Sore throats are common. Most of the time the soreness is worse in the morning and improves as the day progresses.
Like colds, the vast majority of sore throats are caused by viral infections, such as a cold or flu. This means most sore throats will NOT respond to antibiotics. Many people have a mild sore throat at the beginning of every cold. When the nose or sinuses become infected, drainage can run down the back of the throat and irritate it, especially at night. Or, the throat itself can be infected.
Some viruses can cause specific types of sore throat. For example, Coxsackievirus sometimes causes blisters in the throat, especially in the late summer and early fall. Mononucleosis and the flu can also cause specific viral throat infections.
Strep throat is the most common bacterial cause of sore throat. Because strep throat can occasionally lead to rheumatic fever, antibiotics are given. Strep throat often includes a fever (greater than 101°F), white, draining patches on the throat, and swollen or tender lymph glands in the neck. Children may have a headache and stomach pain.
A sore throat is less likely to be strep throat if it is a minor part of a typical cold (with runny nose, stuffy ears, cough, and similar symptoms). Strep can NOT be accurately diagnosed by looking at the throat alone. It requires a laboratory test.
Sometimes breathing through the mouth will cause a sore throat in the absence of any infection. During the months of dry winter air, some people will wake up with a sore throat most mornings. This usually disappears after having something to drink.
A sore throat may also be caused by something stuck in the throat or allergies (allergic rhinitis).
With a sore throat, sometimes the tonsils or surrounding parts of the throat are inflamed. Either way, removing the tonsils to try to prevent future sore throats is not recommended for most children.