Woke up to a sore, scratchy throat? You may want to blame it on dry air, but it’s usually a sign your body is fighting a viral infection.
“The top five causes of a sore throat are a virus, a virus, a virus, a virus and a virus,” said Elisabeth Fowlie Mock, a family physician and director at the American Academy of Family Physicians. The culprits that can trigger a sore throat include rhinoviruses (the most common cause of colds), influenza, coronavirus and respiratory syncytial virus.
Throat pain is often your first symptom because viruses first latch on in this area of your body, said Benjamin C. Tweel, an assistant professor of otolaryngology at the Icahn School of Medicine at Mount Sinai.
“The virus is getting into the cells lining the throat, and it’s probably causing an inflammatory response in your body’s immune system,” said Tweel, also the medical director for the department of otolaryngology at Mount Sinai Health System. When the body recognizes a viral intruder, lymphatic tissue in the back of the nose and throat swells and becomes inflamed, causing pain, the experts said.
“Every so often, your body fights it off, and you don’t get the full-blown thing,” Mock said. Other times, the classic symptoms of an upper respiratory infection follow, including a runny nose, congestion and cough.
Throat pain from an upper respiratory infection usually gets better within one week, according to the Centers for Disease Control and Prevention. Over-the-counter pain relievers such as ibuprofen or naproxen can help, and they may have an advantage over medications such as acetaminophen, Tweel noted, because they reduce pain and inflammation. And of course, there are some home remedies that may soothe your pain. Here are a few to consider:
Saltwater gargle
Salt water has long been considered a tried-and-true approach for sore throats, and there is some scientific research to support it. A small 2019 randomized controlled trial, published in the Journal of Complementary and Alternative Medical Research, found that people with nonbacterial sore throats who gargled with salt water had less severe pain and difficulty swallowing one week later compared with those who used thymol solution, a type of antiseptic gargle or mouthwash.
It’s possible salt helps reduce tissue swelling in the throat, said Cameron Wick, an otologist and neurotologist at University Hospitals. “When you do a saltwater rinse, it’s basic high school chemistry and the whole process of osmosis,” he said. “Some of the water in the cells in your throat actually come out of your tissue and go into the salt solution, so that decreases some of the inflammation.” Saltwater gargling “probably also helps wash out debris and virus particles,” Tweel added.
The research is limited, but saline gargling “is highly unlikely to be harmful,” Mock said. “It might help a little bit, and it’s probably not going to hurt.” A safe ratio is 1 teaspoon of salt for every 8 ounces of warm water, Wick said.
Saltwater rinses may have other benefits. If you’re experiencing thick mucus, congestion or symptoms of allergies, an over-the-counter saline spray or nasal irrigation device can clear out your nasal passages for easier breathing, Wick said. These products also help hydrate the nasal passages and reduce swelling.
Only use water that is distilled, sterile or boiled and cooled in nasal irrigation devices, since tap water may contain germs that are dangerous if they enter your sinuses.
Honey
Honey is known for its antibacterial properties, Wick said, and its thickness may shield your sore throat from further irritation. It should feel good on the throat or a mucosal membrane, he explained. Honey acts as a barrier, so the throat isn’t “exposed to the elements in general and passing liquids and air.”
There’s some research to support honey’s use for the relief of upper respiratory infection symptoms such as a sore throat and cough. One small 2023 study also found that gargling with honey — 15 milliliters of honey mixed in 5 ml of water — helped ease pain from a tonsillectomy, or surgery to remove the tonsils.
Honey can also be an option for children with sore throats and coughing who are at least 1 year old. The American Academy of Pediatrics recommends it instead of over-the-counter medications for children, since there’s little evidence cold medicine offers much benefit to kids younger than 6.
“As long as they’re over 1 year old, a little bit [of honey] in warm liquid or a teaspoon of honey” may help ease kids’ sore throats and help them sleep better, Mock said. You should never give honey to babies under 12 months because of the risk of infant botulism, a rare but dangerous condition.
Tea
Sipping a cup of tea feels good on a sore throat, but not all types are recommended when you have an upper respiratory infection.
“Make sure it’s a non-caffeinated tea,” Wick said. “Black teas, those really tannic teas, often have a relatively high caffeine level, and caffeine does things to your kidneys that makes you urinate more and can actually dehydrate you.”
There have been limited studies linking herbal teas to reduced throat pain; chamomile, ginger and turmeric tea are particularly good options, Wick said.
To give your tea a sore throat-soothing boost, squeeze in honey and lemon. The citrus fruit “adds vitamin C, which has immune support, and increases saliva production,” Wick said. The latter is beneficial because it may help saliva glands in your mouth and throat (there are “hundreds of minor ones underneath the mucosal surface,” he said) flush themselves, so “rather than thick, congested mucus, it’s thinner, and the body can handle it more.”
Warm beverages
If you’re not a tea drinker, other warm beverages such as warm water, bone broth, vegetable broth or soup may be similarly soothing. “There’s a kind of calming effect that occurs with warm water,” Wick said.
Warm beverages may also be easier to drink and thus can increase your overall hydration. “[This] is probably one of the better things you can do for a sore throat,” Tweel said. “The drier you are, the worse your throat is going to be.”
Plus, as long as it doesn’t contain ingredients that irritate the throat, soup can be comforting, Mock added.
Cool foods
Some people prefer cool foods such as ice chips or ice pops for a sore throat, especially if they’re experiencing more significant throat pain, Wick said. After a tonsillectomy, “kids get to binge on ice cream and Popsicles. Usually that is because the coolness calms down those pain fibers and nerve endings,” he said.
There’s little research on cold foods for sore throats caused by upper respiratory infections, but some studies suggest cooling therapies might help ease throat discomfort after medical procedures such as intubation and surgery.
Using a humidifier
Dry air can make your nose, mouth and throat feel scratchy and uncomfortable. “This is part of the reason why people feel worse sometimes immediately after flying on a plane,” Tweel said. Running a cool-mist humidifier or vaporizer may ease some of that scratchiness when you have a sore throat.
The big caveat is you have to keep these devices clean. “I personally don’t use one because I find it hard to keep it sanitized,” Tweel said. Mold and bacteria can proliferate in portable humidifiers, and breathing in that germ-containing mist could make you sick.
The CDC recommends cleaning your humidifier regularly according to the manufacturer’s instructions, emptying the water tank daily, and using distilled or boiled and cooled water, which are less likely to cause germ growth.
If cleaning a humidifier feels too burdensome, you can get similar benefits from a steamy shower or inhaling the steam that comes off boiling water or a cup of tea, Tweel said.
Lozenges
For adults, lozenges or cough drops “help your throat produce more saliva,” Tweel said, which can in turn reduce dryness. “So much of the soreness [of a sore throat] is being dry or dehydrated,” he said, “so if you can do anything to combat that dryness, it will be helpful.”
There are many varieties available, and “essentially whatever feels good is worthwhile,” Tweel said, but some people are partial to the cooling sensation from menthol or eucalyptus lozenges.
Lozenges or cough drops shouldn’t be given to children under 4 years old, since they are choking hazards.
When to see your doctor for a sore throat
A sore throat typically lasts a few days, then starts to get better, Mock said. After that, you’re likely to have a runny nose and congestion, followed by a chest cough. “That’s a normal upper respiratory infection,” she said. “As long as it’s progressing and not getting worse, [the virus] can take a week or two to run its course.”
But a sore throat sometimes warrants a doctor visit. You should make an appointment with your primary care practitioner if you have a fever along with throat pain, severe pain, or difficulty breathing or swallowing, or if you notice white patches on the back of your throat or “any major asymmetry, meaning a size difference between your tonsils,” Wick said. These might signal a bacterial infection such as strep throat, which may require antibiotics.
Long-lasting throat pain is also worth getting checked out. “Should you have a severe sore throat for more than seven days? No, it should be getting better by then,” Mock said.
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