Strep Throat or Sore Throat? Best Ways You Can Tell

A quick and easy test in the doctor's office can tell you for certain
Doctor checking condition of throat with tongue depressor

Sore throats are not only a pain, but they can be caused by many different factors. Viruses, bacteria such as Streptococcus pyogenes, dry air, allergies or even drainage from a runny nose can make your throat hurt.

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But not all sore throats are created equal. While allergies or a runny nose are painful nuisances, strep throat is a 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. Also, the bacteria that cause strep throat can spread to other tissues, causing a more serious infection. Finally, untreated strep can, in rare circumstances, lead to a more severe illness such as rheumatic fever, a potentially fatal disease that can harm the heart valves.

So it’s important to be able to know when it’s just a sore throat that needs home treatment and when it’s likely to be strep, which calls for a doctor’s visit. How can you tell?

When it’s a sore throat

When it’s a sore throat caused by a cold virus, you will often have other cold symptoms that may include:

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

“You do not have a cough with strep. If you’re coughing, that typically means no strep,” says Daniel Allan, MD. “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.”

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Colds usually take several days to develop and typically go away on their own within five to seven days, Dr. Allan says.

There is no cure for a sore throat caused by a cold virus, but you can do things to make yourself feel more comfortable: Drinking warm liquids, gargling with warm salt water, sucking on ice chips, or taking an over-the-counter medicine can provide relief for your symptoms.

You also can speed your recovery by getting enough rest, eating a healthy diet and drinking plenty of fluids.

Symptoms of strep

Strep throat symptoms usually are more severe than a sore throat caused by a virus. They can 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.

Your doctor can spot a likely case of strep based on a defined set of characteristics, Dr. Allan says.

If your doctor suspects strep, a simple, painless and quick test can confirm the diagnosis. The doctor 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.

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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 the throat. This way, your doctor can prescribe antibiotics for treatment, which are appropriate for bacterial illnesses such as strep, but not for viral illnesses such as a cold.


If you were exposed to someone who has had strep recently, that’s important information to share with your doctor, Dr. Allan says. Strep can be spread easily by sharing personal items with an infected person, close contact with an infected person, or even through the air by sneezing or coughing.

Dr. Allan warns that prescribing antibiotics for sore throats without a confirmed diagnosis of strep can create resistance to the drugs or unnecessary side effects. This is why obtaining a confirming test is so 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 says. “If there is any concern of strep, then I would recommend getting tested.”

Dr. Allan says antibiotics treatment for strep takes about 10 days.

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