Sore Tonsils: Why Your Tonsils Hurt and What It Means

A familiar picture: you wake up in the morning and it feels like a hot stone is stuck in your throat. Swallowing hurts, and your thoughts are already circling around one question: is this just a cold or something more serious. Let's calmly sort out what is happening with the tonsils and which signs to pay attention to.

What are tonsils and why do they hurt

The tonsils are lymph nodes deep in the mouth and in the upper part of the throat. They filter bacteria and other pathogens, helping protect the body from infections. When a virus or bacterium lands on them, inflammation develops — tonsillitis. It is this inflammation and swelling that cause the sore throat we habitually call "sore tonsils."

Sore tonsils when swallowing: common causes

Most often tonsillitis is caused by viruses, for example with a cold, but it can also be bacterial — say, streptococcal tonsillitis. Difficulty swallowing and a sore throat are typical symptoms of tonsillitis. Fever, cough, headache, ear pain and general fatigue are often added to this. Symptoms usually resolve within 3–4 days, although they may last longer.

Pain in one tonsil: what it may mean

The cause of pain in one tonsil is determined by a doctor's examination, taking accompanying symptoms into account. In more severe cases, enlarged and tender lymph nodes in the neck appear, along with pustules or white patches on the tonsils and bad breath. If the pain sharply intensifies and it becomes difficult to speak, swallow or open the mouth, this may be a sign of a complication — a collection of pus between the tonsil and the throat wall (peritonsillar abscess).

Sore tonsils without fever: possible causes

Fever is one possible symptom of tonsillitis, but not the only one: sore throat, difficulty swallowing, ear pain and headache can occur without it. Enlarged tonsils that do not hurt and cause no other problems usually do not require treatment. But if sore tonsils without fever last longer than 48 hours, that is already a reason to see a doctor.

What inflamed and swollen tonsils look like

On examination, the tonsils look red and swollen. In more severe symptoms, pustules or white patches are visible on them, and the lymph nodes in the neck can be felt as a tender lump on the side. The doctor assesses exactly this picture together with the complaints.

How a doctor determines the cause and when to make an appointment

Usually the diagnosis is made after taking a history and examining the throat. A throat swab may be taken to check whether the cause is bacterial, and in severe or prolonged symptoms, a blood test for infectious mononucleosis may be done. You should make an appointment if symptoms do not go away within a week or throat infections recur. Do not postpone a visit to the doctor if pustules appear on the tonsils or the pain makes it hard to eat and drink.

• Sore throat lasts longer than 48 hours
• Tender or enlarged lymph nodes in the neck
• White patches or pustules on the tonsils
• Temperature 38.3 °C and above
• Difficulty swallowing or breathing

Tonsil inflammation by itself is not a reason to call an ambulance; 103 or 112 — if the sore throat sharply intensifies, swelling appears inside the mouth and throat, and it is difficult to speak, swallow, breathe or open the mouth.

This material is for reference and does not replace a doctor's consultation: if in doubt, it is better to show your throat to a specialist than to guess.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer