If you have a runny nose and a cough that’s making your throat sore, you may be wondering if you have a common cold that just has to run its course or a sinus infection that needs treatment.

The two conditions share many symptoms, but there are some telltale signs for each. Read on to learn more about the similarities and differences, and how to identify and treat each condition.

A cold is an infection caused by a virus that finds a home in your upper respiratory system, including your nose and throat. Over 200 different viruses are capable of causing a cold, though most of the time a type of rhinovirus, one that primarily affects the nose, is the culprit.

Colds can be so mild you may only have symptoms for a few days, or a cold can hang on for weeks.

Because a common cold is caused by a virus, it can’t be effectively treated with antibiotics. Some medications can help reduce symptoms, but rest is usually the main way to beat a cold virus.

A sinus infection causing inflammation of the sinuses, also known as sinusitis, is commonly caused by a bacterial infection, though it can be caused by a virus or fungus (mold).

In some cases, you can develop a sinus infection following a common cold.

A cold can cause the lining of your sinuses to become inflamed, which makes it difficult for them to properly drain. That can lead to mucus becoming trapped in the sinus cavity, which, in turn, can create an inviting environment for bacteria to grow and spread.

You can have an acute sinus infection or chronic sinusitis. An acute sinus infection tends to last for less than a month. Chronic sinusitis lasts for more than three months, and symptoms may regularly come and go.

Among the symptoms shared by a cold and sinus infection are:

  • congestion
  • runny or stuffy nose
  • headache
  • postnasal drip
  • cough
  • fever, though with a cold, it tends to be a low-grade fever
  • fatigue, or lack of energy

Cold symptoms are usually at their worst within a few days after the infection sets in, and then they usually start to subside within 7 to 10 days. Sinus infection symptoms may last twice as long or much longer, especially without treatment.

Sinus infection symptoms

Sinus infection symptoms are similar to those of a common cold, though there are some subtle differences.

A sinus infection can cause sinus pain and pressure. Your sinuses are air-filled cavities located behind your cheekbones and around the eyes and forehead. When they become inflamed, that can lead to facial pain.

A sinus infection can also make you feel pain in your teeth, though the health of your teeth generally isn’t affected by the sinus infection.

A sinus infection can also cause a sour taste to linger in your mouth and cause bad breath, especially if you’re experiencing postnasal drip.

Cold symptoms

Sneezing tends to accompany a cold, not a sinus infection. Likewise, a sore throat is a more common symptom of a cold, rather than a sinus infection.

However, if your sinusitis is producing a lot of postnasal drip, your throat can start to feel raw and uncomfortable.

Does mucus color matter?

While green or yellow mucus may occur in a bacterial infection, this doesn’t mean you have a bacterial infection. You can have a common cold that produces thick, discolored mucus as the virus runs its course.

However, infectious sinusitis commonly causes thick greenish-yellow nasal discharge.

Colds are very contagious. Young children in daycare settings are especially susceptible to colds and bacterial infections, but people of any age can develop a cold or sinus infection if exposed to the germs causing infection.

Having nasal polyps (small growths in the sinuses) or other obstructions in your sinus cavity can increase your risk for sinus infections. That’s because these obstructions can lead to inflammation and poor drainage that allows bacteria to breed.

You’re also at increased risk for a cold or a bacterial infection if you have a weakened immune system.

If cold symptoms come and go, or are at least significantly improving, within a week, you probably don’t need to see a doctor.

If your congestion, sinus pressure, and other symptoms persist, see your physician or visit an urgent care clinic. You may need medication to treat an infection.

For infants under 3 months of age, a fever at or above 100.4°F (38°C) that persists for more than a day should prompt a visit to the doctor.

A child of any age who has a fever that lingers for two or more days or gets progressively higher should be seen by a doctor.

Earaches and uncharacteristic fussiness in a child can also suggest an infection that needs medical evaluation. Other signs of a serious viral or bacterial infection include an unusually low appetite and extreme drowsiness.

If you’re an adult and have a persistent fever of above 101.3°F (38.5°C), see a doctor. This could indicate your cold has turned into a superimposed bacterial infection.

Also see a healthcare provider if your breathing is compromised, meaning you’re wheezing or experiencing other symptoms of shortness of breath. A respiratory infection at any age can worsen and lead to pneumonia, which can be a life-threatening condition.

Other serious sinusitis symptoms that should be evaluated by a doctor include:

  • severe headache
  • double vision
  • stiff neck
  • confusion
  • redness or swelling around the cheeks or eyes

A common cold can usually be diagnosed with a standard physical examination and a review of symptoms. Your doctor may perform a rhinoscopy if they suspect a sinus infection.

During a rhinoscopy, your doctor will insert an endoscope gently into your nose and sinus cavity so they can look at the lining of your sinuses. An endoscope is a thin tube that has a light at one end and either has a camera or an eyepiece to look through.

If your doctor thinks an allergy is causing your sinus inflammation, they may recommend an allergy skin test to help identify the allergen causing your symptoms.

There’s no medication cure or vaccine for the common cold. Instead, treatment should focus on managing symptoms.

Congestion can often be relieved by using a saline spray in each nostril a couple of times a day. A nasal decongestant, such as oxymetazoline (Afrin), may also be helpful. But you shouldn’t use it for more than three days.

If you have a headache, or body aches and pains, you may take acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for pain relief.

For a sinus infection, saline or decongestant nasal spray may help with congestion. You may also be prescribed a corticosteroid, usually in a nasal spray form. A pill form may be necessary in certain cases in order to help reduce severely inflamed sinuses.

If your doctor thinks you may have a bacterial infection, you may be prescribed a course of antibiotic therapy. This should be taken exactly as prescribed and for the duration recommended by your doctor.

Stopping a course of antibiotics too soon can allow an infection to linger and for symptoms to develop again.

For both a sinus infection and a common cold, stay hydrated and get plenty of rest.

Cold or sinus infection symptoms that linger for weeks shouldn’t be ignored. Even if they seem mild or manageable, see a healthcare provider to find out whether antibiotics or other treatments are needed.

To help avoid colds or sinus infections:

  • Limit your exposure to people who have colds, especially in confined spaces.
  • Wash your hands frequently.
  • Manage your allergies, either through medications or by avoiding allergens, if possible.

If you frequently develop sinus infections, talk to your doctor. They can work with you to try to identify underlying causes or risk factors, which may help you reduce your risk for sinusitis in the future.