Causes of sore throats, plus determining if it's strep, meds to take, information on tonsillectomies.

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What causes  sore throats?


This is the most likely cause of a sore throat—especially in teens, says David Zopf, MD, an otolaryngologist at C.S. Mott Children’s Hospital in Ann Arbor, MI. Viral illnesses like the flu, colds and mononucleosis can all be at fault. “If you have runny eyes and nose with your sore throat, it’s most likely a virus,” says Tina Ardon, MD, a family medicine physician at Mayo Clinic in Jacksonville, FL.

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Bacterial infection

Bacteria like Streptococcus pyogenes—aka strep—can cause a red, painful throat. While it’s more common in young kids, teens and adults can still get strep throat, Zopf says.


Allergies, pollution and climate—like when the overachieving heat kicks on in your kids’ classrooms—can dry out and irritate the throat. A runny nose can also trigger throat pain, Ardon says.

Gastroesophageal reflux disease (GERD)

This condition causes acid reflux—which, besides being painful, can also irritate your throat. If you suffer from GERD, you’ll probably need to work with a gastroenterologist.

Is It Strep?

The way to know for sure is to get a swab test, but here are a few signs you might have strep:  The pain came on suddenly and it hurts to swallow.  Your tonsils are red, swollen or covered with white spots.  You have swollen lymph nodes in your neck or jaw.  You have a fever and throat pain with no virus- or sinus-related symptoms.

Stock Your Medicine Cabinet

If you have strep, you’ll need an Rx, but for other causes, try these.

Cough drops. Pick your favorite flavor, but avoid numbing drops long-term. They usually contain benzocaine, a topical anesthetic, and “can mask symptoms rather than treat the cause,” Zopf says.

Peter Ardito

Nasal decongestants. If you’re struggling with seasonal allergies or a cold, try a med that helps with your runny nose and congestion, like Sudafed. Clearing up your sinuses will diminish postnasal drip and ease your throat pain in the process, Ardon says.

Pain medications. If a sore throat is keeping your teen from swallowing comfortably, Tylenol can help, Zopf says.

If they’re already taking an antibiotic for strep, ask your doctor before combining it with OTC meds.

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When to See a Doc

If your throat doesn’t start to improve after a week of conservative care, or anytime you experience:

  • Difficulty breathing, swallowing or opening your mouth
  • Swollen lymph nodes in your neck and under your jaw
  • Pain on one side of your throat or in one ear but not the other

Should Your Kid Get Their Tonsils Out?

Teens’ larger, more developed tonsils make sur­gery more painful for them than for young kids, Zopf says. Typically, ENTs do not recommend tonsillectomies for teens or adults unless they’ve had tonsillitis seven times in one year, five times a year over two years, or three times a year over three years. But if you or your teen suffers from severe sleep apnea and using a CPAP machine isn’t working, your doc may recommend surgery.