Why Does My Throat Hurt in the Morning?

Why does my throat hurt in the morning? Does it mean you have COVID-19? While a sore throat is among the symptoms of COVID-19 infection, there are several other reasons why you may be experiencing throat pain when you wake up.

The cause of a sore throat can be determined by the type of symptoms you present, from an itchy feeling and painful swallowing to changes in your voice.

Below we explain the causes for throat pain, remedies to help you soothe it and when to see a doctor, according to health experts.

Why Does My Throat Hurt When I Wake Up?

A COVID-19 infection can cause sore throat symptoms that are similar to other respiratory infections, Dr. Eric Moore, an ear, nose and throat (ENT) specialist told Newsweek. However, often a sore throat in the morning is caused by breathing through the mouth or snoring during the night, he said.

"The mouth breathing can dry the membranes of the throat causing soreness, the snoring can cause drying but can also cause microtrauma to the throat from vibrations of the palate,", Moore explained.

Throat pain in the morning can also be a result of post nasal secretions and reflux from the stomach.

"Patients swallow fewer times during sleep when awake, so post nasal secretions and reflux from the stomach can pool in the throat at night and sit in contact with the membranes of the throat and cause irritation and pain," the doctor said.

Dr. Hannah Linnea Kavookjian, Head and Neck Surgery at the Johns Hopkins University School of Medicine, told Newsweek throat pain can be also be "referred" to as pain in the ear through complex nerve connections between the head, neck, and brain.

Why Does My Throat Hurt When I Swallow?

In addition to those mentioned above, other common causes of a sore throat include:

  • a possible infection (viral, bacterial, fungal).
  • dry air quality.
  • upper respiratory tract infections.
  • muscle tension/strain.
  • mechanical trauma or injury.

A sore throat can also be a sign of "some more serious conditions that may include throat cancer," Dr. Erich P. Voigt, the director of the Division of General Otolaryngology—Head and Neck Surgery told Newsweek.

Although throat pain can occur at any time of the day, "the time/situation when it is the worst can often help us identify its cause," Kavookjian said.

Can Allergies Cause Sore Throat?

Those who are allergic to pollens, molds, animal dander or house dust may also experience sore throat symptoms.

Different forms of irritation, including dry heat, dehydration, chronic stuffy nose, pollutants, car exhaust, chemical exposure or straining your voice, can also cause a sore throat.

A woman holding her throat in pain.
A woman holding her throat in pain. A sore throat in the morning is often caused by breathing through the mouth or snoring during the night. iStock/Getty Images Plus

Why Is My Throat Sore? Causes and Symptoms

Viral Infections

Viruses, including ones that cause colds and the flu, are the most common causes of a sore throat, according to Centers for Disease Control and Prevention (CDC).

Viral infections that may cause a sore throat include:

  • measles,
  • chicken pox,
  • croup and mononucleosis (also known as mono).

"Mono has the longest duration of symptoms that can last several weeks", says ENThealth.org.

Below are some of the symptoms that suggest your sore throat is caused by a virus:

  • A cough.
  • A runny nose.
  • Hoarseness (changes in your voice that makes it sound breathy, raspy or strained).
  • Conjunctivitis (also known as pink eye).

Bacterial Infections

Bacterial infections, such as strep throat, are among the less common causes for a sore throat.

Strep throat is caused by Streptococcus bacteria and can also cause scarlet fever, tonsillitis, pneumonia, sinusitis (sinus infections) as well as ear infections.

Common symptoms of strep throat include the following:

  • A sore throat that starts very quickly.
  • Pain when swallowing.
  • A fever.
  • Red and swollen tonsils, sometimes with white patches or streaks of pus.
  • Tiny red spots on the roof of the mouth.
  • Swollen lymph nodes in the front of the neck.

A sore throat can also be a sign of pertussis, also known as whooping cough. This highly contagious respiratory disease can be especially serious, potentially fatal, for babies who are less than a year old.

Tumors

Tumors in the throat, tongue and larynx (voice box) can cause a sore throat, along with pain up to the ear.

A hoarse voice, difficulty swallowing, noisy breathing, a lump in the neck, unexplained weight loss, and/or blood in the saliva or phlegm are among other signs of a tumor in the throat area.

Epiglottitis

In other serious cases, your sore throat can be caused by epiglottitis, which is the most dangerous throat infection. It causes swelling that closes the airway and requires immediate emergency medical attention, warns ENThealth.org.

A man blowing his nose in bed.
A man blowing his nose while sick in bed. Viral infections, such as the flu or colds, are the most common causes of a sore throat. iStock/Getty Images Plus

How Long Does a Sore Throat Last?

Voigt from the NYU Langone medical center advised seeing a doctor if a sore throat lasts more than a week or seems severe (such as causing an inability to speak or swallow).

More said: "[This] can be a sign of more serious illness—stomach acid reflux, even cancer can manifest as a chronic sore throat," he said.

Voigt said: "Tongue, tonsil and throat cancer will present with a sore throat. Sometimes this is the only symptom of these cancers."

Kavookjian explained throat cancer can "sometimes present only with persistent throat pain, but is more often accompanied by changes in voice, swallowing dysfunction, or neck mass."

In addition, some serious infections, including strep throat and abscesses, may be present with sore throats and need urgent medical attention, Voigt warned.

Below are the signs and symptoms of a sore throat for which you should see a doctor, as outlined by the CDC and ENThealth.org:

  • A severe and prolonged sore throat.
  • A frequently recurring sore throat.
  • A hoarseness lasting over two weeks.
  • Difficulty breathing.
  • Difficulty swallowing.
  • Difficulty opening your mouth.
  • Blood in the saliva or phlegm.
  • An earache.
  • A fever (over 101 degrees in Fahrenheit).
  • Excessive drooling (in young children)
  • Dehydration.
  • Swelling of the face or neck.
  • A lump in the neck.
  • Joint swelling and pain
  • A rash.

How To Get Rid of a Sore Throat: Treatments

Treatment options depend on the cause of your throat pain. If your doctor determines your sore throat is caused by a bacterial infection, you will be given a course of antibiotics, which aims to kill the bacteria causing the infection.

It's vital to take antibiotics exactly according to how you've been directed by your doctor. You must finish all doses, even if your symptoms improve, as the infection may not be gone and could return.

If your sore throat is caused by a virus, antibiotics will not help. Most sore throats can get better on their own within a week, however your doctor might prescribe other medicines to help relieve your symptoms.

While antibiotics won't treat viral infections, viruses do lower your body's resistance to bacterial infections, so in the case of a combined infection antibiotics may be recommended.

How to Sooth a Sore Throat

ENT specialist Moore advised drinking plenty of fluids frequently, including tea with honey, as well as gargling with salt water.

These methods "help mobilize thick secretions and post nasal drainage and that can result in relief," while "dehydration, spicy foods and alcohol can all make a sore throat feel worse," Moore said.

Kavookjian said you should rest your throat, avoid acidic foods and stick to soft foods. She also advised not to give honey to children under the age of one.

The CDC also suggests sucking on ice chips, popsicles or lozenges (do not give lozenges to children who are under two years of age) and using a clean humidifier or a cool mist vaporizer to keep the surrounding air from drying out and irritating your throat.

Over-the-counter (OTC) medications, such as acetaminophen or ibuprofen, may be used for pain relief for a sore throat condition.

A person drinking a glass of water.
A person drinking a glass of water. It's important to drink plenty of fluids for a sore throat condition as dehydration can make it worse. iStock/Getty Images Plus