Understanding Sore Throat and Its Association with Upper Back Pain

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Sore throat, or throat pain, is a common health issue that affects people of all ages. 

Though inconvenient and uncomfortable, for most individuals a sore throat is temporary and resolves on its own within a few days. 

However, in some cases sore throat can be accompanied by upper back pain, indicating a possible complication.   

A sore throat is typically caused by an infection in the pharynx, the part of the throat just behind the nasal passage and mouth. Viruses are the most common cause, especially in children, but bacteria can also trigger a sore and inflamed throat.  

Common symptoms of a viral or bacterial sore throat include:

Common Symptoms of a Viral or Bacterial Sore ThroatDescription
A scratchy or painful sensation when swallowingThis symptom indicates irritation in the throat when swallowing, causing discomfort.
Redness and swelling at the back of the throatInflammation and swelling are visible signs of an infected throat.
HeadacheHeadaches can accompany a sore throat and are often a result of the underlying infection.
FeverAn elevated body temperature is a common response to an infection.
Enlarged or swollen lymph nodes in the neckThe lymph nodes in the neck may become enlarged and tender due to the immune response to the infection.

While the exact reason for associated upper back pain is unclear, several possibilities exist:

  • Muscle strain from repetitive coughing   
  • Referred pain from irritation in the throat that radiates to the upper back  
  • Neurological dysfunction involving nerves that innervate both the throat and upper back      

In rare cases, upper back pain accompanying sore throat may point to a more serious condition like rheumatic heart disease. 

Caused by an infection with Streptococcus bacteria (strep throat), rheumatic heart disease damages heart valves and can trigger joint pain.   

To properly diagnose and treat sore throat as well as understand any connection to upper back pain, it is crucial to seek medical evaluation from a healthcare provider

A physical exam and medical history will determine if the sore throat is viral or bacterial in nature. Evaluation of the upper back can identify potential structural issues.  

With timely treatment, viral sore throats typically resolve within one week with self-care measures. Antibiotics may be necessary for bacterial infections. Prescription medications and physical therapy can then address associated upper back pain.

Understanding Sore Throat  

A sore throat is an uncomfortable feeling of pain, scratchiness or irritation in the throat that makes it difficult and painful to swallow. Sore throat is a common diagnosis, though the cause varies by age and medical history.

Sore throats can be caused by infections, allergies, irritants like smoke or pollutants, acid reflux or other medical conditions. Infections are the most common reason, triggered by bacteria or viruses that inflame the pharynx. These include:

InfectionsStrep throat (Streptococcus pyogenes bacteria)
 Viral sore throats (adenoviruses, rhinoviruses, influenza)
 Mononucleosis (Epstein-Barr virus)
 Glandular fever (human immunodeficiency virus)
Acid RefluxGastroesophageal reflux disease (GERD)
Other Medical ConditionsTonsillitis
 Chronic sinusitis

Complications from untreated strep throat include:

  • Scarlet fever - A rash and high fever due to strep  
  • Rheumatic fever - Inflammation of joints and heart valve
  • Rheumatic heart disease - Permanent damage to heart valves

Diagnosis involves a medical history and physical exam focused on the throat, nose and neck. Testing confirms if strep bacteria are present.

Treatment depends on the cause but may involve:  

  • Rest and over-the-counter pain relievers  
  • Limited use of alcohol-based mouthwashes  
  • Antibiotics for bacterial infections like strep
  • Avoidance of smoking,allergens and irritants       

For upper back pain accompanying a sore throat, self-care measures and over-the-counter medications may provide relief

More severe or persistent pain could indicate a secondary condition requiring medical attention. Seeking early medical evaluation and follow-up care is crucial.

Causes of Upper Back Pain with Sore Throat

For some individuals, upper back pain occurs together with a sore throat due to pharyngitis or viral infections. While the specific reasons for associated upper back and throat issues are unclear, there are a few possibilities:

Muscle strain from coughing

Repeated coughing due to a sore throat can strain and tense muscles in the upper back, neck and shoulders. Over time, this can lead to muscle spasms, tightness and accompanying pain.    

Referred pain

Pain originating in the throat may be referred to different areas supplied by the same cervical nerve roots, including the upper back. This is a common phenomenon with nerve-related diseases.

Neurological dysfunction

Certain medical conditions can affect both the throat and spinal nerves in the cervical spine, resulting in concurrent sore throat and upper back pain. Examples include infections and inflammatory diseases.   

Impaired swallowing

Difficulty swallowing due to a sore throat sometimes causes individuals to tense and strain neck and upper back muscles during eating. This effect can worsen existing pain.


Bacterial infections like strep throat have potential to spread systemically,including to vertebrae and spinal discs in the upper back via the bloodstream. This can cause localized inflammation and pain.  

Rheumatic heart disease

An untreated strep throat infection can sometimes lead to rheumatoid heart disease, which is associated with joint and muscle pain throughout the body, including the upper back. 

Early detection and management of strep throat can help prevent this complication.

While upper back pain co-occurring with a sore throat is generally harmless and self-limiting, it is important to monitor any changes in symptoms over time. 

Worsening pain, difficulty moving the back or neck, and high fever could indicate a more serious underlying condition requiring immediate medical attention. 

Healthcare providers can determine appropriate treatment options based on an individual's specific symptoms, medical history and needs.

Diagnosis and Treatment of Sore Throat and Upper Back Pain

For individuals experiencing both sore throat and upper back pain, proper diagnosis is key to determining the best treatment plan. 

Healthcare providers will conduct a thorough medical history and physical examination focusing on:   

Medical history

Details regarding the onset, duration and character of throat pain, difficulty swallowing,upper back pain and any other accompanying symptoms. This establishes the context for the current issues.       

Physical exam

Examination of the throat looking for inflammation,redness, pus or exudate. Evaluation of the upper back to check for tender areas, limited range of motion, and neurological functioning.        


Rapid strep tests or throat culture may be needed to confirm if the sore throat is caused by Streptococcus bacteria. Blood tests and imaging studies can also rule out other possible infections or complications.       

Based on the diagnosis, treatment may involve:   

Sore ThroatRest and increased fluid intake
 Over-the-counter (OTC) or prescription pain relievers
 Avoidance of irritants like smoke
 Antibiotics for bacterial infections like strep throat
Upper Back PainApplication of heat or cold packs
 Gentle stretching and range of motion exercises
 OTC pain relievers like nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen
 Muscle relaxants for severe muscle spasms
 Physical therapy focusing on posture, core strength, and flexibility

Rheumatic heart disease requires prolonged antibiotics to kill Streptococcus bacteria and reduce inflammation. Additional procedures or surgery may also be needed.      

All treatments aim to relieve symptoms, shorten the course of illness and prevent complications. Individualizing care based on an individual's specific medical history, exam findings and priorities provides the best outcomes. 

Regular follow-up allows healthcare providers to monitor progress, adjust treatments and identify any new issues as they arise.

Seeking Medical Advice for Sore Throat and Upper Back Pain

For individuals experiencing both sore throat and upper back pain, it is important to see a healthcare professional for proper evaluation and treatment. A medical professional can:

  • Conduct a thorough physical exam of the throat, neck and upper back  
  • Order diagnostic tests to identify potential infections
  • Recommend medications to relieve symptoms and speed healing   

Beyond addressing immediate concerns, a healthcare visit enables:       

A doctor can develop a tailored treatment plan based on your unique medical history, needs and priorities. 

They can manage any long-term issues through prolonged medications and follow-up care, and detect new or worsening symptoms that require adjusted treatment.      

Visiting a primary care physician, ENT specialist or orthopedist is important to rule out complications, identify underlying conditions and recommend physical therapy if needed. Untreated infections, particularly those caused by strep bacteria, can lead to serious health issues.       

So if you're experiencing sore throat and upper back pain, scheduling an appointment with your healthcare provider is advised. Timely diagnosis, proper management based on your specific presentation and risk factors will optimize outcomes.     

Relieve Your Symptoms and Improve Your Health

While over-the-counter medications may provide temporary relief for your sore throat and upper back pain, the experts at Gramercy Pain Center can determine the underlying cause of your discomfort and customize a long-term treatment plan for optimal results.   

Our medical team will thoroughly examine your throat, neck and upper back to rule out potential infections, inflammatory conditions or spine issues contributing to your symptoms. 

We will perform any necessary diagnostic testing and develop an individualized care plan tailored to your unique health needs, risk factors and priorities.  

Our treatment approach may include:

• Prescription medications to relieve your symptoms and accelerate healing   

• Antibiotics to combat bacterial infections  

• Physical therapy focused on posture, core strength and range of motion

• Lifestyle recommendations for proper nutrition, stress management and exercise

• Ergonomic devices or adaptive equipment to minimize strain        

With proper diagnosis, management and follow-up care, we aim to not just relieve your current discomfort but also address the root cause of issues and improve your long-term health and wellness.  

If you're ready to finally get relief from your sore throat and upper back pain, contact the caring team at Gramercy Pain Center. Our staff is ready to answer your questions and help you schedule a consultation with one of our specialists.     

Take the first step toward lasting comfort and improved quality of life. 

Schedule an appointment with Gramercy Pain Center today - call us now.

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