When you have a sore throat, it can hurt to swallow and even breathe. Most sore throats are caused by viruses or bacteria, which often come with other signs of infection, such as a fever. A number of other issues may also cause this pain, however, which means you may not have a fever or other symptoms with your sore throat.
This article will review what causes a sore throat, what you can do about it, and when to see a healthcare provider.
Sore Throat Without Fever Causes
A sore throat—also called pharyngitis—is usually caused by bacteria or viruses. However, there are many other things that can irritate, inflame, or damage the throat and cause soreness.
Causes and Risk Factors of Sore Throat
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 cause 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.
Is the Flu a Virus or Bacteria?
Bacterial Infections
A sore throat can also be caused by a bacterial infection. These infections often also cause 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 refer to the 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. Most treatments focus on comfort and are not a cure.
What Causes a Sore Tongue and Throat?
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 waste 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 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 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.
Itchy Throat And Allergies
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 bacterium or virus 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.
What to Know About Chlamydia in the Throat
Environmental Irritants
Apart from 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
An Overview of Throat Cancer
When to See a Healthcare Provider
If you are suffering from a sore throat that won't go away or you have other symptoms, such as a fever or weight loss, you should 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.
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Centers for Disease Control and Prevention. Clinical guidance for group A streptococcal pharyngitis.
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National Library of Medicine: MedlinePlus.Tonsillitis.
National Library of Medicine: MedlinePlus.Allergies.
National Institutes of Health.Definitions & facts for Barrett's esophagus.
American Sexual Health Association.Gonorrhea.
Centers for Disease Control and Prevention.STI risk and oral sex.
Centers for Disease Control and Prevention.Sore throat basics.
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By Rachael Zimlich, BSN, RN
Zimlich is a critical care nurse who has been writing about health care and clinical developments for over 10 years.
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