Sore throat no fever: 5 causes and when to see a doctor - Insider

  • Sore throats are often caused by a viral infection which may raise your body temperature slightly.
  • Other causes of a sore throat without a fever include allergies, acid reflux, and STIs.
  • Normally, you don't need to see a doctor for a sore throat if you don't have a fever to go with it.

Sore throats are incredibly common, accounting for about 4% of visits to family practitioners.

The majority of sore throats are caused by viruses, which can raise your body temperature slightly, but usually not enough to cause a fever (100.4 °F or more). 

Sore throat without fever can also be caused by allergies, reflux, STIs, behaviors like yelling or singing, and environmental irritants.

In most cases a sore throat with no fever is nothing to be worried about. "Generally a sore throat without fever is less of a concern than a sore throat with fever," says Hiten Patel, MD, a family medicine physician at The Ohio State University Wexner Medical Center.

Here are five common causes of a sore throat that don't typically cause fever. 

1. Common cold

One of the most common causes of sore throat without fever is the common cold. If you have a cold, you might experience other symptoms including:

  • Sneezing
  • Stuffy nose
  • Coughing
  • Watery eyes
  • Feeling tired

How to feel better: Common colds will resolve on their own in 7-10 days. Resting, drinking hot tea with honey, or taking ibuprofen for pain can help control symptoms, Patel says. 

2. Tonsillitis

Tonsillitis is the swelling of the tonsils, which are those lumps of tissue at the back of the throat. The inflammation, or swelling, is most commonly caused by a viral infection, but it can also be due to a bacterial infection. 

Tonsillitis is most common in children under 2, although it can happen in adults as well. If you or your child have tonsillitis, you might notice these symptoms:

  • A severe sore throat
  • Red, swollen tonsils; white or yellow coating on the tonsils
  • Difficulty swallowing
  • Bad breath
  • Swollen glands on the neck

Fever with tonsillitis is possible, but unlikely, Patel says. 

How to feel better: Viral tonsillitis resolves on its own within 3-5 days, says Patel. Use ibuprofen to control pain and eat soothing foods like popsicles or warm tea. If you or your child have difficulty swallowing or have repeated episodes of tonsillitis, see a doctor. 

3. Allergies

Seasonal allergies, also known as allergic rhinitis or hay fever, can cause a sore throat with no fever. This happens because of postnasal drip, or mucus from the nose dropping down the throat and irritating it. Allergies can cause a sore throat without fever in kids or adults, says Patel. 

If your sore throat is caused by allergies, you'll likely notice that it occurs after you're exposed to triggers like pollen or pet dander. 

The other symptoms of allergies include:

  • Sneezing, runny nose or stuffy nose
  • Coughing
  • Itching, particularly on the eyes, nose, mouth and throat
  • Headache and pressure in the nose and cheeks
  • Watery, red, and swollen eyes

How to feel better: The best way to control allergies is by avoiding your triggers where possible, by taking actions like keeping windows closed when allergy counts are high. If you still experience symptoms, use an antihistamine or steroid nasal spray to help control nasal symptoms, which will decrease post-nasal drip to your throat, Patel says. 

4. Acid reflux

If you have a persistent sore throat without a fever, it could be caused by acid reflux, says Patel. Reflux, also known as gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD), happens when stomach contents come up through the esophagus into the throat and mouth. When this happens, it can irritate your throat. 

Reflux can happen on occasion, or frequently. It's more common in adults, pregnant people, and overweight people, although anyone can experience reflux.  

If you have a sore throat caused by reflux, you'll likely notice other symptoms, including:

  • Heartburn and associated chest pain
  • Chronic cough or hoarseness
  • Trouble swallowing
  • Nausea
  • Regurgitation

These symptoms might get worse when you eat certain foods, like acidic or spicy foods, or when you lie down, says Patel. 

How to feel better: Lifestyle changes like adjusting your diet and losing weight can help with chronic reflux. For mild or occasional bouts of reflux, antacids can help, but you shouldn't use them every day. If your reflux happens frequently, you should see a doctor, says Jim Keany, MD, co-director of the emergency department at Providence Mission Hospital.

5. STIs

Certain STIs can also cause a sore throat, particularly if you've had an oral exposure to the virus. 

"To many people's surprise, sexually transmitted diseases such as gonorrhea and herpes can also cause sore throat," says Keany. 

A sore throat can also be one of the first symptoms of HIV infection, appearing weeks after exposure. If you have HIV, you may or may not experience a fever. 

Oftentimes, STIs have no symptoms. However, you might notice symptoms including:

  • Sores on the genitals or mouth
  • Pain while urinating or urinating more frequently
  • Increased or changed genital discharged
  • Pain in the pelvis
  • Pain within the penis or vagina

How to feel better: STIs often require treatment with antibiotics or other antiviral medication. If you suspect your sore throat is linked to an STI, talk with your doctor about testing. Regular STI screenings are part of routine care for all sexually-active people. 

When to see a doctor

Usually, a sore throat without fever will go away on its own, so Keany recommends waiting a few days before seeking medical care as long as your symptoms are mild.

However, you should seek immediate medical care if you have:

  • Difficulty breathing
  • Noises or whistling when you breath
  • Trouble swallowing
  • Signs of dehydration
  • Drooling (especially in children)
  • Blood in your saliva or phlegm 
  • Joint swelling or pain
  • Rash

If your symptoms do not improve within a week or if you frequently experience sore throats with no fever, see your doctor, says Patel. 

Insider's takeaway

Occasionally, sore throat without fever can indicate an underlying health issue, like reflux, allergies, or post nasal drip. Other times, it can be from a more serious infection like an STI that requires medical treatment. 

In most cases, a sore throat with no fever is due to an infection or other conditions that will resolve on their own and is not a medical concern, says Patel. 

Using ibuprofen to manage pain and sipping warm water with honey can help relieve symptoms until your sore throat goes away, usually within a week.

"This is usually self-resolving and will improve without any treatment," Patel says.

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