What Is Pharyngitis?
Pharyngitis is painful inflammation of the tissues that line the back of your throat (your pharynx). The dry, scratchy, burning sensation you experience when you have pharyngitis can make it hurt to swallow or talk. Often referred to as a sore throat, pharyngitis is not a disease; instead, it’s usually a symptom of an illness, allergy, exposure to irritants, and other causes. In fact, it’s often the first sign that you’re coming down with something. Every year in the U.S., pharyngitis accounts for more than 40 million visits to the doctor.
Acute vs. chronic pharyngitis
There are two primary kinds of pharyngitis:
- Acute pharyngitis. This is the more common type of pharyngitis. It lasts up to 10 days.
- Chronic pharyngitis. This is pharyngitis that lasts longer than 10 days or keeps coming back.
Pharyngitis Causes
Many conditions can cause pharyngitis. The most common are viral infections, which cause as many as 4 out of 5 cases of pharyngitis. These include:
- The common cold
- The flu
- Chickenpox
- Measles
- Mononucleosis (mono)
- Croup
- COVID-19
- Adenoviruses, which cause infections that most commonly impact your respiratory system
- Human parainfluenza viruses (HPIV), which cause lower and upper respiratory infections
Though less common, these other viruses also can cause pharyngitis:
- Herpes
- HIV
- Epstein-Barr virus
- Coxsackievirus, which causes a common childhood ailment called hand, foot, and mouth disease
Bacterial infections also can trigger pharyngitis. Group A streptococcal infections -- the bacteria that cause strep throat -- account for up to about 1 in 3 cases of acute pharyngitis. Bacterial infections typically cause more severe cases of pharyngitis, and they can develop following a viral infection.
Other causes of pharyngitis include:
- Tonsillitis, caused by infection of your tonsils. This can lead to chronic pharyngitis.
- Acid reflux, in which stomach acid backs up into your throat, causing a painful burning sensation. Some types of acid reflux may lead to chronic pharyngitis.
- Allergies that cause postnasal drip, such as allergies to pollen, dust mites, mold, and pet dander. Such allergies can cause chronic pharyngitis.
- Tumors, both cancerous or benign, are possible, though rare, causes of a sore throat.
- Dry air and breathing through your mouth can dry your throat and make it feel scratchy.
- Overuse of your throat muscles -- from yelling or talking without interruption for long periods -- can make your throat hurt.
- HIV infection, a potential cause of chronic pharyngitis.
- Irritation from pollutants like smoke and other chemicals, as well as from alcohol and overly spicy food, can bother your throat. Pollutants can be a cause of chronic pharyngitis.
Pharyngitis Symptoms
Pharyngitis comes with numerous painful symptoms. Some of your symptoms will depend on what caused your pharyngitis. They may include:
- A scratchy, burning feeling in your throat
- Increasing pain when you talk or try to swallow
- Trouble with swallowing
- Swollen, tender glands -- also called lymph nodes -- in your neck
- Red, swollen tonsils
- White spots, patches, or streaks in your throat or on your tonsils
- Pus on your tonsils or the back of your throat
- Hoarseness
Because pharyngitis so often occurs because of a viral infection, you likely will experience the symptoms that accompany the illnesses these infections can cause, including:
- Sneezing
- Runny nose
- Coughing
- Fever, either low or high
- Fatigue
- Body aches
- Headache
- Chills
Many of the same symptoms occur with strep throat, a bacterial infection that also can cause:
- Loss of appetite
- Changes to your sense of taste
- Nausea
Is pharyngitis contagious?
The viral and bacterial infections that cause pharyngitis are contagious. These include:
- The common cold
- The flu
- Chickenpox
- Measles
- Strep throat
- Mononucleosis
- HIV
- COVID-19
- Herpes
- Eppstein-Barr virus
- Croup
Pharyngitis Diagnosis
To diagnose the cause of your pharyngitis, your health care provider will talk to you about your symptoms and discuss your medical history. You also will get a physical exam, which may include:
- Examining your throat, and likely your ears, nasal passages, and tongue as well, with a lighted probe
- Taking your temperature
- Feeling your neck for swollen glands
- Listening to the sound of your breathing
- Using a throat swab or throat culture to collect samples that will be tested for strep throat
- Taking a blood sample to test for mononucleosis
Pharyngitis vs. laryngitis
These are both types of inflammation, but they occur in different parts of your throat. Pharyngitis affects your pharynx, which helps you to breathe as well as move food and liquids into your stomach.
Laryngitis affects your larynx, sometimes referred to as the voice box because it contains your vocal cords and allows you to make sounds so that you can speak. It also helps you to breathe and move food and liquid down to your stomach. Your larynx can be found just below your pharynx. Like pharyngitis, laryngitis makes your throat hurt. You also may lose your voice temporarily. Other symptoms of laryngitis include:
- A dry cough
- Dryness in your throat
- A tickle or feeling of rawness in your throat
Laryngitis shares some common causes with pharyngitis, such as viral and bacterial infections, acid reflux, and overuse of your voice. It also may be caused by candida (yeast) infections and by smoking and heavy drinking. Like pharyngitis, laryngitis can be either acute, or short-lasting, or chronic, meaning that it lasts at least 3 weeks.
Pharyngitis Treatment
The treatment for your pharyngitis will depend on what caused it. In most cases, this is a viral infection. Antibiotics can’t cure such infections, but they usually go away within a week or so. During that time, you can take steps to ease the soreness in your throat:
- Take over-the-counter (OTC) pain relievers like acetaminophen and ibuprofen. These also can help bring down a fever. If you’re treating a child or teen, don’t give them aspirin. Though rare, it can cause Reye’s syndrome, a sometimes fatal swelling of the liver and brain.
- Take OTC antihistamines if allergies are to blame for your pharyngitis.
- Try OTC antacids for pharyngitis caused by acid reflux.
- Ask your doctor about prescribing a numbing mouthwash if you have severe pharyngitis.
If a bacterial infection, such as strep throat, has caused your pharyngitis, your doctor will prescribe an antibiotic. You’ll likely require a 10-day course. Make sure to take your antibiotics as directed and to finish the entire course, even if you start to feel better. Otherwise, your infection may get worse or spread to elsewhere in your body. If you don’t adequately treat strep throat, you put yourself at risk of rheumatic fever, dangerous inflammation of your kidneys, and other complications.
Pharyngitis home remedies
In addition to medications, there’s plenty you can do for yourself in order to feel better.
- Try salt water gargles. Stir a quarter teaspoon of table salt into a half cup of warm water, gargle, then spit it out. You can do this several times a day. This is recommended for anyone age 6 and older.
- Keep hydrated. Drinking plenty of fluids and humidifying the air in your home will prevent your throat from drying.
- Don’t drink alcohol and coffee, both of which can be dehydrating.
- Suck on throat lozenges. These can be soothing, as can hard candy. Keep in mind these can be a choking hazard for young children.
- Avoid smoke, cleaning products, and other irritants.
- Stay home and rest. This can help you recover while protecting others from catching your illness.
- Don’t eat large meals close to bedtime, as this can contribute to acid reflux.
- Drink warm or cold fluids. You may find soup or tea soothing, or you may get relief from ice water or ice pops.
- Enjoy a hot toddy (if you’re of drinking age). This throat-soothing drink blends a small amount of whiskey (too much risks dehydration) with honey, lemon juice, and, sometimes, spices like cinnamon and ginger.
- Have some honey. On its own or stirred into tea, honey may help ease your throat pain. Don’t feed honey to children younger than 1, as it can cause potentially deadly infant botulism.
- Try cayenne pepper. Add a pinch of cayenne or a little hot sauce to some warm water and gargle. Why? Cayenne contains a chemical called capsaicin, which eases inflammation and pain.
Skip apple cider vinegar and essential oils. Neither will help your throat. Other remedies that aren't proven effective include:
- Fenugreek
- Licorice root
- Marshmallow root
When to see a doctor for pharyngitis
Though painful, pharyngitis typically gets better on its own. Call your doctor if any of the following occur:
- Trouble breathing
- Trouble swallowing
- Your sore throat has lasted longer than a week
- You have trouble opening your mouth
- Painful joints
- Earache
- Skin rash
- A fever of 101 or higher
- Blood in your phlegm or your saliva
- A lump in your neck
- A hoarse voice that lasts more than 14 days
- Neck or face swelling
Breathing and swallowing difficulties in children require immediate treatment. If you notice your child drooling, this may mean they are unable to swallow.
Pharyngitis Complications
The most common cause of pharyngitis -- a viral infection -- will usually clear up on its own without complications. The same is not true of bacterial infections like strep throat. Without proper treatment, strep throat can lead to:
- Epiglottitis, a swelling of the epiglottis, a part of your throat that covers your windpipe. This potentially fatal swelling can block air from reaching your lungs.
- Ear infection.
- Mastoiditis, an infection of the mastoid bone, located behind your ear.
- Sinusitis, or sinus infection.
- Rheumatic fever, an inflammatory disease that affects the heart, brain, skin, and joints. It’s more common in children than adults.
- Post-streptococcal glomerulonephritis (PSGN), a rare inflammatory kidney disease.
- Toxic shock syndrome, a rare but potentially fatal bacterial infection.
Takeaways
Pharyngitis can be caused by a variety of things, most commonly viral infections like the flu and common cold. These usually clear up on their own as you ease your painful throat with over-the-counter medications and home remedies. However, bacterial infections like strep throat need antibiotics to cure. Learn the signs and symptoms so you’ll know when to see a doctor.
Pharyngitis FAQs
How long does pharyngitis last? Viral infections, the most common cause of pharyngitis, usually get better within a week. A bacterial infection like strep throat requires about 10 days of antibiotics to cure.
How do you know if you have viral or bacterial pharyngitis? One easy way to tell: if you have a cough, it’s likely a viral infection. Strep throat, the most common bacterial infection causing pharyngitis, does not cause a cough. Other differences: bacterial pharyngitis develops suddenly, comes with reddened tonsils with white spots, and is usually more severe than pharyngitis caused by a virus. But because the two types of pharyngitis do share many symptoms, you may need to see a doctor, who can test you to determine the cause of your pharyngitis.
Is pharyngitis the same as strep throat? No. Pharyngitis is a symptom of strep throat, a type of bacterial infection that requires antibiotics to cure.
What does pharyngitis feel like? Your throat will feel dry and scratchy and like it’s burning. It may hurt to swallow and to speak.
What happens if pharyngitis is left untreated? Most of the time, pharyngitis clears up on its own. But if you have strep throat, which is caused by a bacterial infection, you can develop serious complications if you don’t get treated. These include rheumatic fever, ear infections, kidney problems, and potentially fatal conditions like toxic shock syndrome and swelling of a part of your throat called the epiglottis, which can block the flow of air into your lungs.
How do you get instant relief from pharyngitis? You can ease your symptoms with OTC pain medications and home remedies like salt water gargles. These provide temporary relief from your pain.
