How Sore Throat Is Treated

A sore throat can be uncomfortable and often signals an oncoming cold. While home remedies may help with some types of a sore throat, it's important to note that medical treatment may be needed. A sore throat due to strep throat, for example, requires antibiotic treatment in order to prevent serious complications.

Be sure to consult your doctor if your sore throat is very painful, lasts more than a few days, or if you have other symptoms. Self-treating a health condition and avoiding or delaying standard care may have serious consequences. Certain conditions and symptoms (such as difficulty breathing) require emergency care.

Home Remedies

Most sore throats will clear up in a couple of days. Here are some natural remedies and comfort care tips that may help soothe your pain.

Salt Water Gargle

One of the oldest home remedies for a sore throat, this may help to relieve pain, break down mucus, and reduce swelling. Typically, 1/2 teaspoon of salt is dissolved in a cup of warm water. The saltwater solution should be spit out after gargling and shouldn't be swallowed or reused. Gargling once an hour is sometimes recommended for a sore throat.

Liquids

Prevent dehydration by drinking liquids. Some people may find relief from drinking warm liquids, while others may prefer cold liquids, which can help soothe inflamed tissue. Avoid hot liquids, which may aggravate throat irritation.

Water is always a good choice, but here are two other options you can consider:

  • Warm Lemon Drink: Mix 1 teaspoon of lemon juice or apple cider vinegar, 1 very small sprinkle of cayenne pepper, 1 teaspoon of honey, and 1/4 teaspoon of freshly grated ginger (optional) into a cup of warm water.

    The benefits of this folk remedy haven't been studied, but some say that capsaicin (a compound in cayenne) blocks nerves from sending pain signals, and the acid of the lemon juice or vinegar creates a hostile environment for germs. Note: Cayenne and vinegar can worsen pain and cause burns or irritation in the mouth and throat if consumed solo or in excess.
  • Tea: A warm (not hot) cup of black tea may help to provide relief from a sore throat. Black tea (Camelia sinensis) contains compounds called tannins, which are astringent and may help to shrink swollen tissue. Some also make double-strength black tea and gargle with it several times a day.

Honey

Honey may help suppress a cough and ease discomfort by coating the throat, temporarily relieving irritation. A study published in the journal Pediatrics found that people who consumed honey before bed coughed less frequently and severely, and were less likely to lose sleep due to coughing than those who didn't take honey. (Two teaspoons at bedtime are recommended.)

Add some to a warm beverage, or try it straight off the spoon. Honey should never be given to a child younger than 1 year due to the risk of botulism.

Cold Foods or Application

Some find relief by sucking on popsicles or eating ice cream. If you have swollen glands in your neck, applying an ice bag may also help.

Humidifiers

Since dry air can contribute to a sore throat, a humidifier may help by adding moisture back. Both warm- and cool-mist humidifiers are effective. However, for use around children, it's best to choose cool-mist to avoid hot water spills. You may also want to adjust your thermostat. For some people, a warmer room may lead to dryness, which can aggravate a dry, irritated throat.

Over-the-Counter (OTC) Therapies

You can use over-the-counter pain medications for a sore throat. Ibuprofen and acetaminophen tend to have the greatest effectiveness-to-safety ratio. If you are on blood thinners like Coumadin or have liver problems, ulcer disease, or kidney disease, be sure to discuss which may be better with your doctor.

An anesthetic throat spray, such as Chloraseptic, can be used by children over age 3 and adults. The product instructions say it should not be used for more than two days.

Similarly, medicated or numbing cough drops or throat lozenges can be used. For example, Cepacol Extra Strength lozenges can be used by children of age 5 or 6 (depending on the flavor) or older and adults. They have menthol and benzocaine to numb nerve receptors.

Cough suppressants, such as Robitussin, can be used by children age 6 and over and adults to reduce throat irritation.

If your sore throat is due to allergies and post-nasal drip, you can try over-the-counter antihistamines such as Benadryl or Claritin. These reduce your mucus production during an allergy attack.

For throat pain caused by acid reflux, try an antacid for short-term relief. You can find them in chewable forms, liquids, and tablets. Longer-term OTC medications include H2 blockers, such as Zantac and Pepcid, and proton pump inhibitors, such as Prilosec and Prevacid 24HR. These reduce production of stomach acid.

Prescriptions

While the above can help ease a sore throat, you'll need more than that to get rid of it completely if the cause itself requires its own treatment. 

Depending on your diagnosis, these prescriptions might be deemed beneficial

Antibiotics for Bacterial Infections

Strep throat and scarlet fever require prescription antibiotics to cure the infection and prevent potentially serious complications, including rheumatic fever and kidney damage. A seven- to 10-day course of penicillin, amoxicillin, or erythromycin is commonly prescribed. Fortunately, relief typically comes within 24 hours of treatment. It is important that you take the entire prescription to prevent bacteria from remaining and causing the infection to flair, perhaps leading to complications.

Antibiotics may also be prescribed for other types of bacterial infections that could be causing a sore throat. While these drugs will not cure viral infections, they may be prescribed if your doctor believes you are at risk of developing a bacterial infection on top of a known viral infection.

Corticosteroids for Adults With Severe Sore Throat

A single dose of oral corticosteroids may be used when an adult has a severe sore throat. This therapy is not considered for children.

Topical Anesthetic for Herpangina

Children may have herpangina due to Coxsackie virus or echovirus causing blister-like ulcers in the back of the throat. They rarely have severe pain. If they do, their doctor may prescribe a topical anesthetic containing benzocaine or xylocaine.

Allergy Medications

If you have a sore throat due to allergies, your doctor may recommend prescription allergy medication or desensitization therapy to control allergy attacks.

Medications for Acid Reflux and GERD

For a sore throat caused by gastroesophageal reflux disease (GERD), a doctor may manage your condition with H2 blockers that decrease acid production and proton pump inhibitors the lower the amount of acid your stomach makes.

Narcotic Pain Relievers After Throat Surgery

If your throat is sore because of a surgery such as a tonsil removal, a thyroidectomy, or intubation, your doctor may prescribe a narcotic pain reliever.

Surgeries and Specialist-Driven Procedures

For a sore throat that results in abscesses due to bacterial infection behind the tonsils, a doctor may drain the pus with a needle.

Tonsil removal may be recommended for recurrent strep throat infections or in the case of a severe abscess. Tonsillectomy used to be a common surgery for children who had recurring sore throats. However, it is now less common and only done when there is chronic tonsillitis. It is rarely done for adults. This is usually performed as an outpatient surgery and doesn't require an overnight stay in a hospital.

For a sore throat due to acid reflux, treatment of gastroesophageal reflux disease (GERD) might include surgery if your symptoms don't improve with changes you make to your lifestyle or through medication.

Fundoplication is the most common surgery used to control acid reflux. It is a laparoscopic procedure that is minimally invasive. In this surgery, the top of the stomach is wrapped around the lower esophageal sphincter to make it tighter and prevent acid reflux.

Another type of minimally invasive surgery implants a LINX ring device containing magnetic beads where the stomach meets the esophagus. The magnetic attraction of the beads is just strong enough to allow food to go into the stomach but keep the lower esophageal sphincter closed to prevent acid reflux.

Complementary Alternative Medicine (CAM)

Some traditional herbal remedies have been used for a sore throat. Keep in mind that although many of these home remedies have been used for generations, there is still a lack of solid research on their effectiveness and safety.

Sage

Used in Europe as an herbal remedy for a variety of throat conditions, the herb sage (Salvia officinalis) has a number of compounds, such as cineole, borneol, camphor, and thujone, and astringent properties that may help ease sore throat pain and reduce swelling and inflammation.

Herbalists sometimes suggest a tea or gargle made by steeping 1 teaspoon of dried sage or 1 tablespoon of fresh sage leaves in 1 cup of boiling water. Cover for 10 to 15 minutes and then strain out the leaves. Honey and lemon can be added if desired.

study found that a sage and echinacea spray every two hours (for a maximum of 10 times per day for five days) improved sore throat symptoms as effectively as a medicated spray. Side effects included a mild burning sensation and throat dryness.

Although it may provide some relief in the short-term, the safety of regular or long-term use of sage supplements isn't known. Pregnant or nursing women should avoid sage supplements.

Slippery Elm

Native to North America, slippery elm is an herb that has long been used in herbal medicine to soothe a sore throat, dry cough, or laryngitis. Slippery elm is also found in some throat lozenges. When mixed with water, the inner bark of the slippery elm tree forms a thick gel (mucilage) that coats and soothes the throat.

Herbalists typically recommend pouring 1 cup of boiling water over 1/2 teaspoon of powdered bark. Stir, allow it to steep and then gargle once it has cooled.

Licorice

Licorice root (Glycyrrhiza glabra) has a long history of use as an herbal remedy for a sore throat. According to the National Center for Complementary and Integrative Health (NCCIH), licorice root is sometimes used as a remedy for stomach ulcers, allergiescanker sores, and viral infections.

A study in Anesthesia & Analgesia found that patients who gargled with a licorice root solution five minutes before general anesthesia were less likely to have a sore throat after surgery and experienced less post-operative coughing than patients who gargled with water.

Licorice is a common ingredient in herbal teas, lozenges, and throat drops for a sore throat. It has a naturally sweet taste.

Licorice in large amounts may lead to high blood pressure, salt and water retention, low potassium levels, and may affect levels of the hormone cortisol. It should not be combined with diuretics, corticosteroids, or other medications that reduce potassium levels in the body. People with heart disease or high blood pressure should avoid licorice. Pregnant women should not take licorice.

Marshmallow

Marshmallow, an herb that grows in North America and Europe, has been used for centuries as a home remedy for a sore throat. Like slippery elm, marshmallow contains mucilage.

Herbalists recommend marshmallow root tea as a remedy for sore throats. It is usually made by adding 1 tablespoon of the dried root to a cup (8 ounces) of boiling water and steeping it, covered, for 30 to 90 minutes before straining. Herbalists usually suggest up to three cups a day for a sore throat.

Consult a doctor before taking marshmallow if you have diabetes, as it may make your blood sugar too low, especially when combined with diabetes medication. Marshmallow may also slow the absorption of other drugs taken at the same time. Marshmallow should not be taken by pregnant or nursing women.

Sources:

Agarwal A, Gupta D, Yadav G, Goyal P, Singh PK, Singh U. An Evaluation of the Efficacy of Licorice Gargle for Attenuating Postoperative Sore Throat: A Prospective, Randomized, Single-Blind StudyAnesthesia & Analgesia. 2009;109(1):77-81. doi:10.1213/ane.0b013e3181a6ad47.

Cohen HA, Rozen J, Kristal H, et al. Effect of Honey on Nocturnal Cough and Sleep Quality: A Double-Blind, Randomized, Placebo-Controlled Study. . 2012 Sep;130(3):465-71.

Pelucchi C, Grigoryan L, Galeone C, et al. Guideline for the Management of Acute Sore ThroatClinical Microbiology and Infection. 2012;18:1-27. doi:10.1111/j.1469-0691.2012.03766.x.

Schapowal A, Berger D, Klein P, Suter A. Echinacea/Sage or Chlorhexidine/Lidocaine for Treating Acute Sore Throats: A Randomized Double-Blind TrialEuropean Journal of Medical Research. 2009;14(9):406-412. doi:10.1186/2047-783X-14-9-406.

Stead W. Patient Education: Sore Throat in Adults (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/sore-throat-in-adults-beyond-the-basics#H5.

Disclaimer: The information contained on this site is intended for educational purposes only and is not a substitute for advice, diagnosis or treatment by a licensed physician. It is not meant to cover all possible precautions, drug interactions, circumstances or adverse effects. You should seek prompt medical care for any health issues and consult your doctor before using alternative medicine or making a change to your regimen.