What are the reasons for persistent white spots and pain in the back of my throat?

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Throat pain with whitish lesions over the tonsils and pharynx lasting more than three weeks and not responding to treatment suggests viral pharyngotonsillitis. Usually, viral pharyngotonsillitis is associated with severe throat pain, generalized weakness, difficulty swallowing, and sometimes fever. If you have all these symptoms, then we can suspect viral pharyngotonsillitis. It is self-resolving, and it takes about 4 to 6 weeks to resolve. Meanwhile, symptoms can be reduced by taking painkillers, and antiseptic mouth gargles. A short course of steroids is beneficial but has to be taken under the supervision of an ENT (ear, nose, and throat) doctor. If your symptoms are different from what I have described, let me know. I will analyze your symptoms and give you a differential diagnosis and available treatment.

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I have seen the uploaded photos (attachments removed to protect the patient's identity). I need to correlate findings in your throat with your symptoms. Suppose you have a mild sore throat with whitish lesions that keep changing sides and are not associated with difficulty swallowing and fever. In that case, it is generally due to laryngopharyngeal reflux disorder (LPRD). It is due to frequent reflux of digestive acid and enzymes in the throat, causing inflammation. Usual symptoms are throat pain, foreign body sensation, throat dryness, throat clearing, etc. Whitish lesions in the throat are partially digested food debris collected inside the tonsil crypts and inflamed pharyngeal lymphatic bands. Confirmation of the diagnosis is difficult, but whenever LPRD is suspected, we give a trial of anti-reflux medications for a few weeks. You need to know that there may not be any symptoms of acidity even in a severe case of LPRD.