Tonsils: Causes, Symptoms, and Risk Factors

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- Updated by Judy Mullis, MS, RD, Nutritionist


Tonsils are lymph nodes located at the back of the throat that help regulate and prevent infections from entering the body. However, as a protective barrier, they come in contact with more infections than other areas of the body and cause an infection. Infected tonsils, also known as tonsillitis, include symptoms such as swollen tonsils, redness, sore glands, and neck pain, and may also include a fever, headache, and stomachache. Risk factors for tonsillitis include young age, as younger children still have developing immune systems, and exposure to excessive germs, such as in school or other high-traffic areas. Treatments for tonsillitis include antibiotics for bacterial infections, and rest with pain relievers and other home remedies for viral infections.

What are Tonsils?

Tonsils (palatine tonsil) are two round masses at the throat’s back (pharynx.) Tonsils are lymph nodes containing many white cells, which are an immune system component. Tonsils function as a part of the body’s immune system by catching germs at the throat before they enter the body. This helps us understand what are tonsils. Due to their vulnerable position, tonsils can become infected, which is called tonsillitis. Tonsillitis is when the tonsils become inflamed due to an infection. Several things, such as a bacterial or viral infection, can cause an infection. Strep throat, a bacterial infection, is a common cause of tonsillitis.

How common are Tonsils?

Inflamed tonsils (or tonsillitis) affect almost every child in the USA; however, being infected with an inflamed tonsil affects children differently, depending on age. Children under five are more likely to get tonsillitis from a viral infection. Children between the ages of five and fifteen are more likely to get tonsillitis from a bacterial infection, according to MedlinePlus in 2017. Tonsillitis can affect adults, but its occurrence is much less frequent. Concerning who is affected by tonsillitis the most, women are twice as likely to develop tonsillitis than men, according to Research Gate in 2008.

What are the Causes of Tonsils?

Swollen tonsils (tonsillitis) can be caused by two primary infections, according to NHS Inform in 2022.

  • Viral Infection - A viral infection is the most common cause of tonsillitis, including the flu or common cold.
  • Bacterial Infection - A bacterial infection is another common cause of tonsillitis, usually from a bacteria known as streptococcus.

What are the Symptoms of Tonsils?

The symptoms of inflamed tonsils (tonsillitis) are listed below.

  1. Swollen tonsils - Swollen tonsils are a red swelling on the tonsils located in the throat.
  2. Sore Throat - A sore throat makes swallowing painful.
  3. Fever - A fever is where the body’s temperature exceeds 99 degrees Fahrenheit.
  4. Tender glands - Tender glands are when pain is felt when pressing on the neck, due to swollen lymph nodes.
  5. Throaty voice - A throaty voice sounds rough, and it may be painful to speak.
  6. Bad breath - Bad breath can be caused by inflamed tonsils, which can give off an unpleasant smell.
  7. Stomachache - A stomachache is where a person feels pain in the abdomen and may want to throw up.
  8. Headache - A headache can be closely linked to a fever, and is where a person experiences pain in the head.
  9. Neck Pain - Neck pain is when there is pain in moving or touching the neck.

1. Swollen tonsils

Swollen tonsils look red, inflamed, and may also have small white spots. Swollen tonsils are a sign that the tonsils are being overworked to protect the body from an infection, and they can help us understand what are tonsils for.

2. Sore throat

A sore throat means it becomes painful to swallow, and it can be caused by tonsillitis when the tonsils become infected. Normal tonsils will not cause any pain or soreness, but inflamed tonsils will cause sore achiness in the throat, with different levels of soreness, depending on the severity of the infection.

3. Fever

The body’s normal temperature is between 97 degrees Fahrenheit (36.1 Celcius) and 99 degrees Fahrenheit (37.2 Celcius); however, anything over 99 degrees is considered to be a fever. A fever can be a symptom of tonsillitis as it is an immune response from the body trying to deal with the infection. If a person experiences swollen tonsils no pain, and no fever, it may indicate either a minimal infection, or no infection, and a doctor should check it just in case.


4. Tender glands in the neck

Tender glands in the neck are when the lymph nodes are inflamed, causing pain when pressure is placed on the neck. Tender glands are typically caused by the immune system responding to the infection in the tonsils, and can explain why is one of my tonsils swollen.

5. Throaty voice

A throaty voice is when the voice sounds rough and mucousy, and it may be painful to speak. A throaty voice is due to where are the tonsils, located in the throat. When the tonsils become inflamed from an infection, it can change how air is moved through the voicebox and make the voice sound throaty.

6. Bad breath

Bad breath (concerning the smell of the breath) is a symptom of tonsillitis and can help us define what is a tonsil and how a tonsil can affect the breath. Bad breath is caused when the membrane of the tonsil becomes inflamed, which can cause a foul smell. This is due to trapped bacteria and dead white blood cells not being flushed from the site quickly enough.

7. Stomachache

A stomachache is where a person experiences abdominal pain, and in worse cases, may throw up. A stomachache is a sign of tonsillitis as it is an immune response to an infection. To better understand what are tonsil, it’s important to note that tonsils are a part of the immune system, and help keep infections at bay.

8. Headache

A headache is when a person feels pain or soreness in the head, and is a symptom of tonsillitis due to a build-up of fluids in the sinuses, or as a sub-symptom of a fever. Healthy tonsils won’t cause a headache, but inflamed tonsils may.

9. Neck pain

Neck pain, due to inflamed tonsils, is when the neck is sore, stiff, or hurts to move. When inflamed it’s important to note that when understanding what do tonsils look like, they will appear inflamed in this state. Normal tonsils, however, will appear as two fleshy mounds at the back of the throat.

When do Tonsils Symptoms Usually Occur?

Inflamed tonsils usually occur in children between the ages of five and fifteen, as young age is one of the most significant risk factors for getting tonsillitis, according to the Mayo Clinic in 2023. Being young with an underdeveloped immune system can explain why are my tonsils swollen.

What are the Risk Factors for Tonsils?

The risk factors for inflamed tonsils and tonsillitis, which can help us better understand why do my tonsils hurt, are listed below.

  1. Young Age - Young age is a risk factor due to children having immune systems that are still developing.
  2. Exposure to Germs - Frequent exposure to germs, such as a school, can play a factor in an increased likelihood of developing tonsillitis.
  3. Cardiovascular Disease - Cardiovascular disease
1. Young age

Young age is the biggest risk factor for inflamed tonsils and tonsillitis, affecting the ages of 5-15 the most. This is due to children having immune systems that are still developing. As these immune systems develop in older children and adults, the risk factor for tonsillitis and tonsil pain decreases significantly. For example, a study done by MD Pub in 2019 showed that children aged 6-12 years had about 69 cases of tonsillitis, compared to older children aged 13-18 years, who only had 18 cases. That means the ages of 6-12 are 26% more likely to develop tonsillitis than those of 13-18.

2. Frequent exposure to germs

Frequent exposure to germs, such as in school and classroom settings, can cause school-aged children to be more susceptible to getting infected tonsils. This risk factor is due to increased exposure to bacteria in viruses in these high-traffic places.

3. Cardiovascular disease

Cardiovascular disease is linked to tonsillitis and swollen tonsil, particularly from bacterial infections around strep throat. Cardiovascular disease can occur after tonsillitis develops into a severe condition known as rheumatic fever, associated with a fever and painful joints, according to the NIH National Library of Medicine in 2016.

What are the Complications of Tonsils?

Tonsils Check

The complications of tonsils swollen, according to NIH Inform in 2022, are included below, and only apply to bacterial infections.

  • Ear Infection - An ear infection, explicitly involving the fluid between the eardrum and inner ear, becomes infected. This can happen when the infection from the throat is not contained and travels to the ear.
  • Quinsy - a quinsy is a collection of pus that builds up between the tonsils and the throat wall. This can occur when the infection has neutralized white blood cells, and they are not effectively flushed away from the infected site via the lymphatic pathways.
  • Obstructive Sleep Apnea - Obstructive Sleep Apnea is when the throat walls relax during sleep, which can close too much for the windpipe. This can lead to poor quality of sleep and difficulty breathing.

How do Tonsils Affect the Body?

Inflamed tonsils affect the body by becoming swollen and sore, causing the voice to become hoarse due to pain, along with difficulties eating and swallowing. The body may also be affected by an accompanying fever, soreness in the neck and head, tonsils hurt, and pain in the glandular area.

How do Tonsils Affect the Brain?

Inflamed tonsils affect the brain in rare cases when, according to Columbia University in 2015, immune cells infected by strep bacteria travel to the brain and cause inflammation in the brain. This brain inflammation is thought to lead to neuropsychiatric disorders in young children with recurrent tonsillitis brought on by strep bacteria. This helps us better understand what are your tonsils and how they impact the immune system.

How do Tonsils affect Lifestyle?

Inflamed tonsils affect lifestyle by causing a person to experience frequent infections, or blocked airways, according to ENT Health in 2019. Other impacts on lifestyle include breathing issues, difficulty swallowing, and trouble sleeping. If a bacterial infection causes tonsillitis, there is tonsillitis medicine that a doctor prescribes to help speed up the recovery process.

How are Tonsils being Diagnosed?

Diagnosing inflamed tonsils is done by a doctor as they know what do swollen tonsils look like, and what to look for. The doctor will examine the throat for redness, swelling, and possibly white spots on the tonsils. The doctor will also inquire if the person has other symptoms, such as a fever, cough, or stomachache. They may also look in the person’s ears and nose for possible infections.

How are Tonsils Prevented?

The best way to prevent inflamed tonsils and tonsillitis, according to Mayo Clinic in 2023, include washing the hands, especially before eating and after using the washroom, as this is the easiest way for germs to enter the body, which is what are your tonsils for. Other ways to prevent tonsillitis include not sharing food, drink, or utensils, and using a new toothbrush after getting tonsillitis.

What are the Treatments available for Tonsils?

Two treatments are usually used for inflamed tonsils, antibiotics, and tonsillectomy, according to My Health Alberta in 2021. Antibiotics are used to treat bacterial infections that are causing sore tonsils and are prescribed by a doctor, helping reduce symptoms and the body to recover faster. In complications or extreme cases, a doctor may recommend a tonsillectomy, which is a removal of the tonsils. With the tonsils removed, they can no longer become infected and cause pain.

What are the Treatments available for Tonsils at home?

Treating swollen and inflamed tonsils at home includes plenty of rest and drinking warm liquids, such as soups or teas. Warm liquids help ease the pain in the throat. Likewise, hard foods should be avoided, as this can cause pain in the throat tonsil. For immediate relief of tonsil pain, gargling with salt water can change the pH of the throat, making it more difficult for bacteria and viruses to thrive. In addition, pain relievers like Ibuprofen can help ease pain, and throat lozenges that include mild anesthetics can also help provide relief.

How do Antibiotics Help With Tonsils?

Antibiotics help with inflamed tonsils, specifically bacterial tonsillitis, by attacking the particular bacterial strain causing the infection. In most cases, antibiotics such as penicillin will be prescribed to attack and destroy group A streptococcus bacteria, the type of bacteria most commonly being bacterial tonsillitis. Simply looking in a mirror for signs of redness or swelling can help how do you know if your tonsils are swollen, especially if there is pain and tenderness along with the visible signs.

What to Expect in Tonsils Condition?

You can expect, when you have inflamed tonsils, to have your tonsils feeling sore and swollen. You may also feel it difficult to breathe, talk comfortably, or swallow without feeling pain. You may also have a fever, stomachache, and soreness in the neck and lymph nodes, and it can better shed light on what is tonsils, especially when they are infected. 

How Long Do Tonsils Last?

Infected and inflamed tonsils usually only last 3 to 4 days, according to the NHS in 2021, along with their accompanying symptoms.

What are the Other Types of Tonsils?

The most common types of inflamed tonsils location in the throat, or tonsillitis, are included below.

  • Viral tonsillitis, caused by a viral infection, such as the flu. Viral infections are usually waited out, and not treated with prescribed medications, as antibiotics don’t work on viruses.
  • Bacterial tonsillitis, also known as strep throat, is usually caused by bacterial infections such as Group A Streptococcus. This can be treated with antibiotics.

Can an individual with Tonsils undergo surgery?

Yes, a person can undergo surgery if they have tonsillitis. A specific surgery is used if a doctor recommends a person to have their tonsils removed due to repeated tonsillitis, called a tonsillectomy. This is usually only performed in worst-case scenarios and is not a common practice. Instead, a doctor will typically prescribe over the counter medicine for tonsillitis.

Will tonsillitis naturally go away?

Yes, for the most part, tonsillitis will go away on its own in a few days. Home remedies that help speed up the process and make it easier for a person include rest and plenty of fluids. Other home medicine for tonsillitis include painkillers and anesthetic throat lozenges.

Is tonsillitis caused by bacteria or viruses?

Tonsillitis can be caused by either bacteria or viruses, both of which are treated differently regarding bacteria vs. virus. Regarding bacteria vs. virus infections, viral infections in the tonsils are usually waited out without doctor-prescribed medication. Doctor-prescribed antibiotics can treat bacterial infections. To get a better idea of how to know if your tonsils are swollen, you can check in the mirror with a flashlight, or have someone else shine a light down your throat to see if the tonsils are red, inflamed, or have white spots on them.

What is the difference between Tonsils vs. Strep Throat?

To better understand the difference between tonsillitis vs. strep throat, it’s important to note that one is a general condition, while the other is more specific. Regarding tonsillitis vs. strep throat, tonsillitis refers to inflammation of the tonsils that bacteria or viruses can cause. Strep throat is specifically caused by group A Streptococcus bacteria and can help us better understand normal vs swollen tonsils. Normal tonsils won’t appear inflamed or feel sore, while swollen tonsils are sore, appear red and swollen, and may indicate an infection.