Persistent Sore Throat

Most cases of sore throats are due to cold or a viral infection. In clinical definitions, the average duration for an episode of persistent sore throat may last for up to 3 to 4 weeks. In most cases, medical treatment is needed to control the symptoms as long standing cases are usually suggestive of an underlying medical problem.

What Causes Persistent Sore Throat?

The duration of illness and severity of symptoms depends largely on the inciting cause and pathophysiology. In case of severe throat irritation as seen after the inhalation of toxic smoke, the sore throat can last as long as the person is exposed to toxins. In some cases, bacterial colonization can also present with symptoms of sore throat, which generally responds very well to antibiotics. Sore throat caused by mononucleosis infection usually runs a more chronic course. Some other causes include:

1.       Using too Much Voice

Persistent sore throat is very common after long periods of excessive shouting. For example, excessive cheering after attending your favorite performer's concert or to boost the morale of your favorite team in a game. This may also happen if you are a teacher. Straining your vocal cords can damage your vocal muscles which may then lead to the inflammation of vocal cords, for a couple of days.

2.       Tonsillitis

Tonsillitis is caused by common virus and usually happens in school children and teenagers.  It can cause sore throat and chronic cases can cause your throat to ache persistently. Other symptoms include:

  • Swollen and red tonsils
  • Visible yellow or white patches on the tonsils
  • Difficulty when swallowing, sometimes with pain
  • A muffled or scratchy voice
  • Fever
  • Headache
  • Tender and enlarged lymph nodes in neck
  • Stiff neck
  • Bad breath
  • Stomachache

3.       Laryngitis

Laryngitis is inflammation of the larynx, also called voice box, due to irritation overuse, or infection. It can be caused by minor virus, or something long lasting and serious, thus causing your throat to have persistent pain. Besides persistent sore throat, others symptoms include:

  • Weak voice or in severe cases loss of your voice
  • Hoarseness and rawness
  • Tickling sensation in throat
  • Dry cough
  • Dry throat

4.       Glandular Fever

Glandular fever is caused by Epstein-Barr virus (EBV) and the symptoms usually recover in about two weeks, which include a very sore throat that becomes worst in days 3-5 after symptoms start. Besides, the fever usually lasts 10-14 days. Other symptoms include:

  • Fatigue and general unwellness
  • Muscle aches
  • Sweats and chills
  • Appetite loss
  • Swollen tonsils
  • Purple or red spots on roof of mouth
  • Pain around eyes
  • Swollen or tender stomach
  • Rashes

5.       Injuries

As discussed previously, shouting and screaming can damage the throat easily. In addition, scratching or a lodging of a foreign body in the throat (such as while swallowing large bolus of poorly chewed food or impaction of a fish bone in throat) can also lead to persistent sore throat. It is therefore recommended to chew food properly before swallowing to prevent indigestion and other throat injuries.

6.       Irritants and Allergies

Irritants like smoke and dust particles can also cause sore throat. After exposure to an allergen, human body responds by eliciting an inflammatory response that is characterized by swelling and tissue edema. Allergies can make your mouth and throat dry while producing excess mucus to cause post-nasal dribbling and resultant cough and irritation.

The symptoms of sore throat caused by allergies are same as that of cold, but some factors that may help in making the diagnosis are:

  • Allergies are seasonal, and lasts for some weeks. The symptoms are caused by the reaction of body to allergens.
  • Allergens make eyes watery and itchy.

7.       Acid Reflux

Sore throat can also be due to indigestion, with symptom of Gastro-esophageal acid reflux in the upper area of throat. The thin layered mucus traps particles of smoke make your throat sore.

8.       Bacteria Infection such as Strep Throat

Bacteria also cause sore throat especially when the immune system is weak due to chronic health issues. In most cases it is hard to differentiate if the symptoms of persistent sore throat are due to virus or bacteria.

Severe symptoms are mostly due to bacterial infections, especially streptococcus pyogenes. The infections further cause persistent sore throat for which you should visit a doctor for optimal treatment. A specific type of bacteria, streptococcus causes strep throat which requires optimal treatment in the form of antibiotic prescribed by your doctor. Fever and swollen tonsils can further worsen the symptoms. Doctors diagnose this infection by a throat culture before prescribing medicines.

9.       Medicines and Medical Conditions

Our immune system may get weaken due to medical conditions like AIDS, which makes you sensitive towards certain infections. Some medications can also cause sore throat, such as anti-depressants and anti-histamines etc. They make the throat painful and dry out the mucus in the throat.

10.      Dry Weather

Breathing dry air can also cause persistent sore throat especially if you're travelling in a dry climate or during winter when the humidity gets very low. In all such cases, nose comes to the rescue and therefore you should breathe through nose for better results.

11.      It Can Be Virus Infection That Didn’t Heal

Flu and cold are the most common causes of sore throat. The disease starts from the larynx and eventually involves the entire throat. The symptoms lasts for a few days. In the environment we live, viral infections are very common. Common cold have symptoms like sore throat, postnasal drip, nasal congestion and cough. Common colds take around 3-7 days to go and there's usually no need to visit a doctor.

12.      Other Causes

Some other causes of persistent sore throat include:

  • Breathing from mouth
  • Measles
  • Croup
  • Tumors or cancer which can present as lumps in throat

What to Do About Persistent Sore Throat

It can be treated by some simple home remedies like use of humidifier, honey and lemon tea, salt gargling, hydrated body, OTC medicines and cough drops.

The persistent sore throat usually resolves spontaneously, but if no change in symptoms is observed for a few weeks and you are experiencing swollen glands and fever; then consult your doctor immediately. Sore throat for more than few weeks can have unusual and serious symptoms.

You can soothe your throat pain by following tips:

  • Suck something that soothe your throat like a popsicle.
  • Don't use too much of your voice and get sufficient sleep.
  • Drink a lot of water and fluids to keep your throat hydrated. A warm tea with honey is recommended for more comfort.
  • Some cold foods like ice pops also provide relief to sore throats.
  • Use OTC medicines to relieve pain like ibuprofen or naproxen.
  • To avoid dry air entering into your throat, use humidifier in home. You can also opt to spend some time in a steam bath.
  • Use lozenges for soothing your persistent sore throat but keep them away from children of age 4 or less as they are choking hazard for them.
  • Quit smoking if you haven't already, do not let any smoke enter into the house and don't use cleaning items which cause irritation in throat.
  • Do gargles of a mixture by combining water (8 ounces) and salt (1 teaspoon) couple of times a day.

Help from Echinacea

Echinacea is a herb that is traditionally used to fight against flu and cold symptoms in the body. Its tablets are used to increase the resistance against infections in your body by making the immune system stronger. It allows the body to fight against cold and flu.

Medical Treatments

To find the best treatment for your sore throat, it is imperative that you find the culprit behind it. Sore throats caused by bacterial infections are treated with antibiotics. If you don't treat the strep throat seriously it can cause serious complications like heart disease and valvular defects.

Antiviral medicines are used to treat persistent sore throat that is caused by viral infections or you may get better without any treatment. If your sore throat is due to allergies, then you need medication to control the symptoms in addition to avoiding allergens to ease the symptoms and pain.

What Other People Have Experienced and Suggested?

“I am resident of US (Midwest). I have had persistent sore throat. I noticed that unless I consume dairy products or a lot of protein, my throat doesn’t cause any trouble.  I believe the symptoms are due to a stubborn virus that is not ready to leave. It feels strange because I am the only person in my family and also at work to suffer from this condition”.

“I have had persistent sore throat since the end of Feb, I have been sick badly. 12 years ago I was diagnosed with Hodgkin’s Lymphoma but thankfully I got away with it and since then I remained in good health except this throat problem. According to the doctor, the worrying is enhancing the problem; thankfully all my tests are perfect.”

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