Sore throat without tonsils: what to know

Tonsil surgery removes the tonsils, not the entire throat or all immune tissue in the area. Viruses such as those causing a common cold, influenza or COVID-19 can inflame the throat. Strep throat can affect the throat even when tonsils are absent, although the examination may look different. Glandular fever can also cause prolonged throat symptoms and tiredness. Allergic rhinitis may lead to throat irritation from mucus draining backwards, while acid reflux can cause burning or a lump-like sensation. Dry air, smoke and voice strain are additional irritants.

Sip water or warm fluids, use throat lozenges if safe for you, and choose foods that are easy to swallow. Rest your voice and avoid smoke, vaping and strong fumes. Keep up fluids even if appetite is low. A pharmacist can help you select a pain-relief option after checking allergies, pregnancy, kidney or liver problems and other medicines. Antibiotics do not treat viral causes and should only be used when prescribed.

Get urgent help if you cannot swallow saliva, have noisy or difficult breathing, rapidly increasing neck or mouth swelling, confusion or signs of dehydration. Arrange a clinician review for severe one-sided pain, a muffled voice, difficulty opening the mouth, repeated episodes or symptoms that persist rather than improve. A clinician may inspect the throat, neck and ears and decide whether a swab or other test is useful.

Could this be an infection in the throat despite my tonsil surgery? Do the symptoms fit reflux or allergy? What examination or test would distinguish these causes, and which pain relief is suitable for me?