Sore throat, stiff neck and ear pain: what to know

A viral throat infection can cause throat soreness, swollen tissues and pain that feels referred to an ear. Influenza, COVID-19, the Common Cold and Glandular Fever can include throat symptoms. Tonsillitis or Strep Throat may cause marked pain when swallowing and tender neck glands. Acid Reflux can irritate the throat without causing a typical cold.

A stiff neck may come from tense muscles during an infection, but a severe or rapidly worsening neck stiffness is different from ordinary soreness. Ear pain can also arise from the throat, jaw or an ear infection, so the location and timing help a clinician assess it.

Rest, drink fluids in small frequent amounts, and choose soft foods if swallowing hurts. Warm drinks or a salt-water gargle may soothe the throat. Follow the label for any suitable pain medicine, and check with a pharmacist if you are pregnant, have a long-term condition, or take other medicines. Avoid smoking and sharing cups or utensils while you are unwell.

Arrange a clinical assessment if symptoms are significant, persist, or are accompanied by fever, ear discharge, reduced hearing, or difficulty opening the mouth. A clinician may examine the throat, ears and neck and decide whether testing is useful.

Seek urgent medical help if breathing is difficult, you cannot swallow liquids or saliva, your voice becomes muffled, one side of the throat or neck swells, or the neck is very stiff with severe headache, confusion, vomiting, or marked sensitivity to light. Urgent assessment is also needed if you are becoming rapidly more unwell or cannot keep fluids down.

Ask: Could the ear pain be referred from my throat? Do I need a throat swab or another test? What signs would mean I should return urgently? Which pain relief is suitable with my health history?