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

Medically Reviewed by Poonam Sachdev on June 06, 2024
10 min read

Is your painful, sore throat from a cold, strep throat, or tonsillitis? There are many ways to tell the difference.

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 a 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 lasts longer.

Sometimes, a sore throat is caused by tonsillitis, an inflammation or infection of the tonsils, which are the tissue masses located at the back of the throat. 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.

If you have a sore throat, it could be a symptom of strep throat, colds, and tonsillitis. The sore throat happens because of swelling in the back of the throat.

Strep throat can make your throat and tonsils red, sore, swollen, and filled with white patches or pus, making your throat feel sore.

Viruses that make the nose and throat inflamed cause colds. Although more than 200 types can cause a cold, most of the time, it happens because of a rhinovirus infection. When the throat is inflamed, it becomes swollen and painful, causing a sore throat. That’s why half of people with a cold notice a sore throat first.

Tonsillitis happens with swollen tonsils, causing a sore throat.

Other causes of sore throat include:

  • Smoking
  • Irritants in the air
  • Allergies
  • Dry air
  • Mouth breathing
  • Straining your throat from shouting, for example

Sore throat is a common symptom of cold, tonsilitis, and strep throat, as they all affect the throat. However, you may notice other symptoms besides a sore throat when you have these conditions.

Cold symptoms

  • Sneezing
  • Running nose
  • Stuffy nose
  • Headache
  • Fever
  • Muscle ache
  • Feeling sick
  • Cough

Tonsillitis symptoms

  • Swollen and red tonsils
  • Difficulty swallowing
  • Tiredness
  • Swollen and painful lymph nodes in the neck
  • Fever
  • Headache
  • Loss of appetite
  • Bad breath

Strep throat symptoms

  • Fever
  • Red and swollen tonsils
  • Swollen lymph nodes in the neck
  • Pain when swallowing
  • Tiny, red spots on the roof of the mouth
  • White patches on the tonsils
  • Streaks of pus on the tonsils
  • Headache
  • Nausea
  • Vomiting
  • Rash
  • Stomach pain

How to differentiate the symptoms of strep throat and 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

How to distinguish between the symptoms of tonsillitis and 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 of tonsillitis include the following:

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

Aside from looking at your throat and tongue, doctors may ask about your other symptoms and do tests to determine the exact cause of the sore throat.

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. You likely do not have strep throat if the strep test is negative.

However, if there are strong signs of strep throat, your health care provider can do a different throat swab test, which 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.

Tests for cold

Your doctor will likely start by asking about your symptoms. They may take a nasal or throat swab to confirm your symptoms are not from other causes.

You might also have a chest X-ray just in case a lung condition is causing your symptoms.

Tonsillitis diagnosis

Your doctor will ask about your symptoms and medical history. They’ll also look at your throat and neck for signs such as red, swollen tonsils with white spots and swollen lymph nodes.

You may also do a strep test to rule out strep as the cause. Or a blood test if the strep throat lab test is negative.

How is a sore throat from a cold treated?

Although there is no cure for a sore throat caused by a cold virus, there are ways to help you feel more comfortable, including:

  • Drinking warm liquids
  • Gargling with warm salt water
  • Sucking on ice chips, popsicles, or lozenges
  • Taking an over-the-counter medicine may relieve symptoms of pain or fever

When you are sick with a cold, getting enough rest, eating a healthy diet, and drinking plenty of fluids are important for recovery.

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, ibuprofen, and naproxen, can help ease the aches and pains of a cold and sore throat. (Don’t give aspirin to children. It is linked to Reye's syndrome, a disorder that can cause brain damage and death.)
  • Sore throat sprays and lozenges soothe your throat and numb the throat pain temporarily. (Don’t give children lozenges as it can cause choking.)
  • 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 3 days, or you may have an increase in congestion when you stop them.)

Don’t take antibiotics as they cannot treat a cold virus and sore throat from a virus infection. Antibiotics only work against bacteria.

How is a sore throat from strep treated?

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. For people who are allergic to penicillin, other antibiotics are prescribed.

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.

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 won't help. The virus must run its course for the sore throat to resolve.

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

Home remedies

You can manage your sore throat at home with these tips:

  • Get plenty of rest.
  • Drink lots of fluid.
  • Eat smooth, soothing foods such as gelatin, ice cream, shakes, frozen desserts, and soup.
  • Avoid crunchy or spicy foods.
  • Use a cool mist vaporizer or cool-air humidifier to add moisture to the air and ease your sore throat.
  • Take over-the-counter pain relievers such as acetaminophen, naproxen, or ibuprofen. But don't give aspirin to children.
  • Rinse your mouth with warm salt water to ease discomfort in your throat.
  • Take lozenges to soothe your throat.
  • Keep your space free of irritants such as cigarette smoke and cleaning products.

Strep throat can cause more serious illnesses, such as rheumatic fever, which may harm the heart valves. That's why it's important to get proper medical treatment, which can cure strep throat within 10 days.

Colds can make you feel under the weather, but you’ll feel better within a week. Although you may still have symptoms, they’ll likely be gone in about 18 days. It might take children 3 weeks to recover completely.

Sometimes, colds can lead to more serious health problems, such as asthma, ear infections, or sinus infections.

Most often, tonsillitis goes away quicker than a cold. It goes away on its own in a few days when you rest and stay hydrated without causing any serious health problems. 

See a doctor if your symptoms last longer than 4 days. They may let you know why this might be happening and recommend treatment.

In rare cases, tonsillitis can lead to health problems such as abscesses, rheumatic fever, scarlet fever, and kidney inflammation.

If your strep throat is not improving, let your healthcare provider know immediately.

Do not stop taking your prescribed medicine unless your health care provider tells you to.

Call your health care provider if you have these symptoms:

  • A fever 1 or 2 days after feeling better
  • Nausea or vomiting
  • Earache
  • Headache
  • Neck stiffness
  • Skin rash
  • Cough
  • Swollen glands
  • Painful joints
  • Shortness of breath
  • Dark urine, rash, or chest pain (may occur 3-4 weeks later)

Because colds are the most common cause of a sore throat, the best way to prevent a sore throat is by following measures that reduce your risk of having or spreading colds.

  • Get the flu vaccine every year.
  • Cover your mouth and nose when you cough or sneeze to prevent spreading any germs to others.
  • Maintain physical distance between you and people who have the cold to lower the risk of the virus spreading to you.
  • Wash your hands frequently with soap and water. If you don’t have soap and water, use an alcohol-based hand sanitizer.
  • Avoid touching your eyes, nose, or mouth to avoid spreading germs to yourself.
  • You can make your indoor cleaner to reduce the spread of viruses by opening your windows to let air in or using an air purifier.
  • Clean and disinfect surfaces you touch frequently in your space, such as countertops, handrails, and doorknobs, to prevent the spread of germs.
  • Take care of yourself by sleeping well, eating a well-balanced diet, staying well-hydrated, and taking rest seriously.

Sore throats are usually the first symptom of a cold, strep throat, or tonsilitis. It will go away on its own if it's from a cold. You’ll need to rest, eat healthy, and take plenty of fluids. If it’s from a bacterial infection with strep throat or tonsilitis, you’ll have to see a doctor who can recommend antibiotics. You’ll likely feel better with a sore throat in a few days. But if your symptoms don’t go away after about a week or you feel worse, see a doctor.

Is strep throat worse than tonsillitis?

Strep throat and tonsillitis often cause the same symptoms and go away in about a week. In rare cases, they cause similar complications such as rheumatic fever.

Do I need antibiotics for strep throat?

Yes, you need antibiotics to treat strep throat.

What happens if you ignore strep throat?

Ignoring strep throat can cause serious health problems such as kidney inflammation or rheumatic fever.

Can strep throat spread to the lungs?

Yes, the bacteria causing strep throat can spread to the lungs, causing problems such as pneumonia or sinusitis. 

What causes sore throat on just one side?

One-sided sore throat can be a symptom of many conditions, including strep throat, tonsillitis, and cold. It can also happen when mucus drips to the back of your throat.