A mug of hot tea with honey—two options for how to treat a sore throat.

A sore throat, though one of the most uncomfortable of minor medical issues, is also one of the most common. In 2015, more than 9 million people visited a doctor’s office for sore throat symptoms, according to the latest data from the Centers for Disease Control and Prevention.

But do you really need to see a doctor and get medication, notably prescription antibiotics, for a scratchy, irritated, painful throat? Probably not in most cases, say experts, but it happens all the time when people are trying to figure out how to treat a sore throat.

2016 study in JAMA, for instance, found that 62 percent of office visits for sore throat end with an antibiotics prescription. 

That’s a problem for several reasons, says Jeffrey Linder, M.D., M.P.H., professor of medicine and chief of general internal medicine and geriatrics at Northwestern University’s Feinberg School of Medicine—whose 2014 study came up with similar numbers.

Most sore throats are caused by viruses, not bacteria, which means antibiotics won’t help. Plus, taking antibiotics unnecessarily is a bad idea. They can have side effects such as itchy rashes or severe diarrhea, and inappropriate use of these drugs contributes to bacterial resistance to antibiotics, which can make those infections hard to cure.

A small percentage of the time, though, these drugs may be warranted. Here’s how to know when to dial the doctor, and the best steps for how to treat a sore throat.

What's Causing Your Sore Throat?

Viruses are the most common reason for a sore throat. If your sore throat is accompanied by sneezing, a runny nose, a cough, or a low fever (or no fever), a cold or other virus has probably infected your upper respiratory system.

In such cases, there’s no need to rush to the doctor. “You’ll simply have to wait until the virus runs its course, usually in about 7 to 10 days, for most colds,” says Marvin M. Lipman, M.D., Consumer Reports’ chief medical adviser.

Sometimes the virus behind your sore throat is the flu. If so, you are likely to also experience a sudden high fever, a cough, intense muscle aches, and fatigue.

Most people recover from the flu in a week or two with rest and some self-care strategies. But if you think you may have the flu and are at high risk for complications (over 65, under age 5, pregnant, or with an underlying health condition), ask your doctor whether you should consider an antiviral medication.

The Best Ways to Ease Sore Throat Pain

OTC pain meds: Pain relievers such as acetaminophen (Tylenol and generic), ibuprofen (Advil and generic), and naproxen (Aleve and generic) can all help ease discomfort.

“Sometimes patients don't necessarily think of reaching for those when they have a sore throat,” believing they’re only for muscle pain or headache, notes Wendy Stead, M.D., physician in the division of infectious disease at Beth Israel Deaconess Medical Center and assistant professor of medicine at Harvard Medical School. But they can be pretty effective pain-relief measures for sore throat, she says.

Be sure to take only the recommended dose, though. Too much acetaminophen, for example, can harm the liver.

More on cold and flu symptoms

Cough drops and OTC throat sprays: Here, it’s a matter of, “Do whatever works for you,” Stead says. Look for throat lozenges and sprays that contain ingredients such as benzocaine, dyclonine, or phenol—which can numb the areas they come in contact with—or menthol, which creates a cooling sensation.

These won’t work for as long as OTC pain pills may, Stead says, although drops may last longer than sprays because they remain in your mouth while you suck on them. It’s generally fine, she notes, to use a lozenge or spray along with an OTC pain pill.

Food, drinks, and more: While the home remedies touted for sore throat aren’t generally supported by much research, it’s fine to use them if they reduce your discomfort, especially if swallowing is painful.

Eating or sucking on cold items, such as ice pops, ice, or frozen yogurt, can help to numb the throat slightly, making swallowing easier. And hot liquids like tea or soup may be easier to swallow for some people than room temperature beverages.

Gargling with salt water may also ease pain for some. And a spoonful of honey or piece of hard candy, which can coat the throat, may temporarily dampen pain (though neither should be given to children under 1 year of age).

Scientists have demonstrated a few strategies that won’t work: A 2017 study in the Canadian Medical Association Journal found that neither chewing gum containing the sugar substitute xylitol nor a probiotic supplement had any effect on throat pain.

And herbs or dietary supplements for cold symptoms such as a sore throat aren't very effective, and pose other problems, such as potential side effects. (See our rundown here.)

When to Consider Antibiotics

When might antibiotics for a sore throat be appropriate? Most commonly in the case of a streptococcus—or strep—infection, which is bacterial and causes 5 to 15 percent of sore throats in adults and 15 to 30 percent of sore throats in children.

Other signs include fever, pus or swelling in the back of the throat, and tender lymph nodes in the front of the neck. So if you or your child has a sore throat and one or more of these unpleasant symptoms, especially without a cough, consider calling your doctor to ask whether you should get tested for strep.

If a throat swab detects the presence of strep bacteria, your doctor should prescribe 10 days of penicillin, according to the CDC. The self-care strategies above can help reduce sore throat pain during the day or two it takes for the antibiotics to kick in.

The Sore Throat That Lingers

If you’re still feeling relatively severe pain when you swallow after three to five days, especially if your symptoms aren’t improving, Lipman says, it’s reasonable to call your doctor and ask whether you should come in for an evaluation.

Your doctor should check for signs of other conditions that may also cause a sore throat, such as allergies or gastroesophageal reflux disease. The viruses that cause mononucleosis can also cause throat pain, along with fever, fatigue, and swollen glands.

Certain sexually transmitted infections, including gonorrhea and herpes, may cause a sore throat, too. Some people who are newly infected with HIV may experience flu-like symptoms that can include a sore throat.

Throat pain is rarely an emergency. However, throat swelling can block your airway—signs include difficulty breathing, drooling or pooling saliva, and harsh, noisy breathing—and warrants a trip to the emergency room, according to UpToDate, which provides evidence-based treatment information to healthcare providers.