What is sore throat?
Sore throat (pharyngitis) is one of the most common reasons people seek care. Most are viral — caused by cold viruses, flu, COVID, mononucleosis. About 5–15% in adults are strep, requiring antibiotics.
Distinguishing viral from bacterial is mostly clinical: sudden onset, fever, swollen tonsils with pus, swollen anterior neck nodes, no cough — points more to strep. Cough, runny nose, hoarse voice — points to viral.
Do I have sore throat? Common signs
If most of these describe what you're experiencing, telehealth may be a good next step:
What causes it
Viral (most common): rhinovirus, adenovirus, influenza, RSV, COVID, mononucleosis (EBV). Bacterial: Group A strep (most concerning), occasionally other bacteria. Non-infectious: allergies, GERD, smoke, dry air.
Is it contagious?
Yes for most infectious causes — through droplets and direct contact.
If you have a cough, runny nose, or hoarse voice — it's probably viral. Strep usually doesn't come with those.
Can it be treated online?
Routine sore throat is well-suited to telehealth — clinician evaluates by symptom pattern, photos of throat. Severe pain with drooling/trouble breathing, severe one-sided throat pain, or rapid worsening need in-person evaluation. Rapid strep test or culture may be advised at urgent care.
How sore throat is treated
Viral pharyngitis: supportive — saltwater gargles, throat lozenges, NSAIDs/acetaminophen, fluids, rest. Strep throat: amoxicillin or penicillin VK 10 days, or azithromycin for penicillin allergy. Mononucleosis: supportive, avoid contact sports. Steroids occasionally for severe inflammation.
Self-care while you wait
- Salt water gargles
- Throat lozenges (zinc, honey)
- Warm tea with honey
- Cool fluids
- Cold treats like popsicles
- Humidifier
- Rest
- Acetaminophen or ibuprofen for pain
How long does it last?
Viral: 3–7 days. Strep with antibiotics: improvement in 24–48 hours, full course 10 days. Mono: weeks to months.
Frequently asked questions
How do I know if it's strep?
High fever, severe sore throat, swollen tonsils with white spots, swollen anterior neck nodes, NO cough — classic strep features. Rapid test or culture confirms.
Can strep go away on its own?
Sometimes, but untreated strep risks rheumatic fever, kidney inflammation, and PANS in kids. Antibiotics also reduce contagiousness fast.
How long am I contagious?
Viral: 1–2 weeks. Strep: 24 hours after starting antibiotics.
Should I gargle with salt water?
Yes — actually helps with comfort and mild antibacterial effect.
What about throat coat tea or honey?
Honey has real evidence for cough and throat soothing. Throat coat tea is comforting but not specifically therapeutic.
