redness of the throat
  • Swollen lymph nodes
  • White patches on the throat


If you have been exposed to someone with strep throat, it is important to tell your health care provider.

The sore throat from strep is self-limiting, meaning symptoms usually resolve within 7-10 days whether antibiotics are used or not. What is important about strep is that untreated infections can result in a serious complication, rheumatic fever, which can damage the heart valves and other organs of the body. Appropriate antibiotic treatment for a full 10 days prevents the development of rheumatic fever.

Peritonsillar abscess is another serious complication of strep and tonsillitis, but only occurs in a small percentage of patients. Should you develop worsening pain in the throat and pain with opening the mouth even slightly, a tonsillar abscess may be developing. Antibiotics alone may not fully treat this problem and referral to a specialist may be necessary.

REMEMBER: With strep throat you may get better without antibiotics; however, they are necessary to prevent serious complication and decrease your infectivity. If you are prescribed antibiotics, it is important to change your toothbrush 48 hours after starting treatment.



  • Persistent sore throat
  • Fatigue
  • Swollen lymph nodes (front and back of the neck)

There may also be:

  • Fevers
  • Headaches
  • Body aches
  • Dizziness
  • Skin rash


If your sore throat persists for longer than one week and is accompanied by any of the symptoms listed above, see your health care provider for mono testing.

In most cases of mono, no specific treatment is necessary. The illness is usually self-limited and passes much the way other common viral illnesses resolve.