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Why it Hurts to Swallow: Common Causes of a Sore Throat

July 20th, 2023 | 5 min. read

By Cody B. Jeu, M.D.

common causes of a sore throat

sore throat reasons

You might have a sore throat if you get a dry, scratchy feeling in your throat or it hurts to swallow. A sore throat can cause an itchy or burning sensation in the back of the throat. The condition can worsen, causing pain when you eat, swallow or talk.

Commonly, sore throats are caused by bacterial or viral infections, while a few can happen due to allergic reactions and environmental factors like dry air.

Pharyngitis, the most common cause of sore throat, results from a viral infection ‒ like a cold or flu. Viral infections generally resolve on their own.

In contrast, strep throat is a bacterial infection (streptococcal infection) requiring antibiotic treatment.



Please schedule an appointment for your sore throat consultation at any of our ten convenient locations in Houston, TX, today.


Signs and Symptoms of a Sore Throat

The signs and symptoms of a sore throat depend on its cause.

A sore throat caused by a viral infection like a cold or flu has the following symptoms.

  • Cough
  • Hoarseness that can make your voice sound raspy, strained, and breathy
  • Runny nose
  • Conjunctivitis or pink eye

When a bacterial infection like strep throat causes a sore throat, it can have the following symptoms.

  • Red and swollen tonsils
  • Fever
  • Pain when swallowing
  • Fever
  • Streaks of pus or white patches on the tonsils
  • Petechiae or tiny red spots on the roof of the mouth
  • Swollen lymph node in the front of the neck

A sore throat can have other symptoms like:

  • Headaches
  • Aches and pains in muscles and joints
  • Nausea
  • Skin rashes

Conditions That Can Cause a Sore Throat 

The most common causes of a sore throat are viral and include:

  • A common cold 
  • Flu or influenza
  • Measles
  • Chickenpox
  • Mono (mononucleosis)
  • Coronavirus 2019 (COVID)

You may be wondering why it hurts to swallow. You can have symptoms of a sore throat from other conditions like:

Strep Throat: 

It is a common throat infection caused by the bacteria Group A Streptococcus. Although more common in school children, the disease can also affect adults, leading to fever, inflamed tonsils, and painful throat conditions.

Although not severe, if untreated, strep throat can lead to serious illnesses like rheumatic fever and can cause permanent damage to the heart and heart valves.

Snoring / Sleep Apnea:

Snoring can occur because of an obstruction in the upper airway during sleep. Sleep apnea is another sleep disorder that causes pauses in breathing during sleep. The body does not get enough oxygen during sleep, causing you to wake up and gasp for breath. 

Both snoring and sleep apnea can cause you to breathe through the mouth, causing sore throats.


Tonsilitis occurs when your tonsils get infected. Tonsils are two small lumps of soft tissue on either side at the back of your throat. Tonsils, when infected, can become swollen and sore, making it painful to swallow.

Sinus Infection:

Sinus infection or sinusitis is inflammation of the sinuses, the air-filled spaces inside the bone of the face. Chronic sinusitis can cause post-nasal drip, where the fluid from the sinuses and nose drips back down the throat, causing a persistent cough and sore throat.

Ear Infection:

A bacterial or viral infection can cause a sore throat and sharp ear pain. Sometimes ear infections can arise from a virus or bacteria that causes swollen lymph nodes around the throat. The swollen lymph nodes can become sore, causing a sore throat.

Oral Thrush:

Candidiasis is a yeast infection that, when it happens in the mouth and throat, is called oral thrush. Oral thrush in the mouth and throat can cause sore throat symptoms, like pain while swallowing.


Esophagitis is an inflammation of the esophagus, the tube that runs down your throat to the stomach. The pain can be mild or severe and cause painful swallowing, similar to a sore throat.


Allergies due to pollen, mold, dust, and pet dander can lead to a sore throat, especially when it results in postnasal drip, which causes inflammation and irritation in the throat. 


Tumores of the voice box, tongue, or throat can cause a sore throat, difficulty swallowing, and hoarseness. 


Dry indoor air can make your throat feel scratchy and rough.

Preventative Measures of a Sore Throat 

You can avoid getting scratchy, burning feeling from a sore throat by taking the following preventive measures.

  • Avoid getting viral infections, like cold and flu, by staying away from people who are sick.
  • Avoid sharing utensils, food, or drinks with people.
  • Cough or sneeze into tissues and throw them away. When necessary, sneeze into your elbow.
  • Wash your hands frequently.
  • Use an alcohol-based sanitizer as an alternative to hand-washing where water and soap are not available.
  • Avoid touching your face and eyes to prevent infections.
  • Increase your fluid intake by drinking lots of water.
  • Get plenty of rest and eat a healthy diet.
  • Stop smoking and avoid exposure to secondhand smoke.
  • Avoid exposure to chemical irritants. Wearing a mask can limit chemical exposure, preventing an infection.

Treatment Options for Swallowing with Pain 

Your medical provider will determine the type of treatment based on the underlying disease. Your doctor will ask about your symptoms and do a physical examination. They can also swab your throat.

The treatment options of a sore throat will depend on the type of illness that causes symptoms.

  • In viral infections like colds and flu, antibiotics will not help. Your healthcare provider may prescribe over-the-counter medicines to ease painful throat symptoms.
  • Antibiotics are prescribed for bacterial infections like strep throat to treat infections and prevent rheumatic fever and other complications.
  • Where allergies are causing painful throat symptoms, antihistamines may be prescribed.
  • Over-the-counter antacids are prescribed where acid reflux and heartburn are causing a sore throat. Also, it is advised to avoid big meals and spicy foods to calm the symptoms.

The symptoms of a sore throat can also be treated using home remedies like:

  • Drinking warm liquids, broth or bullion, and tea with honey and lemon can ease dry, scratchy throats.
  • Sucking on ice chips and popsicles can reduce throat pain.
  • Gargling with warm salt water can reduce throat discomfort.
  • Using a humidifier helps dry throats, and can be especially beneficial if your home has dry indoor air. 
  • Resting your throat can ease the painful symptoms.

When to See an ENT Doctor for a Sore Throat

While you can treat an occasional sore throat using home remedies and over-the-counter medications, here are some instances when you need to see an ENT doctor. These include:

  • A persistent sore throat: Ordinary sore throats are temporary and can be resolved without medical intervention. However, you must visit an ENT doctor if you have a persistent sore throat that lasts for a week or more;
  • A throat infection: Where a sore throat is accompanied by pain, inflammation, and visible white spots on the throat tissue and tonsils;
  • A throat injury: If you have suffered a throat injury, an ENT doctor can assess the damage and provide a remedy;
  • Voice loss: If you have total voice loss, also known as Laryngitis, your ENT doctor may diagnose the problem and offer treatment.
  • Lack of obvious reasons: A sore throat without any obvious reasons, like allergies or cold.
  • Fever: A fever over 101 degrees
  • Lump: A lump in your neck
  • Ear pain: A lasting earache
  • Abnormal saliva: Mucus or blood in your saliva.
  • Other problems: Problems with breathing, swallowing, or opening your mouth.

Schedule an appointment to evaluate and treat your sore throat problems with Houston ENT & Allergy.

Although a common cold and flu symptom, a sore throat can have serious complications. If you are experiencing persistent pain in swallowing with a painfully dry and scratchy throat, request an appointment with one of our doctors at Houston ENT immediately.

Our ENT specialists are committed to understanding your specific concerns and offering tailor-made treatments for a complete recovery.

Schedule an appointment with us here or call us at (281) 649-7000.

Cody B. Jeu, M.D.