Unexplained sore throat that won't go away
February 25, 2011 9:59 AM   Subscribe

Extremely sore throat for last four days. Not strep. No other cold/flu symptoms. What is going on?

I went to the doctor, she looked at my throat and said it looked normal - not red or irritated. Declined to give me a strep test because she said there would be visible irritation at least. She seemed pretty dismissive, actually. Gave me a course of amoxicillin "just in case". Told me that if it wasn't better in two weeks (!!!) to come back. I really don't think I can put up with this for another two weeks, it's EXTREMELY painful - as in I have to mentally psych myself up every time I need to swallow.

It's a deep, muscular pain on either side of my throat where my tonsils used to be (they were removed when I was a kid) and I can sort of feel it in my eustachian tube area as well. Paracetamol and Ibuprofen don't touch it, the only thing that seems to help for a few minutes is force myself to chug a glass of ice cold water. In the morning when I wake up I am literally in tears, it hurts so bad. I've been surviving on soup and smoothies but to be honest I don't even feel hungry because even soup or smoothies are so painful to swallow. I'm making sure not to get dehydrated though.

So what could this be if it's not strep or a viral infection? What other tests or treatment should I insist on? Or should I just keep suffering and hope for the best?
posted by Wroksie to Health & Fitness (30 answers total) 3 users marked this as a favorite
Go to another doctor for a second opinion.
posted by amro at 10:03 AM on February 25, 2011 [2 favorites]

Could it be referred pain from elsewhere? Sometimes I get ear pain when I have an irritation in my throat, and you said you can feel it in your eustachian tubes, so maybe it could be referred pain from your ears or sinuses.
posted by infinitywaltz at 10:05 AM on February 25, 2011

Get a second opinion. One of the symptoms of mono is an extremely sore throat without any signs of strep, but then again lots of things manifest as a severe sore throat.
posted by muddgirl at 10:11 AM on February 25, 2011

Also, when my friend had mono a severe sore throat was her only symptom, so don't rule out a viral or bacterial infection just because you aren't presenting with all the classic symptoms.
posted by muddgirl at 10:13 AM on February 25, 2011 [1 favorite]

Second opinion all the way. I can't believe declining to culture, but giving antibiotics anyway. New doctor!
posted by Miko at 10:14 AM on February 25, 2011

Yes, go to another doctor.
This happened to me and the doctor didn't do anything. Two days later I went to another doctor in which he tested it and ended up being strep. He said only lab tests can confirm strep throat and that the other doctor should have done the tests. My throat was so bad that they gave me liquid percocit which took the pain right away and I was able to swallow comfortably right afterwards.
posted by KogeLiz at 10:14 AM on February 25, 2011

As muddgirl said, I had a similar pain like that, strep test negative, and I had mono. Which people kept NOT testing for, grar. (I couldn't even swallow tylenol, I had to have LIQUID tylenol, which was like 10% alcohol and tasted foul, which is awesome on an empty stomach.)

The mono test cost me $10 w/o insurance coverage at the time. (Quick google shows "no more than $20" for uninsured, plus cost of office visit.) Even if you have to pay out of pocket, it's probably worth getting it done.
posted by Eyebrows McGee at 10:20 AM on February 25, 2011

I think you should absolutely go to another doctor.

In the meantime, here are a couple of things I find soothing for a very sore throat:

-slowly swallowing a spoonful of honey
-drinking warm milk and honey
-gargling warm salt water
-sipping ice-cold apple cider vinegar. It tastes like balls, but it really makes things feel better.
posted by phunniemee at 10:22 AM on February 25, 2011

(Also, I was told that if it's mono and you take strep antibiotics, you can feel worse, because mono makes your liver work overtime and strep drugs and processed through the liver? Or something? Someone doctory will know. Anyway, they really should test for one or both.)
posted by Eyebrows McGee at 10:23 AM on February 25, 2011

There's a upper respiratory flu going around that has your symptoms. I had the same thing. The last time my throat felt like that was when I had mono (but that was like 5x as bad). Strep turned out negative.

But... you may have mono.
posted by stratastar at 10:24 AM on February 25, 2011

If your doc's a GP, you should go to an ENT and get it checked out.
posted by anniecat at 10:29 AM on February 25, 2011

Get a second opinion from your friendly neighborhood ENT. They look at throats all day. And try to keep hydrated, even if it hurts to swallow.
posted by honeydew at 10:32 AM on February 25, 2011

Yes, see another doctor. My mom was having a problem with bad sore throat, couldn't swallow, voice entirely gone, trouble breathing, even. The first doctor she went to actually did a strep culture, which came back negative, and he seemed quite pleased to be able to tell her there was nothing he could do and she'd just have to tough it out. Well, she'd been toughing it out for like four weeks already because her regular doc was, for whatever reason, unavailable, and this was the first appt she could get; she had at that point lost twenty pounds from loss of appetite and difficulty swallowing.

When she finally got an appointment with her regular doc, he was quite concerned and sent her to an ENT specialist. They did a lot of tests to rule out really serious possibilities, but in the end, it seems she had had a virus in her vocal folds that paralyzed one of them. They injected a gel of some sort into it so she has a voice again and can swallow and breathe, little things like that, you know?

So, I guess what I'm saying is that there are more options than "strep" or "suck it up." Take care of yourself!
posted by miss patrish at 10:34 AM on February 25, 2011

Chloraseptic spray is great for very sore throats.
posted by galadriel at 10:38 AM on February 25, 2011

I had the same kind of throat pain about 2 months ago. I had to brace myself every time I had to swallow, and there wasn't really anything that made it feel better. I *think* it might have been related to sinus drainage, because I had had some pretty bad sinus issues a few days prior, but I never really noticed anything out of the ordinary running down my throat. The only thing I noticed is that sometimes, as I swallowed, I would press against the side of my throat and would feel something sort of, um, gelatinous (ugh) slide down. After that the pain would subside for a while on that side.

It did gradually get better - only one side would hurt or less overall - but it took at least a week and a half for it to really go away.
posted by jenny76 at 10:43 AM on February 25, 2011

Are you on any other medications?

This is going to sound bizarre, but one time I had a TERRIBLE sore throat for weeks because of some prescription eyedrops I was using. My eye doctor said it was an uncommon but documented side effect.
posted by easy, lucky, free at 10:50 AM on February 25, 2011

Definitely going back to see another doc on Monday. I will try to insist on an ENT referral, but this is the NHS, so... not as easy as it sounds. I will do my best to insist on strep and mono cultures at least.

Thanks for the home remedies, too. I've been gargling salt water like some kind of crazy ocean fish, but I'll definitely try the honey, too. Could use the calories at least considering how little food I'm getting.
posted by Wroksie at 10:51 AM on February 25, 2011

I once had a most excruciating sore throat because of a KIDNEY INFECTION. Surprised me!

Mono and flu can also cause sore throats, but with either you would most likely have fever, fatigue and pain elsewhere. Mono knocked me down so much I barely had the energy to eat. And flu made me feel like I had been run over by a semi-truck--even the muscles in my toes ached.

I would go to another physician and insist on strep test, flu test and mono test. If you also have low back or flank (side) pain, I'd insist on urinalysis as well to rule out a kidney infection.

I hope you feel better very soon.
posted by FergieBelle at 10:54 AM on February 25, 2011

I'm gonna go out on a limb and suggest that it may be your ears, or anyway inflammation in your Eustachian tubes. Did the doc look in your ears at all? Your eustachian tubes drain to just about where you're describing. If you do a valsalva (pinch your nose shut, close your mouth, and blow) does the pain change at all?
posted by KathrynT at 10:57 AM on February 25, 2011

I also think you should go to another doctor. In the meantime, here is a random list of my experiences and suggestions:

I recently learned that drainage from your sinuses will make your ears hurt because the nerves in that area really can't distinguish if the pain is coming from the ears or your throat...it just all hurts (I have allergies that make my ears feel like they are going to explode with no sign of fluid or infection in them). Do you have some drainage going on somewhere? Mucinex (or guafinisin...regular Tussin cough syrup without the DM cough suppressant) will thin the mucus. That does wonders for me when my ears hurt.

Another thing to try to ease the ear tube pain is really warm wet washcloths (or some moist heat) right behind your ear running down toward your jaw/throat. I've done that before and felt my tubes open up and junk drain out. It's worth a shot, and the heat might feel good to your sore throat.

Definitely get a strep test, and definitely get a mono test. When I had mono I got recurrent "throat infections" that would get somewhat better on antibiotics, but then came back as soon as I took the last pill.

Are your lymph nodes swollen/inflamed around your neck, ears, and jaw? That could be causing the pain too.

Definitely go see another doctor...no need for you to keep suffering from this. Get well soon!!
posted by MultiFaceted at 11:23 AM on February 25, 2011

Best sore throat soother - mix honey + lemon juice and microwave for a few seconds, then spoon slowly into mouth.
posted by angab at 12:18 PM on February 25, 2011 [1 favorite]

posted by jara1953 at 1:26 PM on February 25, 2011

You really need to see another doctor.

That said: I have bad reflux and it's worst in the mornings. I get earaches and horrible sore throats (like, I've thought I have strep) from it. Stomach acid goes into all kinds of crazy places, including my sinuses. It makes eating uncomfortable.

I do have obvious irritation, though.

Maybe prop the head of your bed up? Try some liquid Mylanta or a cheaper OTC acid blocker? Stop eating entire balls of chili peppers before you go to bed? ;)

Really though, I seriously doubt it's reflux. One more thing to try if you feel up to it, though.
posted by the young rope-rider at 1:51 PM on February 25, 2011

I'm definitely not going to discourage you from going to another doctor, but from personal experience, it could be allergies (postnasal drip), and it could indeed be acid reflux as suggested above (even with no other symptoms). Try two Maalox, and if that doesn't help, a Pepcid. That only happened to me once (I have no idea what I'd been eating or doing!), and I was really astonished when the antacid (apparently) made it go away.

Hope you feel better soon. A really bad sore throat is a truly miserable thing.
posted by wintersweet at 4:41 PM on February 25, 2011

believe it or not, I found gargling with warm water and a dash of cayenne pepper to soothe and sometimes cure sore throats.
posted by any major dude at 6:33 PM on February 25, 2011

Are you taking the amoxicillin? If it is strep, that should do the trick.
If you are taking it and the throat is not improving dramatically within a day, then I wouldn't even wait til Monday. Go to urgent care now.
posted by SLC Mom at 7:32 PM on February 25, 2011

Pharyngeal Gonorrhea? That is rather antibiotic resistant... apparently.

Try some Difflam spray, or something similar to soothe enough to keep yourself hydrated. Keep up the salt water too.
posted by Trivia Newton John at 7:28 AM on February 26, 2011

The only time I have had the same experience - very sore throat, no other symptoms - it was mono. I have had two big bouts with it, once in high school, once in college. The other symptoms came along later, after a couple of weeks of sore throat and swollen neck glands.

Thirty years later, if I get that tight-sore-throat feeling coming on, especially after a high stress week or two, I immediately get on a regular sleep schedule and take it easier. I haven't had a relapse, thank God.

They can give you a mononucleosis spot test, it's a blood test.

See another doc if the pain is as bad as you say, regardless.
posted by Xoebe at 11:50 PM on February 26, 2011

I used to get horrific sore throats due to allergies. They would last for as long as whatever was spewing pollen or dust or bug feces. You might want to try an antihistamine. For an extreme home remedy, I mix up warm water, salt, lemon, and chili powder as a gargle but I'm crazy like that.
posted by chairface at 9:04 AM on February 27, 2011

nthing other meds. I had a horrible sore throat starting about 30 days after I started taking blood pressure meds (lisinopril). Apparently it's a 10% side effect of the med and I switched to another pill (diovan) and my throat was better in a week.
posted by screamingnotlaughing at 3:46 PM on March 3, 2011

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