Dolor de garganta persistente: Causas comunes y cuándo ver al médico

A sore throat that hangs around for days can turn even the nicest person into a grumpy dragon.
One cup of tea, two lozenges, three nights of bad sleep… and that scratchy, burning feeling is
still there. At what point does a persistent sore throat stop being a simple nuisance and start
becoming something you should take seriously?

In medical terms, a persistent sore throat (often called chronic pharyngitis)
is one that lasts longer than about 10 days or keeps coming back. While most sore
throats are caused by minor viral infections and clear up within a week, there are times when
that lingering pain is your body’s way of saying, “Hey, we should see a doctor.”

This in-depth guide breaks down the most common causes of a sore throat that won’t go away,
the warning signs that suggest something more serious, and practical home care tips. You’ll also
find real-life style examples at the end to help you understand what “normal” vs “worrying” can
look like in everyday life.

What counts as a persistent sore throat?

A typical viral sore throat – the kind that comes with a cold or flu – usually improves within
5 to 7 days. When the pain sticks around longer than that, or keeps returning
over several weeks, doctors start thinking about “chronic” or “persistent” causes instead of a
simple short-term infection.

Different organizations use slightly different cutoffs:

• Some ENT (ear, nose, and throat) specialists suggest getting evaluated if a sore throat lasts more than 5–10 days.
• For possible cancer-related causes, groups like the American Cancer Society recommend seeing a doctor if a sore throat lasts more than two weeks.
• Chronic pharyngitis is often defined as symptoms lasting longer than about 10 days or recurring frequently.

You don’t need to obsess over the exact number of days, but as a general rule:
if your sore throat lasts longer than a week or two, or keeps coming back, it’s worth a medical visit.

Common causes of a sore throat that won’t go away

Before we jump to scary diagnoses, remember that most persistent sore throats still come from
relatively common and treatable issues. Here are some of the frequent culprits.

1. Viral infections that linger

Viruses are the most common cause of sore throat overall – think cold viruses, flu, COVID-19,
or other upper respiratory infections. Often, the sore throat is worst in the
first few days, then slowly fades. But in some people, the inflammation can hang on, especially
if you’re coughing a lot, sleeping poorly, or talking a ton (hello, teachers and call-center workers).

Even after the main infection clears, that irritated tissue can take extra time to heal, leaving
you with a nagging scratchiness or mild pain for days.

2. Bacterial infections like strep throat

Strep throat, caused by group A Streptococcus bacteria, is less common than viral sore
throat but tends to cause more intense pain, difficulty swallowing, and sometimes fever, swollen
glands, or white patches on the tonsils.

Untreated strep throat usually doesn’t just “quietly” linger for weeks; instead, symptoms may
worsen or stay fairly severe. This is why adults are often advised to see a doctor if they have
a severe sore throat that doesn’t improve in several days, especially with fever.

3. Allergies and postnasal drip

Seasonal allergies, dust, pet dander, or mold can inflame your nasal passages and sinuses.
The extra mucus drips down the back of the throat (“postnasal drip”), causing irritation,
scratchiness, and frequent throat clearing.

If your sore throat:

• Is mild but long-lasting,
• Comes with sneezing, itchy eyes, or runny nose, and
• Feels worse when you lie down,

allergies and postnasal drip are high on the list of likely causes.

4. Acid reflux (GERD) and “silent reflux”

With gastroesophageal reflux disease (GERD), stomach acid backs up into the esophagus and can
reach the throat, especially at night. This can cause:

• Morning sore throat,
• Hoarseness,
• Chronic cough, and
• A feeling of a lump in the throat (globus sensation).

Some people have laryngopharyngeal reflux (“silent reflux”), where throat symptoms are more obvious
than classic heartburn. Your ENT or gastroenterologist may suspect this if your sore throat is
worse in the morning, if you frequently clear your throat, or if it improves with anti-reflux
measures and medication.

5. Environmental irritants: smoke, pollution, and dry air

Cigarette smoke, vaping, air pollution, chemical fumes, and very dry indoor air can all irritate
the lining of your throat. If you wake up with a sore throat only at home, next to a
very enthusiastic smoker, or after nights with the heater blasting, the air quality may be the
real villain.

Simple fixes like a humidifier, better ventilation, and avoiding smoke exposure can make a big
difference in these cases.

6. Voice overuse and muscle strain

Shouting at a concert, coaching, teaching, streaming online, or talking for long periods can
strain the muscles of your throat and voice box. Over time, that constant strain can lead to
chronic soreness, hoarseness, or the feeling that you need to clear your throat all the time.

Resting your voice (yes, actually being quiet), staying hydrated, and avoiding whispering
(which can strain the voice even more) are key parts of recovery.

7. Chronic infections or immune issues

Long-lasting sore throat can also come from chronic or recurrent infections, including:

• Chronic tonsillitis,
• Mononucleosis (mono) or related viruses,
• Sexually transmitted infections that affect the throat, or
• More serious infections in people with a weakened immune system.

In these cases, you may also notice fatigue, swollen glands, fever, or other systemic symptoms.

Less common but serious causes you shouldn’t ignore

The vast majority of sore throats are not dangerous. Still, some serious conditions can first
show up as a persistent sore throat, which is why doctors take that symptom seriously when it
lasts more than a couple of weeks.

1. Throat or laryngeal cancer

Throat cancers, including laryngeal cancer, can cause a sore throat or cough that doesn’t go
away, hoarseness, difficulty swallowing, ear pain, or a lump in the neck.
Cancer centers and cancer societies emphasize that a persistent sore throat lasting more than
two weeks should be evaluated, especially if you have risk factors like smoking or heavy alcohol
use.

That doesn’t mean every lingering sore throat is cancer – far from it. But this is one of the
key reasons not to ignore symptoms that just won’t go away.

2. Peritonsillar abscess or other deep neck infections

Sometimes a severe bacterial infection can form a pocket of pus near the tonsils (a
peritonsillar abscess) or deeper in the neck. Signs include:

• Severe one-sided throat pain,
• Difficulty swallowing or opening the mouth,
• Muffled “hot potato” voice,
• High fever and feeling very unwell.

These infections need prompt medical care and sometimes drainage in the hospital.

3. Systemic illnesses and other red-flag conditions

A persistent sore throat accompanied by unexplained weight loss, night sweats, enlarged lymph
nodes, or repeated fevers can signal a more serious underlying condition, such as lymphoma or
chronic infection. Your doctor will look at the full picture – not just
the throat – when deciding which tests to order.

When to see a doctor for a persistent sore throat

So, when should you stop waiting it out and actually book that appointment? Different medical
organizations offer similar guidance:

Call your doctor soon (within a few days) if:

• Your sore throat lasts longer than 5–7 days without clear improvement.
• You have a recurrent sore throat that keeps coming back every few weeks.
• You have a sore throat along with mild fever, fatigue, or swollen glands that isn’t improving.
• You have risk factors like smoking, heavy alcohol use, or weakened immunity.

Seek urgent or emergency care right away if you have:

• Difficulty breathing or catching your breath,
• Difficulty swallowing, drooling, or inability to swallow fluids,
• A muffled voice, severe one-sided throat pain, or a bulge in the throat,
• High fever (around 103°F / 39.4°C or higher),
• Blood in your saliva or phlegm,
• A visible lump in your neck or throat, or rapidly swelling glands,
• A sore throat that lasts longer than two weeks, especially with hoarseness, ear pain, or weight loss.

These are not “wait and see” situations. They warrant fast medical attention, sometimes in an
urgent care or emergency department.

How doctors evaluate a persistent sore throat

At your visit, your provider will start with a detailed history:

• How long the sore throat has lasted,
• Whether it’s constant or comes and goes,
• Associated symptoms (fever, cough, hoarseness, heartburn, weight loss, etc.),
• Your smoking, alcohol, and occupational exposure history,
• Any recent infections or new medications.

Then comes the physical exam, which may include:

• Looking at the throat and tonsils with a light,
• Checking your nose, ears, and sinuses,
• Feeling for swollen lymph nodes in the neck,
• Listening to your lungs and heart.

Depending on what they find, your doctor may order:

• A rapid strep test or throat culture,
• Blood tests (for mono or other infections),
• Imaging or a CT scan if a deep neck infection is suspected,
• A referral to an ENT specialist for fiberoptic laryngoscopy – a tiny camera to look at the voice box and throat,
• Further testing if a tumor or systemic disease is a concern.

Home care and prevention: What actually helps?

While you’re waiting for an appointment – or dealing with a mild sore throat that doesn’t yet
meet “red flag” criteria – there are several evidence-based self-care strategies that can help
soothe your throat.

• Stay hydrated: Warm teas, broths, and water help keep mucus thin and tissues moist.
• Use salt-water gargles: Gargling with 1/4 to 1/2 teaspoon of salt in 8 ounces of warm water can ease irritation.
• Consider lozenges or sprays: Over-the-counter products with mild anesthetics or soothing ingredients can temporarily relieve pain.
• Run a humidifier: Adding moisture to dry indoor air reduces throat dryness, especially at night.
• Avoid irritants: No smoking, no vaping, and try to avoid strong fumes or dust.
• Rest your voice: Speak less, avoid shouting, and resist the temptation to whisper.
• Manage allergies and reflux: Use prescribed allergy meds, elevate the head of your bed, avoid late-night heavy meals, and follow your GERD treatment plan if you have one.

Pain relievers like acetaminophen or ibuprofen, used as directed, can also help with discomfort
and fever in many cases. Always follow the dosing instructions and talk with your
doctor or pharmacist if you have liver, kidney, or bleeding issues.

Special considerations: children, older adults, and high-risk groups

The basic principles are the same for everyone, but certain groups need extra caution:

• Children: Young kids can get seriously ill quickly, and strep throat is more
  common in school-age children than adults. Talk with a pediatrician promptly if your child
  has a persistent sore throat, high fever, or trouble swallowing.
• Older adults: Because they may have other health conditions, persistent
  symptoms, weight loss, or hoarseness in older adults deserve prompt evaluation.
• People with weakened immunity: Those on chemotherapy, steroids, or with HIV or
  other immune-weakening conditions should contact their doctor early for any throat symptoms.

In all of these cases, the threshold for seeing a doctor should be lower – don’t wait for weeks
hoping things will magically resolve.

Putting it together: Listen to your throat (and your gut)

A persistent sore throat rarely means something catastrophic, but it’s also not a symptom to
completely ignore. If the pain is mild, slowly improving, and clearly linked to a recent cold,
allergy flare, or night yelling at a sports game, supportive care and rest are usually fine.

But if your throat:

• Stays sore longer than 1–2 weeks,
• Keeps coming back,
• Or shows up with red-flag symptoms like trouble swallowing, breathing, hoarseness, or weight loss,

it’s time for a professional to take a look. Early evaluation often means simpler treatment –
and more peace of mind.

And one final reminder: no article on the internet can replace an in-person medical exam. Use
this as a guide, not a final diagnosis.

Experiences and scenarios: What persistent sore throat looks like in real life

To make all this more concrete, here are some everyday-style scenarios that show how people
might experience a persistent sore throat – and what actions make sense in each case.

Scenario 1: The teacher with the never-ending scratchy throat

Alex, a 34-year-old teacher, starts the school year with a typical back-to-school cold. After a
week, the congestion improves, but the sore throat lingers – especially at the end of a long
teaching day. She notices that on days with heavy talking, her throat feels raw, and her voice
is hoarse by evening, but weekends are a bit better.

In this case, the persistent sore throat probably has several overlapping causes: a recent viral
infection, constant voice use, and dry classroom air. Alex decides to:

• Use a personal water bottle and sip warm tea between classes,
• Turn on a small humidifier at home,
• Build short “quiet work” blocks into lessons to rest her voice, and
• See her primary care doctor when the soreness is still noticeable after two weeks.

Her doctor rules out strep and serious problems, recommends voice rest techniques, and talks
about allergy management. Within a few weeks, the throat irritation becomes occasional instead
of constant – a good example of how lifestyle tweaks plus medical input can solve a long-lasting
annoyance.

Scenario 2: The “it’s probably nothing” smoker

Sam, 52, smokes a pack a day and enjoys weekend drinks. He notices a sore throat that doesn’t
go away for over three weeks. It’s not horribly painful, so he tries to shrug it off. But he
also has a mild earache on one side and sometimes feels like swallowing is harder than it used
to be.

This situation sets off multiple alarm bells: a sore throat lasting more than two weeks,
one-sided ear pain, swallowing changes, and a strong smoking history – all risk factors for
laryngeal or throat cancer.

The right move here is not to wait. Sam should schedule an appointment with his doctor or an
ENT specialist as soon as possible. If cancer or another serious condition is found early,
treatment options and outcomes are generally much better than if he waits until symptoms are
severe.

Scenario 3: The reflux sleeper

Taylor, 29, wakes up almost every morning with a sore throat and bitter taste in their mouth,
but feels mostly fine by midday. They also notice occasional heartburn after late-night pizza
and soda. Over months, the morning sore throat becomes a normal part of their routine – one
they try to ignore.

This pattern – morning symptoms, history of heartburn, and gradual onset – fits well with
reflux-related irritation. When Taylor finally talks to a doctor, they’re advised to:

• Avoid heavy meals late at night,
• Limit caffeine, alcohol, and acidic foods close to bedtime,
• Raise the head of the bed, and
• Try anti-reflux medication for a trial period.

After several weeks of changes, the morning sore throat fades to a rare event instead of a daily
visitor – a good reminder that chronic throat symptoms can sometimes be a “body notification”
about lifestyle habits.

Scenario 4: The “suddenly much worse” sore throat

Priya, 21, develops a sore throat that feels like a typical cold for a couple of days. On the
third day, the pain becomes severe and focused on one side. She has trouble swallowing, her
voice sounds muffled, and she starts drooling because it hurts to swallow even her own saliva.

This is a classic red-flag situation. The combination of severe one-sided throat pain, muffled
voice, and trouble swallowing can mean a peritonsillar abscess or other deep throat infection.
Priya should go to urgent care or the emergency department, not wait for a routine clinic
appointment.

In this type of case, early treatment with antibiotics and sometimes drainage can prevent more
serious complications.

Scenario 5: The anxious Googler

Jordan, 38, has had a mild sore throat on and off for two weeks after a nasty cold. They’re
mostly back to work, but every time their throat feels scratchy, they worry it might be cancer.
A late-night internet search doesn’t help – every symptom seems to point to something scary.

When Jordan visits their doctor, the exam is reassuring: no suspicious lumps, no persistent
hoarseness, no weight loss, and a clear story of a recent viral infection. Their provider
explains the common causes of lingering irritation and gives specific instructions:

• If the sore throat is clearly improving over the next week, they can continue home care.
• If symptoms plateau or worsen, or if new issues like hoarseness or swallowing trouble appear, they should come back.

For many people, just having a clear plan – “if X happens, I’ll do Y” – can significantly reduce
anxiety. It also helps prevent both over-reacting and under-reacting to symptoms.

These scenarios highlight a key theme: your body sends signals, but context matters. Duration,
severity, associated symptoms, and personal risk factors all help define whether a persistent
sore throat is more likely to be a lingering irritation, a treatable infection, or something that
needs urgent attention.