If you’ve ever felt like you were swallowing razor blades, you’re not alone. A sore throat is one of the most common reasons people see their doctor, according to a 2018 report in the Australian Journal of General Practice.

Children are particularly vulnerable. Figures from Melbourne show that about a third of five to 12-year-olds suffer a sore throat each year.

Brisbane doctor Krystyna de Lange, a Royal Australian College of General Practitioners board member, says most sore throats are caused by viruses and won’t respond to antibiotics. Bacteria cause about 15-36 per cent of cases – with Streptococcus pyogenes (strep throat) the most common.

A strep throat can be very painful and is often accompanied by fever and swollen neck glands, she says. It’s also highly contagious.

“If someone has the bacteria and they cough or sneeze, they’re creating millions of tiny droplets containing the bacteria, which can be passed on to someone else,” Dr de Lange says.

Other causes of sore throats include non-infectious ones, such as voice overuse and dehydration, which is why symptom intensity varies widely.

Telling your doctor about any accompanying symptoms such as muscle aches, fatigue and fever might help them diagnose the cause of your sore throat, Dr de Lange says.

“Strep throat tends to just affect the throat, whereas viruses tend to affect the whole respiratory system. Especially with influenza viruses, you’ll get other symptoms,” she says.

How to get relief

Dr de Lange says antibiotics are rarely needed to treat sore throats. They have been shown – even in bacterial cases – to reduce the duration of the illness by only about a day, she says.

The mainstay of treatment is managing symptoms, especially pain. This includes:

• taking regular paracetamol or ibuprofen;
• gargling salty water;
• sucking lozenges that contain soothing, antiseptic, anti-inflammatory and/or anaesthetic agents;
• keeping up fluids, especially for children, where dehydration can become a problem. Dr de Lange advises giving small amounts of fluid (such as electrolyte replacements) regularly. Or blend a frozen banana for a soothing remedy that also provides some calories.

To reduce the spread of infection, “wash your hands regularly, cough or sneeze into your elbow and have a day or two off work or school so you’re not giving it to all your colleagues”, Dr de Lange says.

Lemon and honey drinks are a natural remedy that can help. Photo: Getty

Natural relief options

Integrative naturopath Marta Browne says classic remedies soothe and line the throat to protect against damage and infection. Some have anti-inflammatory or anti-microbial properties.

She also recommends gargling with salty water, and also:

• warm honey and lemon drinks, which coat the throat and fight infections. “Good quality manuka honey has been shown to have antimicrobial properties, but needs to be taken regularly at a high concentration for proper therapeutic effect,” she says. “Regular honey just won’t cut it.”
• ginger infusions are warming and combine well with lemon and honey for a soothing, anti-inflammatory, anti-microbial drink.

Herbal options include:

• Marshmallow extract – usually prepared in glycerine, it is sweet, thick and anti-inflammatory for the respiratory and digestive tract;
• sage and licorice root, which have anti-inflammatory properties (use licorice cautiously in children, as high doses can cause headaches, high blood pressure and altered electrolytes, Ms Browne says);
• echinacea extract, which can help the body to fight infection;
• clove extract, which cantaken as a spray or lozenge to numb the throat and reduce pain.

Ms Browne says these remedies have reasonable scientific backing for their medicinal properties. She recommends choosing high-quality extracts and being aware of allergies or potential herb-drug interactions.

Most adults should tolerate these remedies, but professional guidance is needed to ensure correct dosing for children.

“Honey (especially raw honey) should be completely avoided in children under one”, Ms Browne says. “Lozenges should be avoided in children under four as they are a choking hazard.”

Other remedies to try

• Use a humidifier and avoiding cold air;
• avoid sick people and crowded places;
• maintain fluid intake to keep respiratory tissues moist;
• avoid allergic triggers;
• keep the throat and chest warm;
• eat soft foods.

If pain doesn’t resolve within a few days to a few weeks, or is accompanied by other symptoms, see your health professional to rule out longer-term issues.