Sore throat vs. strep throat

You wake up one morning with a scratchy, uncomfortable feeling in your throat. Your first thought: Is it just a plain old sore throat or something more serious?

It can be difficult to tell whether you’re dealing with allergies, fighting a virus or dealing with a case of strep throat. Understanding what’s causing your symptoms can help you get the right treatment and feel better sooner.

Causes of throat pain

A sore throat, also known as pharyngitis, is an umbrella term used to describe pain in the throat. Many different factors can cause your throat to hurt, including viruses, bacteria, allergens, dry air and acid reflux.

Most sore throats are caused by viruses — the same ones that cause the common cold, the seasonal flu and COVID-19. Not all sore throats are created equal, however.

Strep throat, which is an infection due to streptococcus bacteria, is another, more serious version of a sore throat. The bacteria that cause strep throat is very contagious and typically spread through respiratory droplets or direct contact.

“Generally, strep throat is more common in children,” says Dr. Daniel Duong, a family medicine doctor with Sharp Rees-Stealy Medical Group. “Adults can get it too, but sore throat symptoms in adults are more likely to be caused by a virus.”

Sore throat vs. strep throat symptoms

Distinguishing between a viral sore throat and bacterial strep throat can be challenging. But there are some key differences.

“Strep throat infections usually have several defining features, such as swollen tonsils with white spots on them, tender and enlarged lymph nodes around the neck, a fever over 100.4 degrees and an absence of cough,” Dr. Duong explains.

Sore throat symptoms

• Cold symptoms such as coughing, headache or runny nose

• Red, swollen tonsils

• Red, swollen throat

• Difficulty swallowing

Strep throat symptoms

• Red, swollen throat

• White patches or streaks on the tonsils

• Swollen lymph nodes in the neck

• Tiny, red spots on the roof of the mouth

• Fever, headache or chills

• Difficulty swallowing

Testing for strep

A strep test or throat culture can determine a strep throat diagnosis. “If the test is negative, the sore throat is most likely caused by a virus,” Dr. Duong says.

There are two types of tests for strep throat:

Rapid strep test: A rapid strep test involves swabbing the throat and running a test on the swab. Results are available within about 15 minutes.

Throat culture: If the rapid strep test is negative, and your provider still suspects strep, a throat culture may be performed. Results are available within a few days.

If you’re concerned about your sore throat symptoms, it’s a good idea to speak with a health care provider. According to Dr. Pany Robinson, medical director of On-Demand Telemedicine at Sharp Rees-Stealy, you don’t have to wait for a visit with your doctor to get care.

“Strep throat symptoms can be evaluated over the phone with our nurse triage team or in a virtual urgent care visit,” Dr. Robinson says. “If appropriate, the provider can quickly get you a strep test ordered at one of our locations.”

Treatment of strep throat

If a diagnosis of strep throat is confirmed, a provider can prescribe an antibiotic treatment. People typically start to feel better after about one or two days of treatment.

“It is important to use antibiotics to prevent the infection from going untreated and potentially causing other conditions,” says Dr. Duong. “In unusual cases, strep throat can cause rheumatic fever, a rare but serious bacterial illness that primarily affects children.”

If it turns out your sore throat is due to a pesky cold or other virus, at-home treatments can help provide some relief. Dr. Duong recommends acetaminophen or ibuprofen to help with the pain.

“Sipping warm tea with honey, gargling warm salt water, and throat lozenges can also help soothe the pain,” he says.

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