The difference between a strep throat and a sore throat

It’s common to get a sore throat from time to time. Nagging, scratchy, or painful symptoms can cause you to wonder: Do I have strep throat?

Understanding what’s causing your sore throat can help you get the right treatment, so you can feel better sooner.

What Causes a Sore Throat?

Pharyngitis is the medical term for a sore throat. Many patients with sore throat have inflammation of the pharynx (pharyngitis). It happens when the mucous membranes in the back of your throat, or pharynx, become swollen or inflamed. Pharyngitis can be due to allergies, irritants like smoke or infections, or even acid reflux.

Strep throat is a type of sore throat which is caused by bacterial infection. It’s a bacterial infection caused by bacteria called group A Streptococcus, or group A strep. Strep throat is one of the common infectious causes of sore throat or acute pharyngitis.

Common causes of sore throat

You can get a sore throat for many reasons. The two most common general causes of sore throat are:

Viral infections

Viruses cause between 50% to 80% of acute pharyngitis, according to the National Library of Medicine. These viruses often target your upper respiratory tract (URI). Your URI includes your nose, nasal cavity, mouth, throat, and voice box.

Common viruses that cause sore throat include:

  • Adenoviruses. These cause mild cold- and flu-like symptoms. They can happen throughout the year.
  • Coronaviruses, including COVID-19. Cough and sore throat are common signs of COVID-19.
  • Rhinoviruses. These viruses are the most common cause of colds, according to the Centers for Disease Control and Prevention.
  • Flu viruses, including influenza or parainfluenza.

Bacterial infections

Bacterial infections are the other common cause of sore throats. Sometimes viral infections can turn into bacterial infections. Severe pain with sore throat is often a sign of a bacterial infection, such as strep throat.

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What Is Strep Throat?

Several types of bacteria can cause you to have a sore throat. Group A Strep is the most common bacterial infection that causes sore throat. It causes 5% to 36% of acute pharyngitis cases, according to the National Library of Medicine.

Group A Strep is very contagious. You can get it from someone who has strep when they breathe, cough, or sneeze. You can also get it from touching an open sore or cut on someone who has strep.

While anyone can get a sore throat, strep throat is more common in children. According to the Centers for Disease Control and Prevention, three in 10 children with a sore throat have strep throat. Only one in 10 adults with a sore throat has strep throat.

Sore Throat Symptoms

Your sore throat symptoms will depend on whether you have a viral infection or bacterial infection.

Viral infection sore throat symptoms

If you have a sore throat no fever, chances are your sore throat isn’t related to strep throat. These are symptoms that a viral infection, and not strep, is causing your sore throat:

  • Cough.
  • Conjunctivitis, or pink eye.
  • Runny or stuffy nose.
  • Hoarse voice.
  • Mouth ulcers.

Strep throat symptoms

Symptoms of strep throat are often more severe than symptoms of viral infections. Common strep throat symptoms include:

  • Fever.
  • A sore throat that starts suddenly.
  • Pain when swallowing. This can make it hard to eat or drink.
  • Red and swollen tonsils.
  • White patches or streaks of pus on the tonsils.
  • Tiny, red spots (called petechiae) on the roof of your mouth.
  • Swollen lymph nodes in the front of the neck

You may not have all of these symptoms. Other symptoms of strep throat include:

  • Headache.
  • Stomach pain, nausea, and vomiting. These symptoms are more common in children.

Treatment for Sore Throat

How you treat your sore throat also depends on what’s causing it.

Viral sore throat treatment

There’s no cure for viruses, such as the common cold. But vaccines for the flu and COVID-19 can help reduce your chances of catching these diseases. Flu vaccines and COVID-19 vaccines also reduce your chances of ending up in the hospital because of severe symptoms.

According to the CDC, it’s safe to take the flu and COVID-19 vaccines together.

The following may help ease the pain and symptoms of a sore throat caused by cold viruses.

  • Taking an over-the-counter pain reliever. These include acetaminophen, ibuprofen, and naproxen.
  • Drinking warm liquids, such as hot tea with honey.
  • Gargling with warm saltwater.
  • Sucking on throat lozenges or ice cubes.
  • Using a nasal decongestant spray. This can help if draining from nasal congestion is causing your sore throat.

Note: Antibiotics don’t work on sore throat caused by viral infections. Using antibiotics when you don’t need to can lead to antibiotic resistance. That means when you need the antibiotics to work, they won’t.

Strep throat treatment

If you have strep throat, it’s important to get treatment right away. Antibiotics are the main treatment for strep throat. These are drugs that kill the bacteria that is causing your strep throat.

Antibiotics help get rid of sore throat symptoms and help you feel better faster. They can also help prevent you from spreading strep. Most importantly, they can help prevent you from developing severe complications from a strep infection.

If your doctor prescribes antibiotics, be sure to follow your doctor’s directions on taking them. Even if you start to feel better, finish all your antibiotics.

To avoid spreading strep throat to others, stay home and don’t return to school or work until:

  • You don’t have a fever for 24 hours; and
  • You’ve taken antibiotics for at least 12 hours.

Complications from strep throat

Left untreated, strep throat can cause serious complications. Taking antibiotics helps to prevent these complications. While they are not common, complications include:

  • Pockets of pus, or abscesses, in your neck or around your tonsils.
  • Ear or sinus infections.
  • Rheumatic fever. This serious disease can affect your heart, brain, skin, and joints.
  • A kidney disease called post-streptococcal glomerulonephritis.

How long does strep throat last?

You will start to feel better within one or two days of starting antibiotics. With antibiotic treatment your strep throat should go away completely within seven to 10 days.

When to See a Doctor.

You should see your doctor if:

  • You have symptoms of strep throat.
  • You have severe sore throat pain or the pain lasts more than two days. A sore throat from colds often goes away after a day or two.
  • You are taking antibiotics for strep throat and you’re not feeling better after 48 hours.

If your doctor thinks you may have strep, they can do a quick strep test. This involves using a long cotton swab to take a small sample from the back of your throat. If this sample tests positive for strep, your doctor will prescribe antibiotics.

Pharyngitis. StatPearls. Link.

Adenoviruses. Centers for Disease Control and Prevention. Link.

Adenovirus Fact Sheet. Centers for Disease Control and Prevention. Link.

Common Colds: Protect Yourself and Others. Centers for Disease Control and Prevention. Link.

The Common Cold. Principles and Practice of Pediatric Infectious Disease. 2008. National Library of Medicine. Link.

Upper Respiratory Tract. Link.

Group A Streptoccal (GAS) Disease. Centers for Disease Control and Prevention. Link.

Pharyngitis (Strep Throat). Centers for Disease Control and Prevention. Link.

Strep Throat: All You Need to Know. Centers for Disease Control and Prevention. Link.

Rheumatic Fever. All You Need to Know. Centers for Disease Control and Prevention. Link.

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