Causes
Complaining of a sore throat, the patient can describe the manifestation of various diseases - under the definition of "throat", which is rather not a medical, but a common term, they understand the various structures of the oropharynx located in the projection of the front of the neck. Therefore, it is not possible to establish an accurate diagnosis in accordance with this symptom. It is necessary to know the characteristics of pain (time of onset, severity, provoking factors, etc.), as well as identify and evaluate concomitant pathological manifestations.
If your throat hurts, the main reasons can be divided into several groups:
- Infections.
- Injuries.
- Neoplasms.
- Neurological pathology.
- Diseases of the blood.
In this case, the affected area is able to be in different anatomical zones - the pharynx, larynx. The reason for the appearance of a pronounced pain syndrome may be tonsillitis, or tonsillitis - inflammation of the tonsils. According to the anatomical boundaries of the inflammatory process, the following pathologies are distinguished:
- pharyngitis;
- tonsillitis;
- laryngitis.
Each of these diseases can manifest itself as an independent pathology or syndrome that accompanies the course of infectious diseases such as measles, scarlet fever, diphtheria.
It should be understood that pain can be both acute and chronic. If it appears suddenly and is accompanied by symptoms of intoxication, a sharp deterioration in the general condition, first of all, they think about the infection. With sluggish chronic inflammatory processes, pain is not pronounced, bothers the patient for a long time, and is not dominant among the main complaints.
Infectious pathologies
Infectious and inflammatory lesions of the oropharyngeal structures are the most extensive group of pathologies developing in this anatomical region. They are registered in patients most often, and the leading symptom is sore throat of varying intensity. These diseases can be triggered by:
- Viruses.
- Bacteria.
- Mushrooms.
Among the most likely causes of the appearance of a bright pain syndrome, one can name acute pharyngitis (inflammation of the pharyngeal mucosa) with ARVI (acute respiratory viral infections), streptococcal and staphylococcal bacterial infections. Group A beta-hemolytic streptococcus provokes scarlet fever, in the clinical picture of which there is tonsillitis syndrome, and acute tonsillopharyngitis.
Severe sore throat most often indicates the presence of bacterial pharyngitis or tonsillitis in the patient, and moderate pain is characteristic mainly of viral infections.
It is worth knowing that the inflammatory process in the pharynx, tonsils and larynx can provoke not only respiratory viruses, but also Coxsackie, ECHO and Epstein-Barr viruses. They are the causative agents of diseases such as herpes sore throat and infectious mononucleosis.
Complaints of pain when swallowing are also presented by patients who have been diagnosed with:
- measles;
- scarlet fever;
- diphtheria.
The intensity of the pain varies. In the case of diphtheria, the painful sensations, as a rule, are not excruciating - on the contrary, they are moderate, unlike other forms of angina. If the patient has a localized form of diphtheria, he often describes a slight discomfort when swallowing. Severe pain syndrome is characteristic only for the toxic course.
With a mycotic (fungal) lesion of the mucous membrane of patients, as a rule, they are worried about long-lasting, but at the same time slightly pronounced painful sensations in combination with dryness and soreness. During the history taking, it is sometimes possible to establish a link with antibiotic therapy prior to the onset of complaints.
If the paired palatine tonsils, pharyngeal mucosa are affected, the pain is localized on both sides. With pharyngitis, the focus of pain is on the back of the throat. One-sided pain is observed with an intratonsillar abscess, tuberculosis infection (the tuberculous process can also be bilateral). Tuberculosis of the pharynx and tonsils can manifest after hypothermia and is accompanied not only by pain, but also by fever, worsening of the general condition, which creates certain difficulties in differential diagnosis.
Injury
There are many types of damage, accompanied by the appearance of painful sensations in the oropharyngeal region. And if in some injuries the etiology of the pain syndrome is obvious, in other cases you have to think about what the causes of a sore throat may be:
- Inhalation of cold air.
- Inhalation of hot air.
- Local hypothermia.
- Eating cold or hot food.
- Exposure to harsh chemicals.
- The presence of a foreign body.
Mucous membranes are quite sensitive to sudden changes in ambient temperature. When unexpectedly exposed to very cold or, conversely, very hot (both dry and humid) air, irritation and tissue damage occurs. Patients describe various situations - from improper use of inhalations to safety violations when working with production equipment. Nasal congestion, in which breathing is through the mouth, is also important.
What makes your throat so bad? Too cold food or drink, walking without a scarf in winter are some of the most common causes of pain. This symptom is then associated with a cold; These factors most often lead to an exacerbation of an already existing chronic inflammatory process in the oropharynx.
Harsh chemicals - acids, alkalis - damage the mucous membrane if accidentally inhaled or ingested. Contact with them leads to tissue damage of varying severity, which is manifested by painful sensations, sharp 
violation of swallowing, speech impairment, and in some cases - the addition of symptoms of intoxication.
A foreign body is usually found in children (a variety of objects that a child tries to try or swallow), but can also cause pain in adults. Most often, these are food debris (for example, fish bones with sharp edges) that scratch the mucous membrane and can even get stuck in folds. Sometimes dentures become a foreign body.
Neoplasms
Tumors in various parts of the oropharynx and larynx can be:
- benign;
- malignant.
In the first case, a bright pain syndrome is not typical if the neoplasm does not cause pressure on the adjacent anatomical structures. Patients may experience irritation and perspiration, which is sometimes perceived as a form of pain.
With malignant tumors in the pharynx and larynx, sore throat is a belated manifestation of the pathological process. It occurs when the neoplasm reaches a significant size, as well as when the tumor is infected and ulcerated. It should be emphasized that in most cases the pain is one-sided.
Neurological pathologies
Among neurological diseases, the cause of sore throat can be glossopharyngeal neuralgia. Chronic tonsillitis, aneurysm of the carotid artery, tumors of the jugular sinus, chronic sinusitis are called etiological factors that contribute to its development. Pain has several main characteristics:
- Sharp.
- Paroxysmal.
- Localized in the back of the tongue, tonsils, pharynx.
- It is provoked by certain actions - swallowing, chewing, yawning, coughing, talking.
- Stored for several minutes.
- Does not appear between attacks.
Pain with glossopharyngeal neuralgia is always one-sided.
When thinking about why a patient has a sore throat, you need to evaluate the accompanying symptoms. A comprehensive examination is required to confirm the diagnosis of glossopharyngeal neuralgia. The pain in this disease is significantly different from the pain syndrome in infectious and inflammatory lesions. It is short-lived, resembles an electric shock, and repeats over many months.
Diseases of the blood
Although, at first glance, blood diseases (hematological pathologies) and lesions of the mucous membrane of the oropharynx are not connected in any way, the throat can hurt:
- with acute leukemia;
- with chronic leukemia;
- with agranulocytosis;
- with alimentary-toxic aleukia.
Why do hematological patients have a sore throat? First of all, systemic blood diseases lead to insufficient mechanisms of anti-infectious defense - the risk of infection, the development of pharyngitis or tonsillitis increases. The use of a variety of pharmacological drugs in the course of chemotherapy is also important.
The observed changes take on a different character - from catarrhal to necrotizing sore throat. In acute leukemia, the primary manifestations can be mistaken for symptoms of a severe acute infection. Bilateral damage to the mucous membrane of the oropharynx develops, necrotic changes sometimes affect not only the posterior wall of the pharynx and tonsils, but also the larynx. For the purpose of differential diagnosis, a study of peripheral blood is mandatory - this is the primary diagnostic measure that allows one to suspect the presence of leukemia when undifferentiated cells (blasts) and other specific signs are detected.
A sore throat in chronic leukemia is not as pronounced as in an acute process. Sometimes the clinical symptoms are so scarce that changes in the blood are detected by chance (for example, during a mandatory medical examination), and patients attribute the unpleasant sensations when swallowing to fatigue, infections, dry air, and smoking.
Intense pain against the background of necrotizing tonsillitis is characteristic of agranulocytosis, alimentary-toxic aleukia.
Agranulocytosis is also called agranulocytic angina, since ulcerative-necrotic lesions of the pharynx and tonsils become a typical manifestation. The disease develops as a result of:
- exposure to ionizing radiation;
- taking pharmacological drugs (Amidopyrine, Analgin, Streptomycin, etc.).
The cause can also be an infectious (tuberculosis, syphilis, malaria) or autoimmune (systemic lupus erythematosus) disease. Pain syndrome in the case of agranulocytosis is very pronounced, appears acutely.
Alimentary-toxic aleikia is currently rare and develops when eating cereals affected by the fungi Fusarium sporotrichiela. Various changes in the blood are observed, however, the primary symptoms correspond to the picture of acute intoxication. Angina is necrotic in nature, proceeds against the background of severe fever, hemorrhagic syndrome. Patients experience excruciating intense pain localized in the region of the pharynx, tonsils, and the entrance to the larynx.
Pain syndrome with damage to the structures of the oropharynx is inherent in a large number of pathologies. This requires the care of both the patient and the physician. Do not self-medicate, especially if you are not sure of the diagnosis. For a successful recovery, the correct therapy is necessary, which can only be prescribed by a specialist after a face-to-face examination. The time factor plays an important role in many diseases, so you need to consult your doctor immediately.
