There are many factors that can be considered when you are being evaluated for sore throat pain. While some of the causes require only treatment of the pain until it subsides, other causes require treatment of the instigating problem. Common causes for sore throat pain include (but are not limited to):
- the common cold
- strep throat
- acid reflux
- herpangina (in children)
- overuse of the vocal cords
- sinus infections
- post nasal drip
Sore Throat Pain That Should be Treated by a Doctor
Acid reflux occurs when stomach acid enters the esophagus and irritates the tissues causing a sore a throat. With the exception of occasional acid reflux from overeating, you should see your primary care physician or a gastroenterologist (an internal medicine doctor that specializes in disorders of the esophagus, stomach & intestines). Treatment for this may include medications such as dexilant, which is a proton pump inhibitor. Untreated persistent acid reflux can damage your esophagus and lead to complications including Barrett's esophagus or cancer of the esophagus.
Strep throat is another cause of sore throat pain that needs to be treated by a doctor. Strep throat is caused by a bacteria and can be cured with a course of antibiotics. However, by not treating a strep infections you put yourself at risk for serious complications.
While there are some disorders that can be treated to prevent recurrence of sore throat pain, other disorders require you to symptomatically treat the pain while your body heals itself. Sore throat pain caused by the common cold is one such instance. Below are common ways sore throat pain can be treated.
Medication for Sore Throat Pain
While there are several types of pain medications available over-the-counter and by prescription, research shows that ibuprofen and acetaminophen tend to have the greatest effectiveness-to-safety ratio in treating sore throat pain. Ibuprofen and diclofenac have been more effective in treating sore throat pain in studies as compared to acetaminophen, however both ibuprofen and acetaminophen seemed to be safer than diclofenac when the side effects of the medications were compared. You should not use ibuprofen if you are on blood thinners like Coumadin and acetaminophen should be avoided if you have liver problems. If you have any questions on whether or not you can use these medications, you should always consult your primary care physician.
As a standard of care glucocorticoids such as Prednisone should not be used to treat sore throat pain. There is no evidence that this is helpful in children, and should therefore be avoided. Use of Prednisone or other glucocorticoid medications may be considered in severe sore throat pain in adults and should only be taken after careful consideration by your primary care physician.
Studies surrounding the use of zinc gluconate as a treatment for the common cold and treatment of sore throat pain have had conflicting results. While a Cochrane review shows that that using zinc (dose and frequency undetermined) within 24 hours of common cold symptom onset reduces the duration of the cold, other studies have shown that you may actually experience an increase in undesirable side-effects. Because of this lack of evidence as an effective treatment, zinc has not been recommended for treatment for sore throat pain.
Antibiotic therapy without the identification of a bacterial infection has not been shown to be helpful in treating sore throat pain. In fact with the presence of “super bugs”, the societal effect of misuse of antibiotics may be more harmful in the long run. Your physician will weigh the cost-versus-benefit and may still decide to use antibiotics when severe sore throat is present. When a bacterial infection such as strep throat is identified, antibiotics should be used and are typically prescribed for 10 days. Penicillin and amoxicillin are both popular choices for the treatment of strep throat; however there are many different broad-spectrum antibiotics that can be used.
There are not many high quality studies that have supported the use of alternative therapies such as herbal teas or acupuncture. Most studies that included herbal remedies did not include a placebo, and therefore it is difficult to determine whether or not there was any real benefit to the use of the herbal substances. One study including Throat Coat showed a short-term benefit, but did not last beyond 30 minutes at which point the placebo and Throat Coat showed equal benefit.
While the most common causes of sore throat pain are likely related to a viral infection, prolonged sore throat pain should be addressed by a physician. You can use the Symptom Checker to help identify a likely cause; however this should not supersede an evaluation by your physician. If you have mild sore throat pain, use of analgesics or alternative therapies may be sufficient, however evaluation of the cause of severe sore throat pain should not be delayed. Members of your treatment team may start with your primary care physician, but may eventually include an otolaryngologist, gastroenterologist, or allergist.
Medline Plus. (2011). Zinc. Accessed: July 30, 2012 from http://www.nlm.nih.gov/medlineplus/druginfo/natural/982.html.
Pelucchi, C., Grigoryan, L., Galeone, C., Esposito, S., Huovinen, P., Little, P. & Verheij, T. (2012). Guideline for the management of acute sore throat. Clinical Microbiology and Infection. DOI: 10.1111/j.1469-0691.2012.03766.x