Why Do I Have a Sore Throat but No Fever?

Everything you eat, drink, and breathe in a day passes through your throat, so it can be difficult to ignore when it gets sore or inflamed.

There are many things that can cause a sore throat, and not all of them are worrisome. Most sore throats are caused by viruses or bacteria, which often come with other signs of infection, such as a fever. 

This article will review other causes of sore throats that might not appear with a fever, what you can do about them, and when to see a healthcare provider.

Sore Throat Without Fever Causes

Although most sore throats (aka pharyngitis) are caused by bacteria or viruses, there are many other things that can irritate, inflame, or damage the throat and cause soreness.

Viruses

Viruses are the top cause of sore throats, with about 50–80% of pharyngitis cases in adults resulting from viruses such as:

• Rhinovirus
• Influenza
• Adenovirus
• Coronavirus
• Parainfluenza
• Herpes
  
• Epstein-Barr
• Human immunodeficiency virus (HIV)
• Coxsackievirus

Viral illnesses that cause a sore throat can also appear with other symptoms including fever, stuffy nose, and cough. There are few cures or treatments for viral infections outside of supportive care, and symptoms will usually pass within two to three weeks.

Bacterial Infections

Bacterial infections that cause sore throat often appear with a fever, but that's not always the case. Group A Streptococcus, or group A strep, is a common culprit in bacterial infections that cause sore throat.

Other causes can include bacteria like:

• Group B strep
• Group C strep
• Chlamydia pneumoniae
• Mycoplasma pneumoniae
• Haemophilus influenzae
• Candida
• Neisseria meningitidis
• Neisseria gonorrhoeae
• Arcanobacterium haemolyticum
• Fusobacterium necrophorum
• Corynebacterium diphtheriae

Bacterial infections can also lead to other complications that can cause sore throat, including abscesses, ulcers, or infections of the lymph nodes. Antibiotics alongside supportive care can usually treat and often cure these infections for symptom relief.

Colds

Colds are the general term for a wide range of viral and bacterial infections that cause symptoms such as a stuffy nose and sore throat. Rhinoviruses are the top cause of the common cold, but there are many others. As discussed in the viral section above, most treatments focus on comfort during viral illness and not a cure.

Tonsillitis

Tonsillitis is a condition that develops from swelling in the tonsils, which are lumps of tissue located in the back of your throat. It can be difficult to determine whether this pain is centered in the throat or the tonsils themselves because the entire area often becomes irritated and inflamed. The tonsils are part of your lymphatic system, which helps to clear wastes and infections from your body. Tonsillitis is most common in children and is usually caused by bacteria or viruses. 

A fever may or may not appear with tonsillitis, but this problem can usually be diagnosed after two days of soreness and other symptoms such as:

• Red or swollen tonsils
• Difficulty or pain with swallowing
• A white or yellow coating on the tonsils
• Swollen glands/lymph nodes in the neck
• Bad breath

Tonsillitis caused by a virus will pass in time with no real treatment, but bacterial causes may require antibiotics. Repeated cases of tonsillitis are sometimes treated with a tonsillectomy, or the surgical removal of the tonsils.

Allergies

Allergies can also cause you to develop a sore throat. Seasonal allergies to things like pollens can irritate the nose and throat, causing drainage and irritation. There are no real cures for sore throats caused by allergies. Instead, the strategy is usually to get your allergic response under control to prevent symptoms, such as a runny nose or sore throat. This might include using treatments like antihistamines and other allergy medications.

Acid Reflux

You can also experience a sore throat if you have gastroesophageal reflux disease (GERD). In severe or chronic cases of GERD, the acids in your stomach can bubble up into your esophagus and irritate the lining of your throat. If this problem goes on for too long, it can even cause permanent changes to the tissue in your esophagus (Barrett's esophagus).

Your healthcare provider may recommend diet changes, weight loss, and medications to help control the production and reflux of your stomach acids.

Sexually Transmitted Infections (STIs)

A sore throat may not be the first symptom that comes to mind when you think of a sexually transmitted infection, but any type of sexually transmitted bacteria and viruses can colonize in the mouth, too.

These infections usually spread through oral sex and often develop with no symptoms at all. A sore throat can develop with these infections, too, but not often. Using oral protection like dental dams during oral sex can help prevent oral transmission of STIs.

Environmental Irritants

In addition to allergens, there are also other things you can inhale that can irritate your throat and cause soreness or inflammation. These include things like air pollution, smoke, and other chemicals. If you are using harsh chemicals that you might breathe in, wear a mask. Supportive care and avoidance of irritants are the best ways to manage these types of sore throats.

Cancers

About 31,000 people in the United States (most of them over the age of 55) receive a throat cancer diagnosis each year—mostly in people over the age of 55. A sore throat that won't go away is just one of the symptoms you may notice with throat cancer. Other symptoms can include:

• Swallowing problems
• Ear pain
• Voice changes
• Nosebleeds
• Headache
• Weight loss
• Bad breath
• Stiff jaw

Throat cancers are most common in people who:

• Use any kind of tobacco products
• Drink excessive amounts of alcohol
• Are infected with the human papillomavirus (HPV)
• Have poor oral hygiene
• Are infected with the Epstein-Barr virus
• Are deficient in certain vitamins or have a poor diet

When to See a Healthcare Provider

If you are suffering from a sore throat that won't go away or have other symptoms, such as a fever or weight loss, you should call or make an appointment to see your healthcare provider. Emergency care might be necessary if you develop symptoms such as:

• Throat swelling
• Difficulty breathing
• Vomiting or coughing up blood

If you experience these symptoms, call 911 or go directly to the emergency department.

Summary

Many things can cause a sore throat, and not all of them are worrisome. Most sore throats are caused by viruses or bacteria, which often come with other signs of infection, such as a fever. 

Even so, there are other causes of a sore throat that may not present with a fever, including allergies, acid reflux, colds, STIs, environmental pollutants, or even cancer.

Treatment of your sore throat depends on the cause. If your sore throat lasts for several weeks without improvement, make an appointment with your healthcare provider to get an evaluation.

A Word From Verywell

Sore throats are a pretty common ailment and are rarely a cause for concern. In addition to the common cold and many types of viruses and bacteria, things like air pollution, allergies, and acid reflux can lead to a sore throat. Talk to your healthcare provider if you have frequent sore throats or a sore throat that doesn't go away for a few weeks.