Sore Throat : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 29/06/2022

Sore throat is pain in the pharynx and larynx, which is often aggravated by talking and swallowing. There are various causes leading to sore throat: viral and bacterial diseases of the pharynx, allergic reactions and tumor processes, hypovitaminosis. To identify the etiological factor, an instrumental examination of the respiratory tract, radiography, ultrasound, bacteriological and serological reactions are carried out. To stop the pain that has arisen in the throat, use a warm alkaline drink, rinses, physiotherapy.

Causes of sore throat

External factors

Particular reasons for the appearance of a burning sensation, perspiration in the oropharynx, less often the larynx - a long stay in a room with low humidity or dry hot climates. There is dryness of the mucous membranes, lack of saliva. Pain is more strongly felt in the throat when talking, eating solid food. The discomfort after waking up is especially intense - due to the ajarness of the mouth in a dream, the mucous membranes dry out even more. In men, pain is provoked by snoring. Patients report that in the morning their throat hurts and it hurts to talk, and to alleviate the condition, you need to drink water.

The throat can be very sore when inhaling polluted air - in mines, when working in sand pits, in large cities due to exposure to exhaust gases. The symptom occurs suddenly when going outside or entering industrial premises. Soreness is accompanied by a dry, hacking cough. The periodic and short-term appearance of such signs is a variant of the norm. If discomfort bothers a person for a long time, interferes with eating or talking, you need to contact a specialist to find out the reasons why the throat hurts.

Viral diseases

Severe sore throat is characteristic of many respiratory infections that damage the mucous membranes of the pharynx and larynx. Causes of pain - direct pathogenic effect on the epithelium, systemic action of the pathogen, damage to nerve endings. In most cases, the symptom occurs against the background of high body temperature, weakness, signs of intoxication. Most often, a sore throat is provoked by:

  • Viral pharyngitis . Initially, there is discomfort, a feeling of soreness, soreness in the pharyngeal region, gradually giving way to severe pain in the projection of the throat, and a painful dry cough. For pharyngitis, a symptom of an "empty throat" is typical - unpleasant sensations increase when saliva is swallowed.
  • Infectious mononucleosis . Under the action of this cause, a person has a severe sore throat, food intake is almost impossible, some patients even refuse water. Simultaneously with the manifestation of pain, regional lymph nodes increase and become inflamed.
  • adenovirus infection . The throat usually begins to hurt a day or two after the onset of a runny nose and watery eyes. Pain is moderate, aggravated by swallowing and talking. Patients often notice a whitish spot on the tonsils, later a barking cough joins.
  • herpetic process . It hurts in the throat with the development of a specific complication - herpangina. Soreness is noted against the background of an increase in temperature to 39-4 degrees. On the mucous membrane of the pharynx, grayish vesicles are visible, upon opening of which the pain syndrome intensifies.

Sore throat

 

Bacterial infections

If your throat hurts and it hurts to swallow, it may be a sign of tonsillitis (tonsillitis). First, there is discomfort and soreness in the throat, which are replaced by a sharp pain. Pain radiates to the ear, neck, neck. Sometimes patients themselves notice an increase and redness of the tonsils, the formation of pinpoint pustules on them. Symptoms occur against the background of febrile fever, general weakness, arthralgia and myalgia. If the pain in the throat intensifies up to the inability to swallow even water, an intratonsillar abscess (phlegmonous tonsillitis) may form.

When a child has a sore throat, and the pain is accompanied by respiratory disorders, epiglottitis, an inflammation of the epiglottis, can be assumed. Due to the intense pain syndrome, the child refuses food and water, and dysphagia develops within a few hours. To reduce discomfort and facilitate breathing, patients take a forced position: they sit, leaning forward, strongly stretch their neck and slightly open their mouth. Sore throat, localized on one side and occurring against a background of severe fever, is a sign of a retropharyngeal abscess.

Laryngitis

In acute laryngitis, the throat often begins to hurt at the same time as the temperature rises to subfebrile values, and weakness appears. The pain is strong, with the localization of inflammation along the back wall of the organ, the pain increases during swallowing. The symptom is combined with a sharp barking cough without sputum, when the vocal cords are involved in the process, the voice temporarily disappears. Chronic laryngitis is characterized by a slight sore throat, fatigue and a change in the timbre of the voice, constant hoarseness come to the fore.

oral candidiasis

With fungal infections of the oral cavity and pharynx, the throat constantly hurts, the intensity of pain increases significantly when trying to eat. Massive white plaques are visible on the mucous membranes, and candidiasis also causes cracks and painful seizures in the corners of the lips. Reproduction of fungal flora is observed in people with reduced immunity: after organ transplantation, with oncological diseases, secondary immunodeficiencies. In such cases, the process can spread to all airways, causing the corresponding symptoms.

allergies

With allergic pharyngitis and laryngotracheitis in the throat, pain of moderate intensity occurs, caused by exposure to a trigger factor. Suddenly, in the throat, it begins to sore and tickle. The condition is accompanied by bouts of superficial dry cough, which does not bring relief. Possible sneezing, profuse lacrimation and itching. Allergy-prone people report that their throat can hurt after inhaling the smell of flowers, contact with household chemicals or cosmetics. The symptom also occurs after eating certain foods.

Foreign bodies of the pharynx

If fish or meat bones are accidentally swallowed, they can get stuck in the throat and cause sharp pains. Pain sensations of a stabbing or cutting nature often have a clear localization. The manifestation is combined with a strong ineffectual cough, sometimes there is redness and swelling of the face due to painful coughing paroxysms. The person begins to choke. In children, the throat can hurt if small parts from toys get into the airways. With foreign bodies of the pharynx, emergency medical care is required.

Gastroesophageal reflux

In adults, possible causes that also cause a sore throat are periodic reflux into the throat and airways of acidic contents from the stomach with GERD. The intensity of pain is not the same during the day: a strong pain syndrome is observed in the morning after sleep, because the horizontal position contributes to the flow of acid into the throat. A sore throat is combined with a hacking dry cough, a constant feeling of tickling and discomfort. Patients also report that they are worried about sour belching and heartburn attacks. These symptoms are typical for hyperacid gastritis, gastrointestinal ulcers, esophagitis.

Scarce States

For the normal regeneration of the mucous membrane of the pharynx, the presence of many biologically active substances and vitamins is necessary. With an unbalanced diet or damage to the gastrointestinal tract, accompanied by malabsorption of food components, vitamin deficiencies may develop, one of the manifestations of which is a sore throat. Probable causes of pain are deficient conditions such as:

  • Hypovitaminosis B2 . Patients complain that the throat burns and hurts when talking, eating. Painful cracks form in the corners of the lips (angular cheilitis) and inflammation of the tongue.
  • Hypovitaminosis B12 . There is burning pain in the tongue and throat, and the tongue is bright red and shiny. Patients may complain of numbness and paresthesia in the lower extremities.
  • Hypovitaminosis C. With a lack of ascorbic acid, sore throat is associated with ulcerative defects of the mucous membranes. Patients report a metallic taste in the mouth, bleeding gums.

chronic diseases

Damage to internal organs is accompanied by the accumulation of toxic metabolites and nitrogenous metabolic products in the blood. Pain, perceived as discomfort in the throat, is due to chronic inflammation and atrophic processes in the pharynx. Pain can be provoked by an increase in blood glucose levels, which is combined with dry mouth and catarrhal processes. The throat can often hurt with the following somatic diseases:

  • Diseases of the internal organs : chronic renal failure, liver damage.
  • Endocrine pathology : diabetes mellitus, Itsenko-Cushing's syndrome, hypothyroidism.

Tumors

Prolonged sore throat with swallowing disorders that are not amenable to standard conservative therapy may be a sign of the growth of neoplasms in the laryngopharynx. With benign tumors, patients complain of a constant feeling of pressure and fullness, there is choking while eating. A sharp pain in the neck and throat, accompanied by hemoptysis, may indicate the development of cancer of the pharynx or larynx as the main cause of pain. Also, the patient notices a gradual loss of voice, hoarseness, there is a periodic dry cough.

Complications of pharmacotherapy

Common causes of sore throat are long-term use of certain drugs. When instilled with vasoconstrictor nasal drops, the medicine flows down the back of the throat, causing chronic irritation and inflammation in the mucous membrane. Patients note a constant feeling of perspiration and burning, there is a dry cough. The throat can also hurt after long-term use of glucocorticosteroids or antibacterial drugs, which provoke a decrease in local immunity. A person complains of dry mouth, increased pain when talking.

Rare Causes

  • Xerostomia .
  • Odontogenic process : periodontitis, galvanism, teething pathology.
  • Heart disease : unstable angina, atypical form of myocardial infarction.
  • Pathology of adjacent organs : pharyngeal-esophageal (Zenker's fistulas), diseases of the thyroid gland.
  • Nerve damage : neurosis of the pharynx, neuralgia of the glossopharyngeal nerve.
  • Damage to the spine : cervical osteochondrosis, tuberculous spondylitis, sciatica.
  • Stylohyoid Eagle-Sterling syndrome.

Diagnostics

An otolaryngologist is engaged in finding out the cause that provoked a sore throat. Diagnostic search involves a comprehensive examination of the oral cavity and respiratory tract using instrumental and laboratory methods, in the presence of concomitant symptoms, visualization of the organs of the chest and abdominal cavities is performed. The following methods are considered the most informative for the diagnosis of acute pain in the throat:

  • Instrumental inspection . For a detailed study of the state of the organs of the respiratory system, pharyngoscopy, indirect laryngoscopy is effective. An otoscopy is performed to exclude an otogenic cause of sore throat. During the study, the appearance of the mucous membranes, the presence of plaque and foci of ulceration are evaluated.
  • Bacteriological analysis . For culture, a throat swab, sputum, or plaque samples are taken. The method is necessary to confirm the most common diseases accompanied by a sharp sore throat - tonsillitis, viral or bacterial pharyngitis. Express diagnostics includes RIF swabs from the pharynx.
  • Sonography . With acute pain in the neck, throat, which are observed for a long time, an ultrasound examination is necessary to exclude the pathology of adjacent organs. The method allows to identify local accumulations of pus in the peripharyngeal tissue, the presence of cysts and space-occupying formations. An ultrasound of the thyroid gland is also required.
  • X-ray examination . If it hurts a lot in the neck and throat, an x-ray of the larynx is shown to exclude the tumor process. For detailed visualization, a CT scan of the larynx is recommended. In some cases, a radioisotope scan of the thyroid gland is performed.
  • Laboratory Research . Patients who feel a sore throat are prescribed a standard clinical and biochemical blood test, and fasting glucose concentration is measured. To exclude chronic diseases, according to indications, liver tests are done, acute phase indicators and the level of certain enzymes are determined.

To identify endocrine pathology as the leading cause of pain, a blood test for thyroid and adrenal hormones is necessary. Serological reactions (RIF, ELISA, PCR) are needed to identify pathogenic microorganisms. Additionally, they can do x-rays and CT scans of the cervical spine. In the presence of dyspeptic disorders, FGDS and intraesophageal pH-metry are used. Patients who have a sore throat should be examined by a dentist for the presence of inflammatory processes in the teeth and periodontium.

Throat examination

 

Treatment

Help before diagnosis

To reduce sore throat, a plentiful warm drink (teas, herbal decoctions) is recommended, while it is desirable to exclude drinks with milk. You can rinse the oropharynx with tincture of calendula, take lozenges. Doctors advise avoiding strong odors, limiting the use of household chemicals that can irritate the mucous membranes. With intense pain, you need to take warm, chemically and mechanically sparing food - soups, cereals. If the throat is very sore or the pain is accompanied by fever, weakness, it is necessary to consult a doctor as soon as possible.

Conservative therapy

Medical tactics depend on the cause of the appearance of pain in the throat. The most effective etiotropic therapy. A combination of drug treatment with physiotherapy methods that are aimed at eliminating the underlying cause of the disorder and individual painful manifestations helps to quickly reduce sore throat. In addition to rinsing, inhalations with essential oils and medicinal solutions are often used. UHF is performed on the pharynx, magnetic and laser therapy. Treatment regimens include:

  • Antibiotics . If the throat hurts due to an infectious process, antibacterial agents are used that selectively act on pathogens of respiratory infections. With candidiasis, specific antifungal drugs are prescribed.
  • Anti-inflammatory drugs . To stop the pain in the throat allow drugs from the group of NSAIDs. Medicines effectively reduce the level of inflammatory mediators and cytokines, have powerful antipyretic and analgesic effects.
  • Antiseptics . Shown are bactericidal agents (chlorhexidine, etc.), which inhibit the growth of bacterial flora in the pharynx and respiratory tract. To relieve pain, the throat is additionally rinsed with mint, eucalyptus, and other natural products several times a day.
  • Antihistamines . When the throat begins to hurt after contact with allergens, oral administration of specific drugs - histamine receptor blockers - is necessary. In severe situations, aerosols with topical corticosteroids are effective.
  • Vitamins . A sore throat can occur due to a severe lack of vitamins, therefore, after passing specific tests, it is necessary to take vitamin preparations, taking into account the direct cause of beriberi. Most often, drugs based on cyanocobalamin, riboflavin are recommended.
  • infusion formulations . With extensive purulent processes, pain felt in the throat is accompanied by massive intoxication of the body, to eliminate which crystalloid and colloid solutions are used, administered intravenously through a dropper.
  • Antisecretory drugs . Sore throat caused by gastroesophageal reflux requires acid-reducing medications. The drugs of choice are proton pump inhibitors, which have minimal side effects.

Surgery

A sore throat that has developed as a result of purulent processes (retropharyngeal or paratonsillar abscess, suppuration of a cyst) requires surgical intervention to eliminate the leading cause. An incision and drainage of the abscess is made, it is washed with antibacterial and antiseptic solutions. With benign neoplasia, an economical resection of the pharynx is done. Malignant tumors, in which complaints of sore throat are made, require hemilaryngectomy with the formation of a tracheostomy. In the remote period, if possible, laryngoplasty is performed.

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