Is Your Sore Throat a Cold, Strep Throat, or Tonsillitis?

Got a sore throat? Wonder if your painful sore throat is from a cold, strep throat, or tonsillitis? Here's help with how to tell.

What's the Difference Between a Cold, Strep Throat, and Tonsillitis?

A sore throat is often the first sign of a cold. However, a sore throat from a cold often gets better or goes away after the first day or two. Other cold symptoms such as a runny nose and congestion may follow the sore throat.
Strep throat, which is an infection due to streptococcus bacteria, is another cause of sore throats and tonsillitis. With strep throat, the sore throat is often more severe and persists. 
Tonsillitis is a painful inflammation or infection of the tonsils, the tissue masses located at the back of the throat.

Is a Sore Throat With a Cold Caused by Viruses or Bacteria?

Sore throats can be caused by viruses or bacteria. The most common causes of sore throats are viruses. Viral sore throats are often accompanied by other cold symptoms that may include a runny nose, cough, red or watery eyes, and sneezing. Other causes of sore throat include smoking, pollution or irritants in the air, allergies, and dry air.

Along With a Sore Throat, What are Other Cold Symptoms?

In addition to a sore throat, other common cold symptoms include:

• Runny nose
• Sneezing
• Cough
• Mild headache
• Mild body aches
• Fever

How Are Sore Throats With Colds Treated?

Although there is no cure for a sore throat caused by a cold virus, there are ways to help you feel more comfortable. Drinking warm liquids, gargling with warm salt water, sucking on ice chips, or taking an over-the-counter medicine may relieve symptoms of pain or fever. When you are sick with a cold, it is also important to get enough rest, eat a healthy diet, and drink plenty of fluids.

Can Medications Relieve Symptoms of a Sore Throat With a Cold?

Over-the-counter cold medications may relieve cold and sore throat symptoms. However, the benefits of these drugs are minimal. Some cold medications include:

• Pain relievers, such as acetaminophen and ibuprofen and naproxen, to relieve the aches and pains of a cold and sore throat. ( Aspirin should not be given to children because of its link to Reye's syndrome, a disorder that can cause brain damage and death.)
• Sore throat sprays and lozenges to soothe your throat and numb the throat pain temporarily. (Lozenges should not be given to young children)
• Decongestant nasal sprays to relieve a sore throat caused by postnasal drip -- nasal drainage that runs down your throat. (Be sure to stop using nasal decongestant sprays after three days, or you may have an increase in congestion when you stop them.)

Antibiotics should not be used to treat a cold virus and sore throat. Antibiotics are effective only against bacteria. They will not work on sore throats associated with colds, which are caused by viruses.

How Is Strep Throat Different From a Sore Throat With a Cold?

Strep throat is caused by an infection of streptococcus bacteria. Strep throat spreads by having contact with an infected person's saliva or nasal secretions. Although strep throat is more common in children aged 5 to 15, it also occurs in adults. To diagnose strep throat, your doctor can check a rapid strep test or send a throat swab to the lab for a culture.

Is Strep Throat More Serious Than a Sore Throat With a Cold?

Strep throat can cause more serious illnesses, such as rheumatic fever, a disease that may harm the heart valves. That's why it's important to get proper medical treatment. With proper treatment, strep throat is usually cured within 10 days.

Are Strep Throat Symptoms Different From a Sore Throat With a Cold?

Strep throat symptoms are usually more severe than symptoms of a sore throat with a cold and may include the following:

• Sudden sore throat
• Loss of appetite
• Painful swallowing
• Red tonsils with white spots
• Fever

Do I Need to See my Doctor if I Think I Have Strep Throat?

The symptoms of a cold and strep throat can be very similar. If you think you have symptoms of strep throat, visit your health care provider. Your doctor will ask you about your symptoms and do a physical exam, and you may be given a strep test. 

What Is a Strep Test for a Sore Throat?

A rapid strep test checks for streptococcus bacteria infection in the throat. The test is painless and takes very little time. The tip of a cotton swab is used to wipe the back of the throat. The swab is then tested right away. If the strep test is positive, you have strep throat. If the strep test is negative, you likely do not have strep throat. However, if there are strong signs of strep throat, your health care provider can do a different throat swab test that is sent to the lab to see if strep bacteria can be grown (cultured) from it. A throat culture takes a couple of days for results. 

What Is the Treatment for Strep Throat?

Strep throat is treated using antibiotics, which kill the bacteria causing the infection. Antibiotics are often taken as pills or given as a shot. Penicillin and amoxicillin are common antibiotics used to treat strep throat. Other antibiotics are prescribed for people who are allergic to penicillin.
Follow your health care provider's instructions for antibiotic use. Take all of the medication, even if you feel better. You should feel better within a day or two. A person with strep throat should stay home until 24 hours after starting the antibiotic.

What If My Strep Throat Isn't Getting Better?

If your strep throat is not getting better, let your health care provider know right away. Do not stop taking your prescribed medicine unless your health care provider tells you to. Call your health care provider if these symptoms occur:

• Fever one or two days after feeling better
• Nausea or vomiting
• Earache
• Headache
• Skin rash
• Cough
• Swollen glands
• Painful joints
• Shortness of breath
• Dark urine, rash, or chest pain (may occur three to four weeks later)

How Is Tonsillitis Different From a Sore Throat With a Cold?

Sometimes a sore throat is caused by tonsillitis, an inflammation of the tonsils. Tonsillitis can be caused by viruses or bacteria. While the tonsils' job is to help fight infection, the tonsils can also become infected. When they do, the result is tonsillitis and a very painful sore throat.

How Are Tonsillitis Symptoms Different From Symptoms of a Sore Throat With a Cold?

In addition to a sore throat, a cold usually causes nasal symptoms, such as runny nose or congestion. With tonsillitis, your tonsils become swollen and may have telltale white or yellow spots. Other symptoms with tonsillitis include the following:

• Bad breath
• Fever
• Voice changes because of swelling
• Painful swallowing
• Swollen lymph glands in neck

How Is a Sore Throat From Tonsillitis Treated?

If the tonsillitis infection is bacterial like strep throat, then antibiotics are given. If the tonsillitis infection is viral, antibiotics will not help. The virus must run its course for the sore throat to resolve. For either type of throat infection, the following treatment measures may help:

• Getting plenty of rest
• Drinking lots of fluid
• Eating smooth, soothing foods like gelatin, ice cream, shakes, frozen desserts, and soup
• Avoiding crunchy or spicy foods
• Using a vaporizer
• Taking over-the-counter pain relievers such as acetaminophen, naproxen, or ibuprofen. Children should not take aspirin.

If the tonsillitis infections occur repeatedly, or if the tonsils are interfering with sleep and breathing, the doctor may recommend a tonsillectomy, which is the surgical removal of the tonsils.