What is a sore throat from a medical point of view?

Sore throat describes pain, burning, or scratching in the area of:

• pharynx
• tonsils
• larynx

The complaints may:

• Occur on one or both sides
• get stronger when swallowing or talking
• persist acutely or over a long period of time

Duration, location and accompanying symptoms provide important clues as to the underlying cause.

Common causes of sore throat

1. Acute pharyngitis

The most common cause of sore throat, usually viral.

Typical symptoms:

• Scratching or burning in the throat
• swallowing problems
• often combined with runny nose or cough

Antibiotics are usually not necessary in these cases.

2. tonsillitis (tonsillitis)

Tonsillitis can be viral or bacterial.

Indications of a bacterial cause:

• severe swallowing pain
• high fever
• whitish coatings on tonsils
• painful lymph nodes on the neck

Whether antibiotic therapy makes sense is decided by an ENT specialist examination.

3. laryngitis (laryngitis)

The following are typical:

• hoarseness
• loss of voice
• pain when talking

Common triggers:

• Infections
• Vocal overload
• reflux
• smoking

Hoarseness that lasts longer than three weeks should always be clarified.

4. irritation of mucous membranes

Not every throat complaint is infectious.

Common causes:

• dry indoor air
• Breathing in the mouth, e.g. when there is nasal congestion
• smoking
• chemical or mechanical stimuli

These factors often lead to chronic clearing and persistent sore throats.

5. Reflux-related sore throat

Stomach acid can rise up to the throat or larynx — even without typical heartburn.

Typical notes:

• morning sore throat
• feeling of a lump in the throat
• hoarseness
• chronic cough

6. Rare but important causes

In rare cases, sore throats may be a result of:

• abscesses
• chronic inflammation
• benign or malignant changes

Rapid clarification is particularly important in the case of unilateral, persistent pain, swallowing disorders or blood admixtures.

When should sore throats be diagnosed?

An ENT specialist examination is recommended for:

• sore throat lasting more than 7-10 days
• high or prolonged fever
• unilateral complaints
• swallowing or breathing problems
• recurrent inflammation
• Hoarseness lasting more than three weeks

Early diagnosis prevents unnecessary medication and enables targeted therapy.

Modern diagnostics by an ENT doctor

clinical examination

• Inspection of the oral cavity, throat and tonsils
• Evaluation of redness, swelling, plaque, or asymmetries
• Palpation of cervical lymph nodes

Endoscopic examination

If symptoms persist or are unclear:

• accurate evaluation of throat, larynx and vocal cords
• particularly important in cases of hoarseness, foreign body sensation or suspicion of reflux
• Can be carried out gently and quickly

Complementary diagnostics

Depending on the findings:

• Streptococcus rapid test
• blood tests
• Ultrasound or further imaging in special cases

Treatment of sore throats — targeted and dependent on the cause

Conservative therapy

For viral or irritant causes:

• Protecting the voice
• adequate hydration
• local measures such as lozenges or inhalations
• anti-inflammatory drugs when needed

Antibiotic therapy

Only useful if there is a clear bacterial cause.
Unnecessary antibiotic doses should be avoided.

Treatment for reflux or chronic irritation

• Adjusting lifestyle and diet
• drug therapy when needed
• Treatment of concomitant nasal or respiratory problems

Chronic sore throats — often underestimated

Sore throats that persist for weeks or months often have no infectious origin.

Common causes include:

• chronic mucosal irritation
• nocturnal mouth breathing
• silent reflux
• prolonged voice load

These symptoms benefit in particular from specialized ENT diagnosis.

Warning signs — when to act quickly?

Prompt medical evaluation is important in the case of:

• severe one-sided sore throat
• increasing swallowing problems
• shortness of breath
• rapid worsening of general condition
• Blood admixtures in saliva
• persistent hoarseness

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