When It Hurts to Swallow


A painful sore throat can mean a cold, strep throat, or tonsillitis. How can you tell the difference?


Throughout the day, you feel a sore throat coming on and dread an oncoming illness. It hurts to swallow, the back of your throat looks red, and you have a fever. Is it just a cold virus that you’ll have to wait out or could it be something worse that requires a trip to the doctor? While most sore throats are caused by viral infections, some can be caused by bacteria.
How can you tell the difference between these everyday sources of sore throats? Here are a few ways.

The Common Cold

One of the first symptoms of a cold is a sore throat. However, with a cold the sore throat usually feels better in a day or two. After the onset of the sore throat, nasal congestion, a runny nose, cough, sneezing, mild body aches, headache, and low fever may set in.

Since colds are caused by viruses, antibiotics will not help. All you can do is rest, take over-the-counter pain medications, drink plenty of water, and practice home remedies to feel better. To relieve a sore throat, suck on throat lozenges or ice chips, drink hot tea with honey, or gargle with warm salt water.

Strep Throat

While viruses cause colds, strep throat is caused by the group A beta-hemolytic streptococcus bacteria. After exposure to this bacteria through an infected person’s nasal secretions or saliva, you’ll start to feel sick in two to five days. With strep throat, the sore throat is generally more severe, comes on suddenly, and lasts longer than with a cold. Other symptoms include a high fever, chills, aches, and a headache. Some people with strep throat also feel sick to their stomach, vomit, lose their appetite, have a rash in their mouth, or have pus on their tonsils. Unlike a cold, strep throat doesn’t usually come with a cough.
Kids ages 5 to 15 are most susceptible to strep throat, but adults can also get it.

Unfortunately, there’s no way to know for sure you have strep throat unless a medical professional performs a rapid strep test or sends a throat culture to the lab.

Treatment for a positive strep test includes a round of antibiotics. After a day or two on antibiotics you shouldn’t be contagious, but it may take a few more days to feel 100 percent. Left untreated, strep throat can cause rheumatic fever, an illness that can damage the heart valves. So if you suspect your sore throat is more than a cold, seek medical attention.


A third cause of sore throats is tonsillitis. The tonsils (the tissue in the back of your mouth on either side of your tongue) are part of the lymphatic system and can become inflamed and infected when your body’s fighting an infection due to a virus or bacteria like the strep bacteria. The result is an extremely sore throat.

Unlike a cold, tonsillitis does not come with congestion or a runny nose. Your tonsils swell and may have yellow or white spots on them and you may experience abnormally bad breath, a different sounding voice, pain when swallowing, fever, and swollen glands in your neck.

Your doctor will determine if the cause of tonsillitis is viral or bacterial. If bacterial is suspected, antibiotics will be given. A person who gets frequent tonsillitis or whose swollen tonsils interfere with breathing may need to have the tonsils surgically removed.

Leave a Comment:

Elina Brooks says April 2, 2023

My throat has been sore for a few days now, so I’m worried that I might have tonsillitis since I don’t have a cold that could have caused this. Thank you for explaining to us that due to tonsillitis, our tonsils swell and can lead to abnormally bad breath, a different sounding voice, pain when swallowing, and swollen glands in our neck. I’ll keep this in mind and visit an ENT doctor later for a proper checkup.

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