THE THROAT—TECHNICALLY the pharynx—is the piping that starts behind your nose and runs behind your mouth, down to where your esophagus and trachea split. It moves food to your stomach and transports clean air to your lungs. The throat “absorbs a lot of damage” that would otherwise hurt your lungs, says Phillip C. Song, M.D., the director of the division of laryngology at Mass Eye and Ear. Plus, it sits at the top of the esophagus, which leads to the cauldron of acid that is your stomach. No wonder it gets sore so often.
Why Your Throat Gets Sore
YOUR THROAT IS coated with a layer of mucus, explains Douglas J. Van Daele, M.D., at the University of Iowa’s Carver College of Medicine. When it dries out or thickens, or its composition changes, a sore throat happens. OTCs can handle a lot, but see a doc if you have a fever, difficulty breathing or swallowing, or soreness lasting a couple weeks.
Viral Infection
Up to four in five sore throats are caused by viruses, like those behind colds, Covid, and the flu, which screw with mucus production.
How You’ll Know: The sore throat comes with other symptoms you’d expect from those viruses.
Treatment: Hydrate, take your preferred OTC meds, and wait out the virus. (And prevent the next one with up-to-date vaxes.) If you’re really run down, test for the flu or Covid to see if you need meds. And by the way, strep throat is an infection, too, but it’s a bacterial one. It’ll require antibiotics.
Irritants From Outside
Allergens like mold, pollen, and dust, if you’re sensitive to them, can inflame the throat and affect mucus production. Post-nasal drip from the allergic reaction can cause you to constantly, and irritatingly, clear your throat.
How You’ll Know: The sore throat is chronic and flares up when you’ve been exposed to allergens.
Treatment: A two-stage attack. Start with an antihistamine and a nasal steroid. If those don’t work, enlist an allergist.
Irritants From Inside
Acid reflux can, believe it or not, make it all the way up the esophagus to your throat, mess with the mucus coating, and irritate the tissue.
How You’ll Know: Most of the time, you’ll notice heartburn, a sour or bitter taste, or subtle bloating and burping. If needed, a doctor can confirm this cause with a small camera that, yes, goes through your nose.
Treatment: OTC reflux meds. According to Dr. Song, a reflux-related sore throat usually takes longer to resolve than the two-week course the box recommends.
Note: Meds you take for other conditions may also cause a sore throat. These include ACE inhibitors, decongestants, and prostate meds. Don’t stop taking them. Just know that they may bother your throat.
How to Soothe a Sore Throat
THE MOST IMPORTANT thing to do is hydrate, which goes a long way toward keeping your mucus in good shape. Beyond that? “This is a place where a lot of home remedies are really pretty good,” says Dr. Van Daele.
USEFUL
- Salt water: Gargling, and also nasal rinses.
- Humidifier: Cool-mist humidifiers are best.
MAYBE USEFUL
- Tea: Great for hydration as long as it’s not caffeinated, which dries you out.
- Cough drops: Quick ingredient rundown: Sugar is bad. Zinc is good. Menthol can potentially be irritating, according to Dr. Van Daele.
PROBABLY NOT USEFUL
- Hydrogen peroxide: Gargling it might help, but there are a lot of ways to do it wrong and get no benefit.
What Else Goes Wrong
Sleep Apnea
Shallow or interrupted breathing while sleeping isn’t strictly a throat problem, but throat muscles relaxing and blocking airways can be part of it. Worth noting: The CPAP machine used to treat some forms of sleep apnea can dry you out and cause soreness.
Laryngitis
“Losing your voice” is a result of inflammation of the larynx (a neighbor to the pharynx). Sore throats often go with it. There are a lot of potential causes beyond karaoke night. If you have unexplained hoarseness for more than four weeks, it’s time to go to a doctor—that means something else is going on, such as a viral infection or vocal-cord–specific issues like nodules and scarring.
Cancer
Cancers of the larynx and pharynx are very treatable, usually with surgery and/or radiation, if caught before they spread. The top two risk factors: drinking and smoking. The third notable one is human papillomavirus (HPV), which is more commonly associated with cervical cancer. HPV-related cancers happen—usually in the tonsils and the back of the tongue—even to people who don’t drink or smoke. They’re on the rise in younger men. Luckily, the HPV vaccine is effective at preventing them. Ideally, get it before age 26 (though you can get it up to age 45). Make sure your doctor and dentist keep an eye out, especially if you’re 46 or older.
Wait! Please Explain the Tonsils
THERE ARE A few kinds of tonsils, but the ones you’re thinking of are the palatine tonsils visible on either side of the back of your mouth. They help your immune system learn what bugs to defend against, which is also why they may be prone to infection and inflammation. The tonsils are largest when you’re young and your immune system is developing, and that’s one reason they’re usually taken out during adolescence if there’s trouble. Adults who suffer frequent infections (which will give you a chronically sore throat) can have them removed, too, but the recovery is more arduous.
This story appears in the November/December 2024 issue of Men’s Health.
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