Pain in the tongue
Pain in the tongue can be a consequence of microtrauma, irritation of the mucous membrane, occurs with glossalgia, some glossitis, abscess and phlegmon of the tongue, acute candidiasis of the oral cavity, xerostomia, neuralgia, dental problems, pernicious and iron deficiency anemia, allergic reactions. More often burning, stinging, tingling, tingling. With purulent processes – sharp, bursting, jerking, pulsating. It is diagnosed on the basis of complaints, examination data, instrumental and laboratory tests. Treatment includes rinsing, applications, the appointment of physiotherapy techniques, general drugs, sometimes – operations.
Why does the tongue hurt
Physiological causes
Traumatic injuries
Glossit
Abscess and phlegmon of the tongue
Candidiasis of the oral cavity
Glossalgia
Xerostomy
Neuralgia
Anemia
Other reasons
Diagnostics
Treatment
Pre-hospital care
Conservative therapy
Surgical treatment
Prices for treatment
Why does the tongue hurt
Physiological causes
Pain in the tongue often results from minor injuries: superficial burns with too hot liquid, accidental biting, damage by hard pieces of food, fish bones. Pain is combined with numbness or, on the contrary, hypersensitivity. They disappear within a few minutes or hours, less often – days.
Burning, soreness of the tongue can also be provoked by the intake of spicy foods, some spices, the use of strong alcoholic beverages. In smokers, the sensitivity of the tongue increases due to the constant effect of tobacco smoke on the mucous membrane, which leads to the frequent appearance of pain syndrome under the influence of other stimuli.
Traumatic injuries
More serious injuries occur due to tongue biting during an epilepsy attack, sports, accidents. Abrasions and wounds in the form of teeth marks are found on the tongue. Depending on the severity of the injury, soreness persists from several days to 1-2 weeks. In patients with incorrectly selected orthodontic structures, poorly fitted removable prostheses, pain is the result of chronic irritation of the tongue. With advanced caries, the organ is systematically injured by the sharp edges of the teeth.
Glossit
Pain syndrome is not observed with all glossitis, it is more characteristic of infectious lesions. The inflammatory process of bacterial etiology is manifested by hyperemia, swelling, an increase in local temperature, aching, aching pains. With viral glossitis, bubbles form, which are subsequently opened with the formation of painful erosive defects.
Pain in the tongue
Pain in the tongue
Abscess and phlegmon of the tongue
An abscess develops against the background of microtrauma or becomes a complication of bacterial glossitis. Characterized by the rapid appearance and progression of symptoms. Superficial abscesses are localized under the mucosa, usually in the back area. They represent a site of limited edema with a painful seal in the center. Accompanied by sharp pain during tongue movements, swallowing, sometimes with irradiation in the ear.
Deep abscesses are located in the thickness of the organ. They are manifested by hyperthermia, intoxication syndrome, in some cases – chills, an increase in regional lymph nodes, profuse salivation. The tongue is so swollen that it hardly fits in the mouth, makes it difficult to speak and breathe. The pain is sharp, twitching, bursting, throbbing, intensifying with movements, swallowing, touching.
In patients with phlegmon, the purulent inflammation zone is not limited, it quickly spreads to the entire tongue, the bottom of the oral cavity, and the neck. Febrile fever, chills, regional lymphadenitis are observed. The pain syndrome is intense, diffuse, sleep-deprived. Eating is very difficult or impossible. Speech is slurred. Due to the overlap of the respiratory tract due to swelling of the soft tissues of the oral cavity and oropharynx, suffocation attacks develop.
Candidiasis of the oral cavity
Painful sensations are more often observed in acute candidiasis, uncharacteristic for the chronic form of the disease. Children, the elderly, weakened patients with severe somatic pathologies suffer. A loose or dense milky-white curd coating forms on the tongue, spreading to the palate, cheeks, lips. When the plaque is removed, the bleeding, eroded or macerated mucous membrane is exposed.
When eating, soreness, burning sensation occur. In the absence of therapeutic measures, transformation into atrophic candidiasis is possible. The tongue becomes shiny, fiery red. Papillae atrophy. The mucous membrane of the oral cavity is edematous, hyperemic, dry, thinned. Patients complain of severe pain in the affected area. The plaque is not detected or insignificant.
Glossalgia
Glossalgia is a pathology accompanied by unpleasant sensations in the language in the absence of organic changes. It occurs in diseases of the liver and gastrointestinal tract, vascular, endocrine diseases, pathologies of the central and peripheral nervous system. Painful sensations without a clear localization, diffuse, have a burning, tingling or stinging character, are more pronounced in the area of the tip and sides, less often appear on the root, the back of the tongue. They can be episodic or regular. As a rule, they are combined with neurotic disorders.
Xerostomy
The pain in the tongue worries at the final stage of the disease. Against the background of complete suppression of the function of the salivary glands, glossitis develop. Constant dryness of the mucosa leads to the formation of erosions and ulcers. Painful sensations increase during conversation, during meals, combined with constant dry mouth. In patients with xerostomia, multiple caries may be detected.
Neuralgia
Pain in the two anterior thirds of the tongue is characteristic of the lesion of the third branch of the trigeminal nerve (n.mandibularis), combined with painful sensations in the chin, lower jaw, lower lip, gums, cheek mucosa. The pain syndrome has a paroxysmal character, it is a series of pulses resembling an electric shock. It is provoked by cold influences, shaving, chewing, speech, laughter.
With neuralgia of the pharyngeal nerve, pain appears in the root of the tongue, from where it spreads to the tonsils, soft palate, pharynx, sometimes – ear, eye, lower jaw. The attack is provoked by swallowing, chewing, yawning, coughing, talking, accompanied by dryness in the throat, which at the end of the paroxysm is replaced by increased salivation.
Neuralgia of the sublingual node is characterized by pain in the anterior parts of the tongue, the sublingual zone: drilling, burning, pulsating, paroxysmal. Lasts from a few minutes to 1 hour. It radiates into the lower jaw, temple, occiput, lateral surface of the neck, upper arm, sometimes arm, upper chest. It increases when talking, eating, especially – abundant or spicy.
Anemia
Pain in the tongue is typical for pernicious anemia, caused by glossitis. The tongue becomes “varnished”, acquires a crimson color. There is weakness, tachycardia, dizziness. Characteristic symptoms are shortness of breath, pallor of the skin, puffiness of the face. Loss of appetite, hepatomegaly, instability of the stool are detected. Neurological disorders are revealed: muscle weakness, gait changes, stiffness, numbness of the limbs.
Sometimes painful sensations in the area of the tongue occur with iron deficiency anemia. Glossitis is combined with dysphagia, angular stomatitis, atrophic gastritis. The prevailing symptoms are weakness, tinnitus, dizziness, shortness of breath, palpitations. Dry skin, nail deformity, hair loss are noted.
Other reasons
Pain in the tongue is sometimes detected in the following conditions:
Allergy. Soreness, paresthesia, severe itching are caused by food allergies, less often by a reaction to plant pollen, animal hair. Combined with sneezing, lacrimation, swelling of the mucous membranes.
The initial stages of cervical osteochondrosis. Unclear pain sensations in the tongue are complemented by awkwardness, restrictions on neck movements, neck pain.
CHD. Pain in the tongue, oral cavity, lower jaw can be observed with an atypical course of an attack of angina pectoris, myocardial infarction.
Examination of the oral cavity
Examination of the oral cavity
Diagnostics
The cause of the symptom is determined by the dentist. If there are indications, patients are referred for consultation to a gastroenterologist, therapist, neurologist, and other specialists. The doctor determines when the pain first appeared, what symptoms it was accompanied by, how the disease developed. To clarify the diagnosis, the following procedures are performed:
Inspection. During a physical examination, general changes are sometimes detected (for example, pallor and dryness of the skin in anemia). When examining the tongue, edema, hyperemia, discoloration, the presence of erosions, ulcers, infiltrates may be detected. With neuralgia, the pain zones indicate a lesion of one or another nerve. During the dental examination, carious teeth, defects in prostheses, orthodontic structures may be detected.
Instrumental techniques. Sialography and ultrasonography are recommended to exclude xerostomia and assess the condition of the salivary glands. If gastrointestinal pathologies provoking glossalgia are suspected, esophagogastroduodenoscopy and contrast examination of the stomach are performed. With neuralgia, electromyography is indicative.
Laboratory tests. Confirm the presence of pernicious or iron deficiency anemia. As part of the differential diagnosis, saliva is examined. With candidiasis, bacterial lesions, seeding of the separated on nutrient media is performed. In case of viral infections, PCR is performed.
Treatment
Pre-hospital care
It is recommended to abandon too hot, cold, spicy and spicy dishes. You should use soft foods that do not injure the tongue, preferably stewed, boiled, steamed. The best option is a diet that includes mashed potatoes, slimy porridges, pureed soups. Before and after meals, you need to rinse your mouth with weak solutions of chlorhexidine and potassium permanganate or a solution of furacilin. In case of severe pain, the surface of the tongue can be lubricated with local anesthetics.
Conservative therapy
An important part of the treatment is the rehabilitation of the oral cavity, if necessary, replacement of prostheses and orthodontic structures. The list of therapeutic measures is determined by the nature of the pathology:
Glossit. Rinses, applications with anesthetics are shown. In case of intense pain, lubrication with a mixture of glycerin and anesthetic is effective. The plaque is removed with a swab with proteolytic enzymes. They are treated with antiseptics. Local healing drugs are used.
Phlegmon and abscess of the tongue. With superficial abscesses, rinsing with antiseptic solutions is carried out, antibacterial agents are prescribed, if ineffective, surgical interventions are performed. With deep abscesses and phlegmon, conservative therapy is an auxiliary method of treatment, is carried out against the background of operations, includes antibiotics, analgesics, antihistamines, anti-inflammatory drugs.
Candidiasis. As local remedies, alkalizing solutions for rinsing are used. The oral cavity is lubricated with antifungal ointment, treated with solutions of iodinol, lugol, fucorcin. The therapeutic regimen also includes antifungal drugs of general action, in severe cases – immunotherapy.
Glossalgia. It is recommended to take light tranquilizers, motherwort, valerian. A good result is achieved when performing trimecaine blockades of the lingual nerve, injecting vitamins of group B. Unpleasant sensations are eliminated by oral baths, applications with anesthetics. They treat the underlying pathology, neurotic disorders.
Xerostomia. They advise giving up smoking and taking alcohol, using toothbrushes with soft bristles, frequent drinking to moisten the oral cavity, resorption of sugar-free lollipops to stimulate saliva production. The oral cavity is lubricated with a solution of vitamin A. Novocaine blockades of the salivary glands are performed, vibromassage, medicinal electrophoresis, galvanotherapy are prescribed.
Neuralgia. Anticonvulsants, non-narcotic analgesics, vitamin complexes are used. In case of severe pain, antidepressants, sleeping pills, sedatives, neuroleptics are recommended. Medical blockades are carried out. Lubricate the tongue with a solution of cocaine. Patients are given a referral for SMT, galvanization, diadin therapy.
Anemia. With iron deficiency anemia, treatment of the underlying disease, full nutrition with a high content of heme iron, and ferropreparations are required. In case of pernicious anemia, the provoking pathology is corrected, vitamin B12 is prescribed.
Surgical treatment
Operations are indicated for patients with phlegmon and abscess. An abscess is opened by a longitudinal incision of the tongue or a skin incision under the chin. The cavity is washed with a solution of antibiotics and proteolytic enzymes. Perform drainage. With neuralgia caused by compression of the nerve by a tumor, a blood vessel or tight walls of the bone canal, surgical interventions to eliminate compression are required.
