Do I have a sore throat or strep throat?

Navigating Healthcare

by Baylor Scott & White Health

Sep 16, 2021

An itch in the back of your throat is usually an early warning sign that you’ve caught a bug. But after a few days it can be hard to tell, do you have just a sore throat or could it be strep throat?

Strep throat and sore throats are very common and they can be hard to distinguish. Strep throat is most common in children under age 6 during the cold months of the year, but it can occur in people of any age during any season.

Family physician John L. Manning, MD sees patients at the Temple Santa Fe Clinic and also is the director  of the Family Medicine Residency Program. As part of his practice, he helps upcoming doctors know how to properly diagnose and treat patients with a variety of conditions, including infections in the throat.

“A sore throat is obviously a very common problem,” said Dr. Manning. “While most of the time it is due to a virus and does not need treatment, more than ten million people are diagnosed with strep throat every year.”

What’s the difference between a sore throat and strep throat?

So, if you’re wondering what the difference is between a sore throat and strep throat, consider the following:

  • Sore throat: The “average” sore throat is caused by a virus, is self-limiting, and does not require antibiotics for treatment. Dr. Manning says the management is conservative which means rest, fluids and pain medications.
  • Strep throat: Strep throat is caused by bacteria (called Group A Beta Hemolytic Strep). This infection is spread from person to person (contagious) through coughing, sneezing or other close contact. If diagnosed, it does need to be treated with antibiotics.

That means the main difference is the cause of the irritation. For sore throat, it’s due to a virus, where a strep throat is caused by bacteria.

“Our role includes making a diagnosis of either strep throat or a viral sore throat, and then providing the proper treatment depending on which diagnosis is made,” said Dr. Manning.

How do I know which is which?

You have painful irritation in your throat, but how do you know if you caught a virus or a bacteria? Chances are you’ll have to wait a day or so to see if your symptoms are getting better or worse.

Dr. Manning explained:

  • Viruses usually cause less serious infections than bacteria. The infections usually resolve themselves, and most importantly are not killed by antibiotics.
  • Bacteria are a type of organism that is more likely to cause a serious infection and needs to be treated with an antibiotic (a drug that helps the body kill bacteria).

“While both types of infections can cause uncomfortable symptoms, treatment of a viral sore throat is primarily designed to help decrease the symptoms until the body can fight off the infection, and treatment of strep throat with antibiotics kills the bacteria and decreases the likelihood of damage to the heart or kidneys,” Dr. Manning said.

What symptoms should I look for?

There is no single symptom that would require you to seek medical attention for a sore throat, but there are a number of symptoms that suggest that a sore throat might be strep.

“The more symptoms you have, the greater the likelihood that you have strep,” Dr. Manning said.

Symptoms of throat irritation that are more likely due to strep include:

  • Painful, swollen, red tonsils or throat.
  • Fever or chills.
  • Pain or difficulty when swallowing.
  • White or yellow spots on the tonsils or throat.
  • Swollen, tender lymph nodes or “glands” of the neck or under the jaw.

“The combination of symptoms that would be most worrisome for strep are a very painful sore throat associated with fever and painful lymph nodes in the neck,” Dr. Manning said.

If you are wondering if you may have strep throat, talk to your doctor. They are trained to help you get back on track as soon as possible. Even more, they can educate you about common illnesses, so you know what to look for the next time you catch a bug.

“Just as important, my role is to educate our patients so that they understand the importance of diagnosing and treating strep throat and therefore, know when to come in and be evaluated,” he said. “And also that they understand that a viral sore throat will resolve on its own.”


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