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What causes a chronic sore throat?

Many health issues can cause a chronic sore throat, including allergies, infections, and underlying conditions. Identifying the cause is the first step toward receiving the right treatment and avoiding any triggers.

Chronic throat pain often results from lingering throat infections, irritants or allergens in the air, or dry air conditions. People with allergies or asthma may be especially sensitive to these triggers.

Some causes of a chronic sore throat require medical treatment. See a doctor if a sore throat lasts longer than 5–10 days.

In this article, we look at common reasons why a chronic sore throat develops.


Possible causes of a chronic sore throat include smoking, air pollution, and allergic reactions.

Inhaling smoke irritates the sensitive tissues lining the throat. This irritation results from inhaling the hot, dry air and toxic chemicals in tobacco smoke. People who smoke regularly may experience a sore throat that does not go away.

Smoking also makes a person more susceptible to health conditions that can cause a sore throat, including a cold, the flu, and respiratory tract infections. This is because smoking weakens the functioning of the immune system. It also increases a person's risk of throat cancer, and a lasting sore throat can be a symptom of the disease.

If a person smokes and develops a sore throat that does not go away or comes and goes regularly, they should see their healthcare provider. A doctor can also provide assistance to anyone who wants to quit.

Air pollution

Smog and air pollution are common in larger cities and in areas near industrial factories or power plants. Breathing in smog or air pollution has similar health consequences to inhaling smoke from a cigarette. Inhaling smog on hot days can be particularly harmful.

People who breathe in polluted air may experience symptoms such as:

pain in the chest, a sore throat, coughing, other asthma symptoms.


Allergens are substances that cause an allergic reaction. Allergens can include foods, pollen, and chemicals in cleaning products or cosmetics, for example.

People with seasonal allergies may notice lasting throat irritation during warm months and other times when the pollen count is high.

Allergies can cause postnasal drip, which involves excess mucus draining down the back of the nasal passage into the throat. Postnasal drip can lead to a persistent, raw sore throat.

Colds and the flu, reactions to medication, and certain weather conditions can also trigger postnasal drip.

A person allergic to an airborne substance such as pollen, grass, or mildew may experience any of the following symptoms when exposed to the allergen:

itchy eyes a runny nose coughing and sneezing watery eyes postnasal drip

Breathing through the mouth

A person can develop a sore throat from breathing through their mouth for a long period. This is most likely to occur while a person sleeps.

A person may be breathing through their mouth overnight if they wake up with a dry mouth that goes away after drinking or eating.

Obstructions to the nasal passage — from enlarged tonsils or excess mucus, for example — can cause a person to breathe through their mouth while asleep.

Anyone who consistently wakes up with a sore throat should consult a healthcare provider.

Viral and bacterial infections

A lingering cold or flu can cause pain in the throat for weeks after the main infection has begun to subside.

Colds and the flu are caused by viruses, and viral infections are the most common cause of sore throats. They usually go away on their own with time.

Otherwise, a bacterial infection — such as strep throat — may be the underlying issue. Antibiotics can treat bacterial infections, but they will not treat infections caused by viruses.


Symptoms of tonsillitis include swollen tonsils, a fever, and difficulty swallowing.

Tonsillitis is a throat infection that causes inflammation. Both viruses and bacteria can cause tonsillitis.

Children are more prone to tonsillitis, but it can affect people of any age. The treatment will depend on whether the infection is bacterial or viral.

Some additional symptoms of tonsillitis include:

red or swollen tonsils a fever chills difficulty swallowing a hoarse or scratchy voice a severe sore throat yellow or white spots on the tonsils bad breath


Mononucleosis — typically referred to as mono — can last for up to 2 months. Mono often causes flu-like symptoms, which can include a sore throat.

In some cases, the sore throat lasts for the duration of the infection.

Peritonsillar abscess

A peritonsillar abscess results from a bacterial infection in the tonsil.

A peritonsillar abscess can develop when tonsillitis does not fully heal. The abscess forms as a pus-filled bump on one tonsil, and the infection then spreads to surrounding tissue.

Symptoms of a peritonsillar abscess are very similar to those of tonsillitis, but they are often much more severe. If a person receives treatment for tonsillitis, but the infection does not appear to go away, they should consult a doctor.


Gonorrhea is a very common sexually transmitted infection in the United States. The Neisseria gonorrhoeae bacterium causes it.

In addition to affecting the genitals, gonorrhea can also develop in the throat, after oral sex.

Acid reflux

Acid reflux occurs when a muscle at the top of the stomach weakens and leaks acid into the esophagus, which is the tube that connects the mouth and stomach.

This causes a painful burning sensation known as heartburn.

Acid reflux can cause a sore throat. Anyone who suspects that they have acid reflux should speak to their doctor about treatments. Over time, it can damage the esophagus and cause further health problems.

A weakened immune system

A person with a weakened immune system is more likely to experience a chronic sore throat. This is because their body is less able to fight off infections when bacteria and viruses enter the body.

If a person has any of the following, they may have weakened immune system function:

rheumatoid arthritis, lupus, HIVAIDS, cancer and other conditions that require chemotherapy.

Throat cancer

Throat cancer, which is also called laryngeal cancer, can cause a chronic sore throat.

Some other symptoms of laryngeal cancer include:

hoarseness or voice changes constant coughing difficulty or pain when swallowing trouble breathing weight loss a lump or mass in the neck

If cancer starts developing above the voice box, people may not notice hoarseness or voice changes.

The American Cancer Society recommends seeing a doctor if hoarseness or other voice changes last for more than 2 weeks.

When to see a doctor

If a sore throat lasts longer than 5–10 days, a person should consider seeing a doctor.

A person should see a doctor if a sore throat lasts longer than 5–10 days, according to the American Academy of Otolaryngology-Head and Neck Surgery.

Sore throats are often easy to diagnose and treat. However, seek immediate medical attention if any of the following occurs:

a high fever difficulty turning the head swelling in the throat that impairs breathing, talking or swallowing severe pain on one side of the throat and swollen glands a lump or obstruction in the throat

People can often relieve the pain of a sore throat using over-the-counter treatments and home remedies.


Sore throats are common and can result from a variety of conditions and illnesses.

If sore throats occur frequently or become persistent — lasting longer than 5–10 days — speak to a doctor.

A healthcare provider can determine the cause and suggest effective treatments.



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