Do You Have Just a Sore Throat or Is It Strep?

Many different factors can cause sore throats. Viruses, bacteria such as Streptococcus pyogenes, dry air, allergies or even drainage from a runny nose can make your throat hurt.

But not all sore throats are created equal. While allergies or a runny nose are painful nuisances, strep throat is an illness that needs a doctor’s diagnosis and treatment.

If you suspect strep throat, there are several reasons to seek treatment. For one thing, you can infect others. The bacteria that cause strep throat can also spread to other tissues, causing a more serious infection. And if you leave strep throat untreated, in rare circumstances, it can lead to a more severe illness like rheumatic fever, a potentially fatal disease that can damage your heart valves.

But how can you tell if you just have a sore throat or if you’re developing the worse condition of strep throat? Family medicine specialist Daniel Allan, MD, breaks down the difference and explains when you should make a doctor’s appointment.

Symptoms of sore throat vs. strep

Viral infections, like the common cold or flu, cause sore throats (pharyngitis). And it usually comes with other symptoms like:

• Runny nose.
• Red or watery eyes.
• Sneezing.
• Cough.

So, what’s the difference between a sore throat and strep throat? For starters, having a cough is a major symptom that sets a sore throat apart from strep.

“You do not have a cough with strep. If you’re coughing, that typically means no strep,” says Dr. Allan. “Also, when you look in the throat of a person with a sore throat caused by a cold virus, you typically do not see pus or exudate in the back of the throat.”

Colds usually take several days to develop and typically go away on their own within five to seven days. But strep throat is a bacterial infection that doesn’t always go away on its own.

If you were exposed to someone who had strep recently, that’s important information to share with your healthcare provider. Strep can be spread easily by sharing personal items with a person who’s infected, having close contact with someone who’s infected, or even through the air by sneezing or coughing. Plus, it comes with a more severe set of symptoms that include:

• Sudden sore throat.
• Red tonsils that have white spots on them.
• Pain when swallowing.
• Fever.
• Swollen neck glands.
• Loss of appetite.
• Headache.
• Abdominal pain.

Viral illnesses can have the same symptoms as strep throat, so it’s important to get a throat swab to confirm the presence of the strep bacteria in your throat if you experience any of these symptoms. A healthcare provider will dab the back of your throat with a cotton swab and the swab is then tested for the presence of the bacteria Streptococcus pyogenes.

Tips to find relief

If you have strep throat, a healthcare provider can prescribe antibiotics for treatment. But taking antibiotics for sore throats without a confirmed diagnosis of strep can create resistance to the drugs or unnecessary side effects, so getting tested for strep is important.

“Most strep will self-resolve. However, there is the risk of rheumatic fever if it’s untreated, so I would not recommend forgoing testing and treatment,” Dr. Allan warns. “If there is any concern of strep, then I would recommend getting tested.”

Antibiotic treatment for strep takes about 10 days, but treating a sore throat can be a bit less defined. There’s no one set cure for a sore throat caused by a virus and, often, the only thing you can do is wait until the virus works its way out of your system. But you can take steps to make yourself more comfortable and manage your symptoms by:

• Drinking warm liquids and plenty of water.
• Gargling with warm, salt water.
• Sucking on ice chips.
• Taking over-the-counter pain medicine like acetaminophen or ibuprofen for relief.
• Prioritizing rest.

If common winter illnesses have you guessing what ails you, it’s always good to make an appointment with a healthcare provider. And while there are home remedies that can help soothe symptoms, making an appointment with your provider’s office is key to figuring out just what might be happening with your body (and what kinds of treatments are available).