Pain under the tongue


All subjective pain sensations in the lower part of the oral cavity are summarized as pain under the tongue. The severity and quality of the pain in this area can vary. Depending on the cause, burning pain, pressure pain or tension pain can dominate, for example. Pain under the tongue is based on the fact that the oral cavity is in contact with many substances in the environment. If certain substances or irritants are classified as "dangerous" by the body's own defense system, they can lead to inflammation and pain under the tongue.

Read more about related topics under: Pain in the tongue.


The causes of pain under the tongue can be roughly divided into 3 categories. A distinction is made between intolerance / allergies and bacterial / viral inflammation and other diseases as triggers.


Often, intolerance reactions or allergies occur with mouthwashes, toothpaste, food (see: Food allergy) or medication (see: Medication intolerance). These intolerances are often harmless and the symptoms will spontaneously resolve if the irritant causing them is avoided. However, rarely is an allergic reaction so strong that swelling occurs in the entire throat area, which leads to shortness of breath and requires emergency medical treatment.

Read more on the subject at:

  • Symptoms of an allergy
  • Therapy for an allergy

Viral and bacterial inflammation

Viral and bacterial inflammation can cause pain under the tongue. An example of a viral cause is the so-called herpes simplex infection. As part of the infection, mouth rot, a so-called Herpetic gingivostomatitis develop. Various bacteria can also cause pain under the tongue. Among other things, these can also cause inflammation of the salivary glands with associated pain under the tongue. For differential diagnosis, so-called floor abscesses and tongue base abscesses (see: Abscess), which cause pain under the tongue, must be differentiated. As a rule, the abscesses form due to inflammation caused by injuries to the oral mucosa, for example after dental surgery or other interventions in the oral cavity. If there is a high susceptibility to inflammation, an underlying metabolic disease, such as diabetes mellitus, should be excluded.

Read more on the subject at:

  • Inflammation of the lining of the mouth
  • Inflammation in the mouth


In addition, ulcers in the mucous membrane, so-called canker sores, can cause pain under the tongue. These often arise due to vitamin and mineral deficiencies, stress or hormonal changes. These often develop, for example, during puberty, menstruation, pregnancy, menopause or in immunocompromised people.

Read more on the subject at: Canker sores on the tongue.

There may also be a cyst under the tongue called a frog lump (Ranula), form. Salivary stones can also cause tension pain under the tongue. Burns from food or drinks that are too hot can also injure the oral mucosa and cause pain.

Read more on the subject at: Burned Tongue - You Should Do This!

Through tongue piercing

After a tongue piercing, the procedure can cause painful swelling of the tongue and floor of the mouth. These symptoms should usually subside after a few days and be completely healed after about 2-3 weeks. In rare cases, unclean materials or material incompatibilities can lead to inflammation. It can also injure the lining of the mouth, inflame the area, and cause pain under the tongue. In these cases it is advisable to consult a doctor.

Through salivary glands

Lumps, inflammations, stones, and tumors of the salivary glands can cause pain under the tongue.

A frog tumor is a congenital or trauma-acquired adhesion of the sublingual salivary gland. If the gland is blocked, the swelling can cause pressure pain under the tongue and even push the tongue to the side if the gland is heavily filled.The tumor usually appears as a red-bluish, fluid-filled cyst.

Salivary gland inflammation mostly affects the parotid gland (see: Inflammation of the parotid gland) and only causes pain under the tongue if the pain is severe.

Salivary stones can cause tension pain under the tongue. Often the mandibular salivary gland is affected because of the winding duct. The salivary stones develop when the saliva composition changes. It is believed that this can happen as part of an infection. Salivary stones can also follow a permanent stagnation of secretion with a narrowed salivary gland duct. The formation of salivary stones can express itself with or without signs of inflammation and with more or less pain.

More rarely, tumors of the salivary glands are responsible for pain under the tongue. The parotid gland is affected in 80% of cases. A tumor in the sublingual salivary gland is a rarity.


The doctor first asks the person concerned about the exact symptoms, the quality and localization of the pain and any accompanying symptoms. Then he looks at the oral cavity. He feels the 3 large salivary glands and tests their functionality by painting them out. He also feels the lymph nodes in the neck area and on the lower jaw.

If an infection is suspected, a smear will be taken and the signs of inflammation in the blood checked. If an allergic reaction is suspected, an allergy test is done. In order to differentiate possible salivary stones, abscesses and tumors, an ultrasound examination can be useful if the diagnosis is suspected. Tissue samples or x-rays of the salivary glands using a contrast medium (sialography) rarely have to be taken. In exceptional cases, other imaging techniques such as computed tomography and magnetic resonance imaging are used if there is pain under the tongue.

Concomitant symptoms

Depending on the cause, different symptoms can occur in addition to the pain under the tongue. Infections can lead to swelling of the lymph nodes, fever, difficulty swallowing, skin rashes, sore throats, pain radiating to the ear and fatigue. If a herpes simplex virus causes pain under the tongue, characteristic vesicles usually also appear (see: vesicles in the mouth). If the cause is bacterial, purulent secretion can escape. In both cases, very unpleasant halitosis can arise. If the pain was caused by something called angioedema, the entire throat may swell. This can lead to life-threatening shortness of breath and is an absolute emergency!

difficulties swallowing

The pain under the tongue can make it difficult to eat. If there is also swelling, the swallowing difficulties add up. The pain when chewing and swallowing can increase due to increased salivation if salivation has triggered the symptoms. Often, liquid and soft foods such as yogurts and soups are preferred. In spite of the difficulty swallowing, you should always ensure sufficient fluid intake.

Read more on the subject at: Home remedies for swallowing difficulties.

With bubbles

Mouth rot as part of a herpes infection usually speaks 1-4 mm large blisters under the tongue. Children and young people are often affected. The vesicles usually tear shortly after they have formed and lead to painful, speckled mucous membrane injuries on the floor of the mouth and possibly in the entire mouth area.

Read more on the subject at:

  • Vesicles in the mouth
  • Herpes in the mouth

Swollen lymph nodes

If the pain under the tongue is caused by inflammation, the lymph nodes may swell. They may remain swollen for a while after the inflammation subsides. A medical examination is recommended if the size of the lymph nodes is more than two centimeters, and if they have been swollen or hard to the touch for longer than 3-4 weeks. If, in addition to the pain under the tongue, other symptoms such as visible skin changes in the area of ​​the swollen lymph nodes, fever, night sweats, sudden unclear weight loss and difficulty breathing occur, a doctor should also be consulted.

Read more on the subject at: Lymph node swelling in the lower jaw.

Sore throat

If the pain under the tongue is caused by inflammation, this can also lead to a sore throat. On the one hand, the accompanying sore throat can arise due to the protective and defense reactions of the tonsils, and on the other hand due to the general spread of infection. If the pain under the tongue was caused by a tongue piercing, a sore throat may develop into a kind of "sore muscles". Since the tongue is pulled far out of the oral cavity during the procedure, the throat area can be painful afterwards.

Read more on the subject at: Sore throat - what to do?


Treatment for pain under the tongue depends on the cause.

Some people find teas, tinctures or gels with medicinal plant extracts beneficial for pain under the tongue. Linden blossom, chamomile, mallow leaves, aloe vera or marshmallow roots are used, for example. Adequate hydration and avoiding spicy foods and irritants can provide relief. A general strengthening of the immune system through a balanced diet and a balance between exercise and relaxation phases can also support the healing process. If necessary, anti-inflammatory and analgesic solutions, numbing the oral mucosa, lozenges and medication can be administered. However, this should be geared towards the type of application and duration.

In the case of salivary gland inflammation and salivary stones, the underlying disease is treated first. The flow of saliva can be regulated, for example, by eating lemons, chewing gum and massaging the gland. In some cases, larger salivary stones are crushed or surgically removed with the help of shock wave therapy. During this operation it may also be advisable to have the salivary gland duct in question widened. In the case of a frog tumor that does not empty spontaneously or keeps returning, an operation is also advisable.

Read more on the subject at: This is how you can effectively remove salivary stones.

Herpes infection is usually treated with acyclovir. In the case of other viral causes, good oral hygiene is generally advisable, at best with mild, well-tolerated substances without alcohol and preservatives. If the cause is bacterial, antibiotics are recommended, especially in immunocompromised people.

Emergency medical treatment is required for life-threatening angioedema due to an allergy.


Depending on the cause, the duration of the pain under the tongue is very variable and can range from a day to a few months. If the pain persists for more than a few days and occurs again and again, as well as accompanying symptoms such as fever, a doctor should be consulted.