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Strep Throat Vs. Sore Throat: Which Is It?
Most sore throats (medically known as pharyngitis) are caused by viruses, but one variety—caused by bacteria from Group A streptococcus (Streptococcus pyogenes)—can have lasting effects if not treated properly. Strep throat is a bacterial infection that causes 1 out of 10 sore throats in adults and 3 out of 10 in children.
It can be tricky to tell the difference between "regular" sore throats and strep, but the appearance of your throat and pain severity may help you decide whether to let it run its course or see a provider for testing and treatment.
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Strep Throat vs. Sore Throat vs. Normal Throat Throat and Inflammation Appearance A healthy throat is pink, moist, and not painful. When you have a sore throat, the inside of your mouth, throat, and the lymph nodes around your head and neck can become inflamed and swollen. Sometimes, the inside of your mouth may also appear swollen and red from inflammation. Strep throat can appear similar, but tiny red spots called petechiae on the roof of your mouth or white patches on your tonsils are telltale signs of a strep throat infection. Sore throats can develop suddenly from injury or irritation, and viral sore throats can develop throughout an illness, such as a cold. In the case of strep throat, you will usually start to notice symptoms between two and five days after exposure to Group A strep. Sensations and Pain Intensity How your throat feels can also give you clues about what's causing it. A sore throat often develops with a cold and improves in about a week. In comparison, strep throat usually appears very quickly with painful swallowing. Instead of noticing differences in pain and sensation, you might notice symptoms in other areas of the body when you have strep throat. Sore Throat Dryness Hoarseness Painful swallowing Scratchy feeling Different Causes Viruses are the primary cause of sore throats, but allergies, a dry environment, and smoking or exposure to secondhand smoke can also trigger them. You may also experience a sore throat after straining or overusing your voice or from a traumatic injury, such as swallowing hot liquids or foods that scratch your throat. Strep, on the other hand, has just one cause: Group A strep. Group A strep is highly contagious, and symptoms usually appear two to five days after exposure to the bacterium. How to Relieve Throat Pain With Strep vs. Soreness There are many home remedies and self-care options to soothe a sore throat, including: These same treatments could soothe soreness caused by a strep infection, but prescription antibiotics are necessary to effectively treat strep throat and prevent complications. Healthcare providers typically prescribe penicillins and clindamycin to treat strep throat. When to Consider Antibiotics If you think you have strep throat, go to urgent care or schedule a sick visit with your primary care provider for resting. They will swab the back of your throat and use that sample to determine if Group A strep is present. If so, you'll need antibiotics to treat the strep throat infection. Sore throats caused by injury, irritation, allergies, or viral infections should not be treated with antibiotics. More than half of all outpatient antibiotics in the United States are prescribed inappropriately for things like viral upper respiratory infections and skin conditions. You can develop antibiotic resistance when you take antibiotics for nonbacterial conditions. When this occurs, bacteria build up an immunity to the drugs designed to kill them, and they don't work as well over time. Without careful prescribing and use of antibiotics, superbugs resistant to many antibiotics will become more common and dangerous. Sore Throat, Strep, or Something Else? If you have tried home remedies, tested negative for strep, and continue to have a sore throat that isn't improving, a healthcare provider may check for other conditions that could appear with a sore throat like: It's important to identify the actual cause of your sore throat to prevent ongoing infection and complications. Post-Infection Complications A sore throat that is left untreated or takes a long time to resolve can lead to a wide range of complications—often due to the cause rather than the sore throat itself. These complications may include things like: Blood clots Chronic irritation Lemierre's syndrome (an infected blood clot in a vein) Severe infection or sepsis Group A strep can cause lasting complications, too. Complications of untreated or ineffectively treated strep throat include: Abscesses (pockets of pus) in tonsils or the neck Ear infection Kidney damage Rheumatic fever Scarlet fever Sinus infection Summary A sore throat is a symptom of many infections and some chronic conditions. If your sore throat is severe and unrelenting and causes spots to appear on the roof of your mouth or tonsils, you should see a healthcare provider to be tested for Group A strep (strep throat). Group A strep requires antibiotic treatment to prevent dangerous complications, but sore throats can often be eased with supportive care like cold liquids and lozenges. 10 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Martin JM. Sore throat (pharyngitis). Antimicrobe. N.D. Centers for Disease Control and Prevention. About strep throat. Center for Disease Control and Prevention. Sore throat basics. Avcı D, Bayar Muluk N, Hao SP. Pharyngitis. In: Cingi, C, Yorgancıoğlu, A, Bayar Muluk, N. Cruz, A.A. (eds) Airway Diseases. Springer, Cham. 2023. Doi:10.1007/978-3-031-22483-6_32-1 Perry M. The throat: Part II - Inflammation, infections and the acutely painful throat. Diseases and Injuries to the Head, Face and Neck. Springer, Cham. 2021. Doi:10.1007/978-3-030-53099-0_31 Coutinho G, Duerden M, Sessa A, Caretta-Barradas S, Altiner A. Worldwide comparison of treatment guidelines for sore throat. IJCP. 2020. Doi:10.1111/ijcp.13879 Johnson AF, LaRock CN. Antibiotic treatment, mechanisms for failure, and adjunctive therapies for infections by group A streptococcus. Front. Microbiol. 2021. Doi:10.3389/fmicb.2021.760255. Centers for Disease Control and Prevention. About group A strep infection. Centers for Disease Control and Prevention. Outpatient antibiotic prescribing in the United States. Young EH, Panchal RM, Yap AG, Reveles KR. National trends in oral antibiotics prescribing in United States physician offices from 2009 to 2016. Pharmacotherapy. August 2020;40(10):1012-1021. Doi:10.1002/phar.2456. By Rachael Zimlich, BSN, RNZimlich is a critical care nurse who has been writing about health care and clinical developments for over 10 years. Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an ErrorSore Throat: The Basics
Everyone knows what a sore throat feels like. It's one of the most common health complaints, particularly during the colder months of the year when respiratory diseases are at their peak.
The raw, scratchy, burning feeling at the back of your throat that hurts most when you swallow is often the first warning sign that you have a cold or that the flu is on the way. Rarely, it can be a symptom of more serious conditions, so you should watch how it develops.
Another name for the throat is the pharynx. That's why a sore throat is sometimes called pharyngitis.
There are two main types of sore throat:
Acute. This means your sore throat goes away quickly. In most cases, acute sore throats are caused by the cold, flu, or other common illness. They typically last 3-10 days.
Chronic. If your sore throat lasts longer than that or it keeps coming back after it goes away, it's called chronic.
Sore throats differ based on what part of your throat is affected. Some examples include:
Tonsillitis causes inflammation and soreness of the tonsils, the two small masses of tissue at the back of your throat
Laryngitis is inflammation of your larynx, or voice box, which can also cause your throat to feel sore.
Epiglottitis is a bacterial infection that causes the flap at the entrance of your esophagus, called your epiglottis, to swell. This condition can cause a life-threatening airway blockage.
Croup is a viral infection that mainly affects children. It causes inflammation of the larynx and trachea.
Each of these types of sore throat will feel different because of the different areas of the throat that are affected.
If you have a sore throat, you might notice:
Most sore throats are caused by infections. If you have an infection, you also might notice:
If you have a sore throat from a cold or flu, you may also have swollen glands on your neck. (Photo Credit: Moment RF/Getty Images)
There are many causes of sore throat. The most common are bacterial and viral infections like the cold and flu.
Viral infections
This is the most common cause of a sore throat. It happens when a virus gets in your body and makes you sick.
Some viruses that can cause sore throats are:
Bacterial infections
Not all infections are caused by viruses. Some are caused by a different type of germ called bacteria. There are many different kinds of bacteria, but the one most likely to cause a sore throat is Streptococcus pyogenes (group A streptococcus), or "strep" for short. Some cases of sinus infections or tonsillitis are also caused by bacteria.
Allergies
Some people get sore throats from allergies. Common culprits include pet dander, dust, and pollen. Allergies can trigger a postnasal drip, which is when mucus drips down your throat. And if you breathe out of your mouth because of a stuffy nose, the dry air also can irritate your throat.
GERD
Gastroesophageal reflux disease, or GERD, is a condition when stomach acid backs up into your throat. You might feel a burning sensation and get a sore throat. Some other signs your sore throat is caused by acid reflux are heartburn, hoarse voice, and a lump-like feeling in your throat.
Smoking or being around people who smoke
Tobacco and other chemicals can irritate your throat, even if you're only breathing in someone else's smoke. Plus, smoking raises your risk of getting throat, tongue, or mouth cancer.
Other things that can cause a sore throat include:
Dry air. This can dry out your throat, making it feel scratchy.
Mouth breathing. Breathing through your mouth, usually when you're asleep or have a stuffy nose, also can dry your throat out.
Pollution. Chemicals in the air can irritate your throat.
Spicy foods. Eating spicy foods can trigger a sore throat.
Overuse. Shouting, talking loudly, and singing can tire out your throat muscles, causing them to feel sore.
Some cancers. Tumors in your throat or tongue can cause a sore throat. Keep an eye out for hoarseness, trouble swallowing, loud breathing, a lump on your neck, and blood in your spit or phlegm.
Your doctor will probably start by looking at your throat with a tiny flashlight. They may also check your nose and ears. Then, they'll feel the sides of your neck for any lumps, which can be a sign of swollen lymph nodes. The doctor also will use a stethoscope to listen to your lungs as you breathe.
If your doctor thinks you might have strep throat, they'll do a throat swab. This is when they brush a sterile swab (like a long Q-tip) against the back of your throat. Then, they test the swab to see if it picked up any of the bacteria that cause strep throat. You'll probably get a result in a few minutes from a rapid antigen test, but will need to wait a day or two for the results to be finalized with a more reliable test called a throat culture.
The way you treat a sore throat depends on what is causing it. Most sore throats are caused by viral infections, which usually go away on their own in 5–7 days. Antibiotics won't fix this kind of infection. But in the meantime, you can take over-the-counter medications to help ease the soreness.
Over-the-counter (OTC) medicines for sore throat
Medications like acetaminophen and ibuprofen can help relieve fevers and pain. If your child is sick, look for a children's version of these drugs. Don't give aspirin to children or teens as it can cause life-threatening swelling in the liver and brain.
If your sore throat is caused by allergies, antihistamines might help. These OTC drugs decrease allergic reactions.
Prescription mouthwash for sore throat
If you have a severe sore throat from cancer, ask your doctor about getting a special mouthwash. Also known as "magic mouthwash," this treatment contains painkilling drugs like lidocaine or Benadryl.
Antibiotics for sore throat
If you have strep throat, antibiotics can help. These are medicines that kill bacteria, including the bacteria that causes strep throat. They don't work on viruses.
If your doctor gives you a prescription for an antibiotic, follow their directions carefully. Ask them what to do if you accidentally forget a dose. Keep taking the medication as directed until you have used all of it, even if you start to feel better. Stopping antibiotics too soon can cause the infection to get worse.
Medications for GERD sore throat
To treat a sore throat caused by acid reflux, you'll probably need antacids. Some are available over the counter. Or you can talk to your doctor about getting prescription-strength medication. There are also small lifestyle changes that can help, like not eating a big meal before bed.
Most sore throats are caused by viruses, which means there's no immediate cure. But in the meantime, there are a few easy things you can do to help feel better.
You can:
Rest. Give your body a chance to recharge so it can fight off any infection you might have. Resting will also give your throat muscles time to repair after shouting or singing.
Stay hydrated. This will keep your throat moist so it won't feel so scratchy. Focus on getting plenty of water. Avoid caffeinated or alcoholic drinks, which can dehydrate you.
Eat or drink something warm. Warm liquids can feelsoothing for your sore throat. For an extra comfort boost, add honey to your tea—but don't give any to babies under 1 year old.
Eat something cool. Ice pops or ice water can help soothe your throat and reduce inflammation.
Gargle. Try gargling a cup of warm water with a half teaspoon of salt. The salt brings down inflammation, which can cause redness and swelling. This tip works for adults and kids ages 6 and older.
Turn up the humidity. Dry air can aggravate a sore throat, so try using a cool-air humidifier. If you don't have one, you can sit in a steamy bathroom after a hot shower.
Enjoy a hard candy or lozenge. This causes your mouth to release saliva (spit), which can moisturize a sore throat. Don't give hard candies or lozenges to children under 5 years old.
Try alternative medicine. Some people say that herbal teas, sprays, or lozenges help them feel better. Popular varieties include licorice root, slipper elm, and marshmallow root. Talk to your doctor before trying any herbal products or supplements.
Avoid triggers. Stay away from cigarette smoke, cleaning products, spicy foods, very hot drinks, and other things that can irritate your throat.
It's time to go to the doctor if you're in severe pain, the sore throat doesn't go away within a week, or it keeps coming back. Other signs to get medical care are:
Get immediate help if your child has:
To help prevent a sore throat, you can:
Get vaccinated. Most sore throats are caused by viruses, including influenza and COVID-19. Stay up-to-date with your flu shot and any other recommended vaccines.
Wash your hands regularly. Make sure to do this after using the bathroom, after sneezing or coughing, and before and after eating. Wash for 20 seconds, or the time it takes to sing "Happy Birthday" twice. If there's no soap or water around, use an alcohol-based hand sanitizer.
Don't touch your face. Your hands come into contact with a lot of germs, and touching your face gives them an easy ride into your eyes, nose, or mouth.
Don't share cups, forks, or other utensils. Germs can spread through saliva (spit), even if you can't see any.
Be careful when touching public or shared items. Use a cleaning wipe to disinfect phones, doorknobs, light switches, remotes, and other commonly shared items. When using public phones or drinking fountains, make sure you don't touch them with your mouth.
Avoid spending time with people who are sick. This can lower the chances that you'll get sick too. And if you're sick, stay home and rest to protect others.
Most sore throats are caused by viral infections like the common cold, influenza, and COVID-19. Antibiotics won't help these infections, but they tend to go away on their own in about a week. In the meantime, try home remedies like drinking hot tea with honey, gargling salt water, staying hydrated, and getting plenty of rest. If your sore throat is severe or doesn't go away, talk to your doctor about what could be causing it and possible treatments.
The FDA Approved A Self-Administered Nasal Spray For The Flu. Here's How It Compares To The Traditional Flu Shot
CHICAGO - OCTOBER 8: Three 10-dose Influenza Virus Vaccine vials are seen at Ballin Pharmacy ... [+] October 8, 2004 in Chicago, Illinois. (Photo by Tim Boyle/Getty Images)
Getty ImagesThe U.S. FDA recently approved FluMist as a self or caregiver-administered nasal spray flu vaccine to prevent Influenza disease. The nasal spray prevents the flu from Influenza virus subtypes A and B in individuals between the ages of 2 and 49. FluMist can now be administered by a healthcare provider at a pharmacy, or even self-administered by adults at the comfort of their homes.
The new approval provides a novel level of flexibility and accessibility for flu vaccine administration, as many may experience barriers to getting to healthcare facilities to receive the shot. In addition, many children and adults have a fear of needles, and the nasal spray circumvents that barrier as it is sprayed into the nose.
So how does FluMist differ from the traditional flu shot? Although prior studies showed that the nasal spray worked better in children than the standard shot, more recent studies show similar efficacies in fighting Influenza between both FluMist and the flu shot, according to WebMD.
The two options are two different types of vaccines that result in similar protection against Influenza. The flu shot is made from dead Influenza virus and cannot give you the flu. It is usually injected into a muscle in the arm or a muscle in the thigh if you are less than three years of age. The shot is absorbed in the muscle where there is more blood, which theoretically can enter the bloodstream and induce an immune response. FluMist is made from a live weakened virus that is sprayed into the nose. This stimulates an immune response quicker than the shot because it targets the mucosal tissue where the flu virus enters and infects the mucosal tissue of the airways. The nasal spray targets the very location where the influenza virus infects the body.
FluMist can only be given to individuals between the ages of 2 and 49, while the flu shot can be given to anyone above the age of six months. There are many more restrictions for the nasal spray. For example, according to the CDC, aside from age restrictions, the nasal spray flu vaccine should not be given to those with a severe allergic reaction to any ingredients in the vaccine, to children and teens on aspirin, children between 2 and 4 years of age with asthma, individuals with weakened immune systems and chronic medical conditions, pregnant females and those without a functioning spleen.
In contrast, those who cannot receive the standard flu shot are babies less than six months of age, those with severe allergies to any ingredients in the vaccine and those with a history of an infection known as Guillain-Barrie, whereby the body's immune system attacks the nerves.
Both vaccines are generally very safe and tolerated well, but the nasal spray can elicit more side effects. For example, FluMist can result in flu-like symptoms like fever, sore throat and runny nose in adults. In children, the nasal spray can cause wheezing, vomiting and muscle aches. In contrast, the flu shot usually just results in soreness in the arm or aches for a day or two.
Ultimately, the most important thing isn't necessarily deciding which shot to get, but to in fact get a flu shot to prevent serious illness and hospitalization. Annually, the flu is responsible for up to 51,000 deaths in America, according to the CDC, as well as up to 710,000 hospitalizations. Getting vaccinated still represents the best protection against a potentially deadly infection.
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