Throat infections or irritations commonly cause pain on both sides. Pain exclusively on one side when swallowing, known as unilateral odynophagia, suggests a localized issue rather than generalized inflammation. The throat area contains many structures, including tonsils, lymph nodes, and salivary glands. A problem in a single location within these structures can lead to one-sided symptoms. Understanding the specific causes of this asymmetric pain is the first step toward finding relief.
Common Infectious Reasons for Unilateral Pain
Unilateral throat pain often signals an infection concentrated in a specific area. Tonsillitis, which is inflammation of the tonsils, can affect only one tonsil, localizing the pain to that side of the throat. This inflammation often presents with fever, bad breath, and visible redness or pus on the affected tonsil.
Infectious mononucleosis (mono) is a viral cause that can lead to severe throat discomfort, sometimes concentrated on one side. The Epstein-Barr virus that causes mono frequently causes significant swelling in the neck’s lymph nodes. If one node becomes more enlarged than the others, it creates asymmetric pain. Mono is also characterized by extreme fatigue, fever, and a sore throat that may not improve with typical strep throat treatments.
A peritonsillar abscess (Quinsy) is a collection of pus that forms near one of the tonsils. This condition typically begins as a complication of untreated tonsillitis. It causes intense, unilateral pain that makes swallowing difficult and may radiate to the ear on the same side. The swelling can also cause difficulty opening the mouth (trismus) and result in a muffled or “hot potato” voice.
Structural and Non-Infectious Irritants
One-sided throat pain can also stem from non-infectious issues that mechanically irritate the throat’s lining. Gastroesophageal Reflux Disease (GERD) or Laryngopharyngeal Reflux (LPR) occurs when stomach acid backs up into the throat, causing irritation. If a person consistently sleeps on one side, the acidic contents may pool there. This leads to localized inflammation and pain upon waking.
Pain can also be referred from nearby structures, making the throat feel sore when the problem originates elsewhere. A dental abscess or infection in a back tooth, such as a wisdom tooth, can radiate pain through surrounding nerves, causing unilateral throat pain. Similarly, a foreign object like a small bone or piece of food can scratch the tissue. This irritation leads to a scratchy or painful feeling localized to that spot.
Postnasal drip, where excess mucus drains down the back of the throat, can also cause irritation that feels like one-sided pain. If sinus drainage favors one side, the constant flow of mucus can inflame that specific area of the pharynx. Other causes include structural lesions like canker sores or vocal cord lesions. These lesions cause localized irritation or pain, often resulting from overuse or trauma.
Immediate Steps for Symptom Relief
Several immediate steps can help soothe the irritation and reduce discomfort while investigating the underlying cause. Staying well-hydrated is important, as dry tissues are more susceptible to irritation. Warm fluids like tea with honey can provide temporary relief to the inflamed area. Gargling with a solution of warm salt water helps reduce swelling and discomfort by drawing fluid out of the inflamed tissues.
Sucking on throat lozenges or hard candies stimulates saliva production, which keeps the throat moist and provides a protective layer against irritants. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can also be taken to manage the pain and reduce any associated fever.
When Unilateral Pain Requires Professional Attention
Certain accompanying symptoms indicate that a medical evaluation is required. A persistent, high fever exceeding 101°F, especially with chills, suggests a significant bacterial infection needing specific treatment. If swallowing becomes so difficult that you cannot drink liquids, or if you begin drooling, urgent care is necessary. These symptoms pose a risk of dehydration or airway compromise.
The inability to open your mouth fully (trismus) or a noticeable shift of the uvula away from the painful side are signs of a developing peritonsillar abscess. Any pain that lasts more than 48 to 72 hours without improvement, or pain that is rapidly worsening, should prompt a visit to a healthcare provider. Other signs requiring immediate medical attention include swelling in the neck that feels hard or is increasing in size. Difficulty breathing or a change in voice quality, such as a muffled sound, also requires immediate diagnosis and management.