• Rashes
• Infections
• Pain
• Cold Sores

Why Does My Tongue Hurt? What You Need to Know About Tongue Problems

Tongue pain might seem like a small nuisance, but it can also be a red flag signaling deeper health concerns. 

From sharp stings to persistent burning, this discomfort can indicate anything from minor irritation to serious underlying conditions.

In this article, we’ll explore the causes of tongue pain and outline the best treatments and prevention strategies to help you avoid it.

What Does a Sore Tongue Feel Like?

Tongue pain is a subjective experience and can vary depending on its cause. It may be described as sharp, stabbing, throbbing, aching, or burning. 

General sensation and taste are sent to the brain through different pathways.

What are the symptoms of sore tongue problems?

A sore or painful tongue can result from several factors, including irritation, infections, or other health issues. Recognizing the symptoms is key to understanding the cause and seeking the right treatment.

Here are some common signs to look out for if you're dealing with a sore or painful tongue:

• Rashes or blisters on the tongue

• Ulcers

• Dry mouth

• Swelling of the tongue

• Unusual growths on the tongue

• Bad breath (halitosis)

• Changes in tongue color or pattern

• Altered taste sensation

• Fever or flu-like symptoms

Is a Sore Tongue a Symptom of Anything?

A sore tongue can be a symptom of other illnesses affecting the body, such as:

• Anemia  

• Vitamin B deficiency  

• Infections: Various infections can cause tongue pain. Notably, group A streptococcus (GAS) can lead to a painful red "strawberry tongue," a symptom of Scarlet fever that affects the entire body.  

• Medications: Antihypertensives, contraceptives, and antibiotics can contribute to tongue soreness.  

• Irritants: Alcohol, tobacco, and spicy foods can irritate the tongue, leading to discomfort.  

• Kawasaki disease (KD): This condition involves inflammation of the coronary artery walls and can cause tongue pain as part of its symptoms. Kawasaki disease primarily affects children, with nine to 20 cases per 100,000 children in the U.S. each year.

What are the Common Causes of Tongue Pain?

Tongue pain can have a variety of causes, from minor injuries to more serious underlying conditions. 

Understanding why tongue pain occurs can help you manage and prevent discomfort.

Minor injuries

Trauma to the tongue can occur when eating hard or abrasive foods, or from consuming very hot or cold items. Accidentally biting the tongue while chewing is also common and can cause pain. 

In epileptics, tongue injuries during seizures can be more severe, as they may accidentally bite their tongues harder due to a lack of pain sensation at the time, leading to significant pain and bleeding.

Irritation from foods

Certain foods with rough or abrasive textures can lead to small injuries on the tongue. Additionally, acidic or alkaline foods can cause chemical burns. 

Even seemingly harmless foods like citrus fruits or pineapple can chemically irritate the tongue by wearing down its protective outer layer. 

Spicy foods can also cause pain and a burning sensation without physically damaging the tongue. 

This happens because capsaicin – the chemical responsible for the heat in spicy foods – binds to pain receptors. This promotes the brain to interpret it similarly to an actual mouth injury.

Smoking and alcohol use

Nicotine from cigarette smoke can irritate the mucous membranes in the mouth, resulting in a burning sensation. 

Additionally, smoking is a major risk factor for oral cancers, which can cause intense pain as they spread through the mouth.

Alcohol also irritates the tongue and can lead to swelling, a condition referred to as glossitis – more on this below.

Glossitis (tongue inflammation)

Glossitis is the inflammation of the tongue, which can result from a variety of causes. 

It may be triggered by injury to the tongue or eating spicy food, but it can also be linked to more serious conditions, such as autoimmune disorders like psoriasis or genetic abnormalities such as Down syndrome. Since glossitis is nonspecific, it can indicate a wide range of underlying issues.

In some cases, a swollen tongue may be part of a life-threatening allergic reaction, such as angioedema or anaphylaxis. If you experience glossitis and are unsure of the cause, or if it persists, consult a healthcare provider.

Should you notice symptoms of an allergic reaction alongside a swollen tongue or lips, such as hives, shortness of breath, dizziness, fainting, heart palpitations, diarrhea, or vomiting, seek emergency medical help. 

If you have a known allergy, use your EpiPen if necessary and contact emergency services.

Canker sores or mouth ulcers

Canker sores (aphthous ulcers) are painful ulcers that develop inside the mouth or on the tongue, appearing as red, swollen spots with a white center. They can occur individually or in clusters. 

While the exact cause is unknown, certain factors, such as acidic or spicy foods, are known to trigger or worsen them.

Canker sores typically heal on their own without treatment, but pain relievers can help manage discomfort. Gels, mouthwashes, and creams may also provide relief from symptoms.

Other mouth ulcers can be caused by viruses, particularly herpes viruses. One of the most common is cold sores, caused by the herpes simplex virus. 

These painful blisters or ulcers are highly contagious and often cause a burning or tingling sensation before the rash appears. 

Cold sores typically heal within two weeks but can reoccur in the same area inside the mouth or around the nose due to triggers like stress, menstruation, sun exposure, or viral illnesses like the flu. 

Treatment usually involves pain relievers or antiviral medications, such as acyclovir (Zovirax).

Oral thrush (yeast infections)

Oral candidiasis — also referred to as “white tongue” — is a yeast infection of the mouth caused by the fungus Candida albicans. 

It’s marked by white patches on the tongue and inside the mouth, which can typically be scraped off. Associated symptoms include a red mucous membrane beneath the white patches, an abnormal taste, and, less commonly, a burning sensation.

Oral candidiasis usually occurs in individuals with weakened immune systems, such as those with HIV, those undergoing chemotherapy, babies, and the elderly. 

Steroid medications – particularly inhaled steroids used for asthma – can also increase the risk of developing candida infections. 

To prevent this, individuals using inhaled steroids are advised to rinse their mouths after using their controller or preventer medications.

Treatment for oral thrush typically includes antifungal medications like nystatin (Mycostatin). In people with compromised immune systems, oral medications may be necessary, as the infection can extend to the esophagus, causing painful swallowing.

Burning mouth syndrome (BMS)

Burning mouth syndrome is a condition marked by recurring sensations of burning, scalding, or prick-like pain in the mouth. 

This condition is thought to result from nerve damage affecting taste and sensation or may be linked to other underlying health issues such as acid reflux, depression, teeth grinding, nutritional deficiencies, or infections.

Treatment often involves addressing the underlying cause and may include medications like antidepressants (e.g., amitriptyline) or antipsychotics (e.g., amisulpride).

Geographic tongue

Geographic tongue is a harmless condition characterized by “map-like” red and white patches on the tongue. It’s typically asymptomatic, and the exact cause remains unknown. 

While no treatment is usually required, maintaining good oral hygiene and avoiding irritants is recommended.

Certain medications

Certain medications can lead to glossitis and a painful tongue, but it’s crucial to recognize a more serious condition called angioedema. This life-threatening swelling of the tongue and lips can obstruct breathing and requires emergency medical attention. 

People with angioedema caused by medication often also experience a chronic, dry cough. 

A common cause of this reaction is antihypertensive drugs in the ACE inhibitor class, such as enalapril, captopril, lisinopril, and perindopril. If you notice tongue swelling and suspect angioedema, contact emergency services immediately.

How are Tongue Problems Treated?

Maintaining a healthy mouth is key to preventing discomfort and issues like tongue pain. You can prevent and treat tongue and mouth problems by:

• Prioritizing good oral hygiene  

• Managing underlying causes, if applicable  

• Avoiding alcohol, tobacco, and spicy foods  

• Eating soft foods that aren’t overly hot or cold  

• Having regular checkups with your dentist (typically every one to two years) 

When Should You See a Doctor for Tongue Problems?

Certain signs and symptoms related to tongue issues should not be ignored, as they may indicate a more serious underlying condition. 

Here are some key symptoms that may require medical attention:

• White patches on the tongue that cannot be scraped away — often mistaken for candidiasis, but may be a precancerous condition known as oral hairy leukoplakia  

• Persistent tongue pain that doesn’t improve with over-the-counter (OTC) pain medications  

• Unexplained weight loss, fever, or night sweats  

• If you have a weakened immune system  

• Symptoms of anaphylaxis, such as breathing difficulties, dizziness, hives, or loss of consciousness  

• Rashes appearing elsewhere on the body  

Where Can I Learn More About Managing Tongue Pain?

While LifeMD doesn’t provide dental treatment, we can help you manage underlying health conditions or symptoms that may be contributing to tongue pain.

A team of healthcare professionals can offer guidance and prescribe the medication you need to feel better.

Make your appointment today to take control of your health — all from the comfort of your own home.

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