From a minor tickle to trouble swallowing, coughing fits to a painful burn, a sore throat can feel like — and mean — a lot of different things.
Even the slightest uncomfortable sensation in the back of the throat can elicit panic. But before going down the dark path assuming it's something serious like flu, pneumonia or mono, remember that many of the symptoms can be treated easily.
How long a sore throat lasts depends on why it's started. In some cases, a sore throat can be stopped dead in its tracks before it progresses into something more.
What causes a tickle in the throat?
“When I hear the word tickle ... I think about inflammation and not infection,” Dr. Kevin Potts, an ear, nose and throat (ENT) specialist with the University of Louisville told TODAY. “One possible, benign condition is acid reflux.”
The throat lining isn’t equipped to manage acidity the way the stomach and esophagus can, he said. This leads to not only the annoying feeling but can also lead to red streaks in the back of the throat which can last for months if not addressed.
Acid reflux or gastroesophageal reflux disease (GERD), affects 20 percent of the U.S. population, according to the National Institute of Diabetes and Digestive and Kidney Diseases. The disease significantly impacts an individuals’ quality of life, results in missed workdays and lower productivity among employees. If left untreated, the acidic irritation can progress to respiratory problems including asthma, laryngitis, pneumonia and, in some cases, esophageal cancer.
“Staying away from acidic foods like tomatoes, citruses and anything spicy will ease symptoms," Potts said. "Avoiding caffeine and alcohol combined with an acid reflux medication such as Nexium or Zantac can make the tickle all but disappear."
Allergies are another possible culprit, especially if coupled with sneezing, watery eyes and a stuffy nose, according to Dr. Sarah Burgin, Assistant Professor of Otolaryngology at Indiana University School of Medicine.
Seasonal allergies affect 40 percent of adults, The Mayo Clinic estimates. The most common winter allergies are dust mites, mold and pet dander.
“If it’s allergies, I would recommend over-the-counter [allergy medicine],” Burgin said. “All would be appropriate, help with the discomfort and resolve the issue quickly.”
What if it's hard to swallow?
Trouble swallowing can indicate many things. Cough drops and a good night’s sleep will often do the trick, adding some ibuprofen when the swallowing includes pain. However, there are times when something worse like an infection or problematic tonsils may be at play.
“If swallowing is an issue for more than seven to 10 days, it could mean strep throat,” said Burgin. “If a patient is constantly coming in due to strep, I’d seriously consider taking the tonsils out.”
Approximately 11,000 to 13,000 cases of strep throat occur per year in the U.S., according to the Centers for Disease Control.
But if chronic strep is not the cause and the issue has continued for months, especially for people 55 and older or who smoke, Burgin said it's time to go to the doctor immediately for tests.
“It could mean cancer in the tonsils, the pharynx (nasal cavity) or vocal cords," she said. "The persistent soreness with swallowing combined with ear pain, voice changes and/or coughing up blood is a sure sign of throat cancer.”
What could coughing fits mean?
Coughing fits are most likely due to post-nasal drip caused by allergies or infections, explains Dr. Jonathan Miller, pediatrician at Nemours/Alfred I. duPont Hospital for Children.
Common colds, the flu and the dry, cold winter air also cause post-nasal drip which lead to coughing fits.
Miller recommends using a saline nasal spray, which is basically a mild salt-water solution, as an effective way to combat the post-nasal drip responsible for the coughing.
“If you then blow out all of the saline or salt-water and other kinds of phlegm and mucus you might have ... that can really prevent [the mucus] from dripping back," he said. "Dripping back is what irritates your airways.”
Although there are many kinds of nasal spray on the market, a simple saline formula is the best bet as it's the least likely to cause irritation.
“They’re very safe.Any kind of action into the nose like spraying or putting the applicator in there could potentially irritate the nose a little bit," Miller added. "Perhaps cause a nosebleed. But beyond that, I wouldn’t be worried about any side effects from it.”
What's causing this burning in the throat?
Several conditions are associated with a burning sensation, two of which are tonsillitis and bacterial pharyngitis, especially if coupled with throat pustules, redness, fever and chills. These are not accompanied by coughing.
“When a patient describes a burn without coughing, it’s usually bronchitis,” said Potts. “With bronchitis, people feel that terrible burn not only in the throat but in the chest as well.”
This is different than a raw sensation someone might feel in the throat. Rawness occurs when mobilizing the muscles while swallowing. Burning is continuous, with or without swallowing. But it’s rare if a patient complains of rawness without burning, he said.
Allergies associated with dust, mold and pet dander are also common causes of behind burning and soreness.
“To combat both we [doctors] try to look at a patients’ home and address things to minimize the environment that can minimize dust,” Potts said.
He recommends spray products and pillow and mattress covers to protect against dust mites and pet dander. Hepa-filtration vacuums are also helpful.
Proper moisture is important, but be careful of humidifiers, Potts warned.
“What loves moisture?" he said, "Mold. Without constant monitoring, you’ll end up throwing mold spores into your bedroom as you’re sleeping. Not something we [ENTs] recommend.”
But, sometimes a sore throat requires just a good days’ rest.
Relax on the couch, get some rest and do some salt-water gargles. If there’s pain, it’s OK to take an ibuprofen or two.
“The most important thing is to respect what your body is telling you,” said Burgin. “If it’s not well, it needs to heal. Take the time from work so you don’t spread what’s going on to co-workers. Stay hydrated and give your body the rest it needs.”
Also, according to Burgin, mother still knows best.
“Remember when mom used to give you popsicles and chicken soup?" she said. "Those are actually the right things for you ... as long as [the food or liquids] don’t hurt going down.”
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