8 Causes of a Sore Tongue and Throat

A sore tongue and throat may be due to a cold or flu, but there can be more serious causes, such as a severe allergic reaction, a damaged nerve, or even cancer. Your healthcare provider can diagnose and treat the cause.

1. Allergies

Allergies to substances such as mold, pollen, dust, or dander can cause a sore throat. Occasionally, food allergies may cause symptoms that affect the tongue, including itchiness or tongue swelling (this sometimes occurs during a severe and dangerous allergic reaction called anaphylaxis).

Symptoms

Symptoms of allergies may include:

• Sore throat
• Runny nose
• Postnasal drip
• Sneezing
• Itchy eyes or ears
• Hives or rashes
• Coughing
• Nasal congestion

Symptoms of anaphylaxis may include:

• Hoarseness
• Difficulty breathing, blue coloration of the skin or around the lips (cyanosis)
• Swelling of the tongue, difficulty speaking, drooling
• Face swelling
• Redness, hives, or rash
• Feeling dizzy or fainting

Causes

Allergies are common and often hereditary. Allergy symptoms occur when the immune system overreacts to a certain substance (called a trigger), such as pollen, food, or pet dander. Most of the symptoms occur when the immune system releases a substance called histamine.

Treatment

A sore throat caused by allergies can be soothed with over-the-counter (OTC) products such as acetaminophen or cough drops. A sore throat related to allergies is often a result of another symptom called postnasal drip. This can be helped with:

• Decongestants
• Increased fluid intake
• Using a cool mist humidifier

The underlying condition may benefit from treatment with antihistamines, most of which are also available over-the-counter, although it is recommended that you consult your healthcare provider about which product to use. Anaphylaxis is a life-threatening illness that requires emergency medical attention.

2. Trauma

Injuries from a variety of sources can result in a sore tongue and throat.

Symptoms

• Sore throat
• Hoarseness
• Redness or inflammation of the tongue
• Discoloration or blisters on the tongue
• A cut or sore on the tongue
• Tongue pain
• A burning sensation in the tongue or throat
• Heartburn, stomach pain, or feeling full, which are symptoms of gastroesophageal reflux disease (GERD)

Causes

Biting your tongue or burning your tongue or throat while consuming hot foods or liquids may cause a sore tongue and/or throat. While it is more common to burn only your tongue when eating or drinking, cases have been reported of burning the throat or esophagus with food and drink as well.

You can also get a sore tongue or throat if the tissue is irritated by contact with highly acidic or chemical substances. This happens to people who have GERD (acid reflux). When they lie down to sleep at night, stomach acid can travel up the esophagus and irritate the back of the throat. This is a common cause of a sore throat.

Treatment

Minor burns of the tongue from drinking or eating hot food or fluids are easily treated at home by eating and drinking cold food and fluids or using over-the-counter pain relievers such as acetaminophen or ibuprofen. You should consult a medical professional if you notice blisters or blackened tissue.

If you have bitten your tongue or it was injured from dental work or braces, you can usually treat it at home by eating and drinking cold food and fluids and using over-the-counter pain relievers. Consult a healthcare provider if you have a deep wound, especially if it continues to bleed or if you have a sore that does not go away in a week or two.

If you are experiencing a sore throat from GERD, it’s best treated in consultation with a qualified healthcare provider. Antacid medications and proton pump inhibitors are frequently used. Elevating your head while you sleep can also help with nighttime GERD symptoms.

3. COVID-19

Viral infections are a common cause of a sore tongue and throat. These infections include the common cold and flu, but also COVID-19.

Symptoms

In addition to a sore throat, COVID symptoms include:

• Respiratory symptoms, including a runny nose, cough, and shortness of breath
• Fever or chills
• New loss of taste or smell
• Fatigue and/or muscle aches
• Headache
• Nausea or vomiting

Causes

COVID-19 is caused by a coronavirus. Other viral infections can include infectious mononucleosis, most often caused by the Epstein-Barr virus (EBV).

Treatment

Viral infections cannot be treated with antibiotics. Your healthcare provider may recommend antiviral medications, depending on age and other factors. COVID-19 can be treated with:

• Paxlovid (nirmatrelvir with ritonavir) in people 12 years and older and within five days of first symptoms
• Lagevrio (molnupiravir) in adults within five days of first symptoms
• Veklury (remdisivir) in adults and children, within seven days of first symptoms

Talk with your healthcare provider about home remedies and OTC medications. Also, consider getting a COVID vaccine to help prevent serious illness.

4. Strep Throat

Bacterial infections can cause symptoms of a sore throat and tongue. Strep throat is a common bacterial cause, responsible for 20% to 30% of all sore throats in children and up to 15% in adults.

Symptoms

Strep throat is known to cause:

• Small red spots in the mouth and throat, known as petechiae.
• Painful swallowing
• Fever
• Swollen lymph nodes on the neck
• Red or swollen tonsils that can show white spots of pus.

Causes

Strep throat is a common bacerial infection, caused by A Streptococcus bacteria. Other bacterial causes include whooping cough, and certain sinus and ear infections with sore throat symptoms.

Treatment

Bacterial infections can be treated with antibiotics, such as penicillin or amoxicillin. This can prevent complications including rheumatic fever or kidney inflammation.

You can try these home remedies, too:

• Lozenges and ice chips to moisten throat
• Fluids to stay hydrated
• Honey (but not in children less than a year old)
• Steam humidifier

Over-the-counter medications recommended by your healthcare provider also can help.

5. Oral Thrush

Fungal infections also can lead to a sore tongue and throat. Oral thrush is a common fungal infection caused by a type of yeast. It can cause pain in the tongue and the throat, along with other characteristic symptoms.

Symptoms

Oral thrush is characterized by white patches inside the mouth, the tongue, and/or the back of the throat. Other symptoms include:

• Red, sore tissue under the white patches
• Pain when swallowing
• Cracked lips, especially at the corners
• Dry mouth
• Unpleasant taste in the mouth
• Bad breath
• A feeling of something stuck in the throat

Causes

Oral thrush is caused by an overgrowth of the yeast Candida albicans. This yeast is naturally present in the mouth and throat, but problems with the immune system or the body’s natural balance of bacteria can cause it to grow out of control. You are more likely to get oral thrush if:

• You’ve been taking antibiotics, which can kill some of the healthy bacteria in your mouth.
• You have a condition that affects the immune system, such as HIV or AIDS.
• You are being treated for cancer or with other drugs that weaken the immune system.
• You are older or in poor health.
• You have certain health conditions, such as diabetes.

It is also common for newborns to develop thrush.

Treatment

Mild thrush can be treated with OTC acidophilus pills. Eating yogurt may also help restore the healthy balance of bacteria in your mouth.

If you have a more severe case of oral thrush, your healthcare provider may recommend:

• Nystatin, an antifungal mouthwash
• Clotrimazole lozenges
• Antifungal medications such as Diflucan (fluconazole) or Sporanox (itraconazole)

6. Neuralgia

Glossopharyngeal neuralgia is a condition that causes severe nerve pain in the tongue, throat, and sometimes the ear.

Symptoms

Symptoms may include:

• Severe pain in the tongue, throat, or ear lasting from a few seconds to a couple of minutes that can be described as sharp, stabbing, or like an electric shock
• Pain that occurs after swallowing, coughing, talking, or yawning
• Possible heart symptoms (low pulse, low blood pressure, fainting) or seizures

Causes

Glossopharyngeal neuralgia is typically caused by a compressed nerve, damage to a blood vessel supplying a nerve, or a deterioration of the protective sheath covering the nerve (such as occurs with a disease like multiple sclerosis). A growth or tumor may compress the nerve, or it can be compressed by a blood vessel or other nearby structure.

Treatment

Over-the-counter medications such as acetaminophen and ibuprofen are not very effective for neuralgia. Instead, your healthcare provider may recommend the following:

• Medications like Neurontin (gabapentin) or Tegretol (carbamazepine) target nerve pain. These may initially relieve the pain caused by glossopharyngeal neuralgia but tend to lose effectiveness over time.
• For throat pain, some people find it effective to use a local anesthetic medication called Lidocaine (xylocaine) to numb the back of the throat, making it more comfortable to swallow. Consult your healthcare provider before using lidocaine, as a lidocaine overdose can be serious.
• Surgery may be effective for some people. For example, if the neuralgia is caused by a blood vessel that is compressing the nerve, a surgical procedure called microvascular decompression (MVD) can be used to re-route the blood vessel. If the nerve is compressed by a growth or tumor, it can also sometimes be surgically excised.

7. Burning Mouth Syndrome

Burning mouth syndrome (BMS) is a complex illness that mostly affects people over the age of 60, especially those who have gone through menopause. If you suspect this may be the cause of your sore tongue or throat, talk with a healthcare professional.

Symptoms

Symptoms of burning mouth syndrome may include:

• Severe, constant burning sensation usually located at the tip of the tongue that may also affect your throat, lips, or your whole mouth
• Numb, stinging, or tingling sensation in the mouth
• Dry mouth and increased thirst
• Metallic taste in the mouth
• Problems swallowing or chewing

Causes

The causes of burning mouth syndrome can be numerous and difficult to identify. Some conditions known to contribute to burning mouth syndrome include:

• Nerve damage to the nerves that control pain or the sense of taste
• Fungal infections, such as oral thrush
• Hormone imbalances
• Vitamin deficiency (vitamin B and iron)
• Oral habits, like grinding teeth
• Diabetes
• Allergies to dental products and materials, or food allergies
• Acid reflux
• Dry mouth, including side effects of chemotherapy

Treatment

Treatment for burning mouth syndrome depends on the underlying cause. It may involve:

• Antiseizure medication such as clonazepam
• Vitamin B supplements
• Medications for nerve pain
• Oral thrush medication
• Cognitive behavioral therapy (CBT)
• Oral rinse
• Saliva replacement products

Treatment will not be the same for everyone. The most effective therapies will depend on a person’s symptoms. For example, a fungal infection needs to be treated with anti-fungal medication, and hormone imbalances and vitamin deficiencies must be corrected.

Other less common treatment methods may be aimed at blocking the pain receptors through electrical devices or with the use of topical medications, behavioral or lifestyle changes, or counseling if stress or psychological issues are thought to be a contributing factor.

8. Tongue Cancer

Oral cancer involving the tongue is one of the most common types of head and neck cancer. Traditionally, cancer of the tongue has occurred more frequently in males of older age who have a history of drinking alcohol or smoking tobacco.

In recent years, although the overall incidence of tongue cancer has been decreasing, this type of cancer has increased in incidence among younger women who do not have a history of drinking alcohol or using tobacco. Tongue cancer has also been increasing in younger patients due to exposure to the human papillomavirus (HPV).

Symptoms

The most common and first noticed symptom of tongue cancer is usually a sore on the tongue that does not go away. This sore may hurt and may bleed easily. Other symptoms may include:

• Difficulty swallowing or experiencing pain when swallowing
• Weight loss
• Difficulty speaking (slurring words)
• Lumps in the neck or surrounding area, or swollen lymph nodes if the cancer has spread

Causes

It is not always possible to identify the exact cause of tongue cancer. Still, certain risk factors are associated with this type of malignancy, including alcohol and tobacco use, inadequate oral hygiene, and HPV infection.

Treatment

The treatment for tongue cancer depends on the stage of cancer at the time of diagnosis. If caught early, surgery may be the only treatment necessary.

The extent of surgery required depends on the size of the tumor, whether more than one tumor is found, or if there is localized spread of the cancer. Depending on how much of the tongue is affected, reconstruction may be necessary to preserve speech and the ability to swallow.

Later stages of the disease usually require several types of treatment. Depending on where the cancer is found, surgery or combinations of surgery, radiation, and chemotherapy may be necessary.