Exploring Causes: Why Does Only One Side of My Throat Hurt?

One-sided throat pain is often caused by tonsillitis, strep throat, a swollen lymph node, or postnasal drip. See a doctor if it is severe or you have trouble swallowing or breathing.

Common causes

• Tonsillitis or tonsil stones.
• Strep throat.
• Swollen lymph node.
• Postnasal drip.
• Abscess (peritonsillar).
• Acid reflux.
• Referred pain from the ear or teeth.
• Rarely, tumors.

Home care

Warm salt water gargles, fluids, lozenges and pain relievers.

See a doctor if

Pain lasts more than a week, you have trouble swallowing or breathing, drooling, high fever, a lump, or blood in saliva.

Emergency

Severe one-sided pain with trouble opening the mouth or voice change can signal an abscess.

Smokers

One-sided sore throat for weeks needs evaluation for cancer.

Why one side hurts

A throat that hurts on one side can be caused by something that affects only that side, such as a swollen tonsil, an abscess, a lymph node, a sore at the back of the throat or referred pain from the ear or teeth. Infections tend to hurt both sides, but they can begin on one side.

Common causes

• Tonsillitis or strep throat, in which one tonsil may be more swollen. Strep causes about 20% to 30% of sore throats in children and 5% to 15% in adults.
• Peritonsillar abscess: a collection of pus beside a tonsil, with severe one-sided pain, a muffled voice, trouble opening the mouth, drooling and fever. It needs drainage.
• Swollen lymph nodes in the neck.
• Postnasal drip from sinus problems draining on one side.
• Ear infection with pain referred to the throat.
• Dental infection or wisdom tooth problems.
• Acid reflux irritating one area.
• A foreign body such as a fish bone.
• Thyroiditis, with pain in the front of the neck.
• Mononucleosis, which causes very sore throat and swollen glands.
• Mouth sores or ulcers.

Home care

• Gargle with warm salt water, a half teaspoon in a cup, several times a day.
• Drink warm tea with honey, and plenty of fluids.
• Take ibuprofen or acetaminophen.
• Suck on lozenges (not for young children).
• Rest your voice and use a humidifier.
• Avoid smoke and irritants.

See a doctor if

Pain lasts more than a week, is severe, comes with high fever above 101 F, swollen lymph nodes, white patches on the tonsils, a rash, difficulty opening the mouth, or a lump in the neck. A rapid strep test or culture can check for strep, which needs antibiotics.

Emergency

Call 911 or go to the ER for trouble breathing, trouble swallowing saliva, drooling, a muffled “hot potato” voice, severe swelling in the neck, or stridor.

Smokers

Persistent one-sided sore throat for more than 2 to 3 weeks, especially in smokers and heavy drinkers or with HPV risk, should be examined for throat cancer. Signs include a lump, hoarseness, ear pain and weight loss.

Anatomy and causes

One sided throat pain can be due to tonsillitis or a peritonsillar abscess, which causes severe pain on one side, difficulty opening the mouth and a muffled voice, and needs urgent care. Swollen lymph nodes, a sore from an infection, acid reflux, a foreign object such as a fish bone, dental problems and postnasal drip may lead to uneven pain. Strep throat affects about 10 percent of adults with sore throat and about 30 percent of children, and testing is needed because antibiotics are only used for bacterial infections. Smoking, heavy alcohol use and HPV raise the risk of oropharyngeal cancer, so a sore throat lasting over 2 weeks, a lump in the neck, ear pain on one side or voice changes warrant evaluation. Warm saltwater gargles, hydration, throat lozenges and acetaminophen or ibuprofen help ease mild pain. Difficulty breathing or swallowing or drooling is an emergency.

Based on data from the CDC and the American Cancer Society