What might cause tongue pain?

As a feature of CNNhealth.com, our team of expert doctors answer readers' questions. Here's a question for Dr. Gupta.

From Anna, Washington, D.C.

“Is it possible to sprain/strain your tongue? I get shooting pains in my tongue. What can I take to stop the pain?"

Answer:

Anna, thank you for your question. We consulted Dr. Steven M. Roser of Emory University School of Medicine’s division of oral and maxillofacial surgery and a professor of oral surgery. Roser has been in  practice for more than 20 years and said  he has never made the diagnosis of a sprained or strained tongue.

The tongue is one of the strongest and most robust muscles in the body, pound for pound, when you compare it with other muscles. We use our tongues almost constantly for talking, eating, and swallowing.  Rosen noted that, as with any other muscle,  overuse injuries are possible.

But as a medical professional, Rosen said,  if a patient came to him complaining of tongue pain, he would ask questions to rule out other, more common problems first.  He stressed the importance of seeing a dentist, oral surgeon or medical professional who can conduct an examination and  ask more questions about the pain.

The first thing a medical professional will do is try to get a better description of the type of pain you are experiencing:  Is it a sharp pain?  Where does it originate from or travel to? Is the pain constant or intermittent? How long have you had the pain? Have you taken anything to relieve the pain? Is it on both sides of your tongue?

Some of the possible causes for the pain include nerve-related problems. If the pain has existed for several years and you experience it when you are sitting still, it could be trigeminal neuralgia, which is a chronic painful condition that involves the nerve that carries sensation from your face to your brain. For trigeminal neuralgia, there is evidence that the nerve, which passes through base of the skull, is compressed by blood vessels or something that pushes on the nerve and causes pain. The pain is usually triggered by a stimulus– even a simple gesture like brushing your hand against your face can cause searing pain. Doctors can often relieve the pain with medication, injections or surgery.

If the pain is centered at the back of the tongue and involves the back of the nose and throat, and the ear, it might be glossopharyngeal neuralgia. The exact cause of this condition is unknown, but it’s believed to be tied to irritation of the ninth cranial nerve and may be the result of a viral illness such as shingles or herpes. Swallowing and speech can cause shooting types of pains.

If the pain has existed for only a few weeks, your doctor will thoroughly examine your tongue, mouth and throat for any evidence of lesions that might be evidence of oral cancer. Often you can’t see areas that have an ulcer, so your medical professional will most likely use a mirror to view areas behind the tongue and in the throat. Oral cancer has high rates of treatment success when caught early.

A sprain or strain of the tongue is probably the least likely cause of your pain. It’s important to see a medical professional who can ask specific questions about your tongue pain, thoroughly examine you, and assess whether you need treatment for the pain.