What to do if the root of the tongue hurts when swallowing, why does this happen?

Tongue cancer is a fairly common pathology in the structure of malignant neoplasms of the head and neck organs (about 55% of cases), and in the general structure of malignant neoplasms it accounts for 0.45%. The average age of those affected is 60 years, men suffer from it 3 times more often than women. But the tumor can also occur in young people and even children.

• Causes of tongue cancer
• Symptoms of tongue cancer
• Methods for diagnosing tongue cancer
• Treatment of tongue cancer
• Prevention

Most often, cancer is localized on the lateral surface, a little less often on the root of the tongue, and very rarely in the area of ​​its back and tip. [1,2]

Anatomical structure of the tongue

Causes of tongue cancer

The following risk factors have been described that significantly increase the likelihood of developing tongue cancer:

• Use of tobacco products in various forms (smoking, chewing, sucking).
• Alcohol abuse.
• Infection with human papillomavirus.
• Chemical and thermal damage to the mucous membrane of the tongue, including conditions after burns.
• Chronic trauma to the tongue, for example, biting it, rubbing it with dentures, etc.
• Hereditary predisposition.

Also of great importance are precancerous diseases, which with varying degrees of probability lead to the development of tongue cancer:

• Leukoplakia.
• Bowen's disease.
• Post-radiation stomatitis.
• Chronic ulcers and fissures.
• Systemic lupus erythematosus.

Ulcers or changes in the mucous membrane that have existed for more than 2 weeks should be grounds for contacting a doctor. The initial examination is traditionally carried out by a dentist, who, if necessary, will refer the patient to an oncologist. But if you contact an oncologist yourself first, this will in no case be a mistake. [1.8]

What is dystonia?

Dystonia of the tongue muscles causes involuntary movements of the tongue and uncontrolled mobility of structures adjacent to the tongue, which can lead to problems with chewing food and articulating sounds. As experts note, this may result in weight loss and loss of the ability to speak. In particularly severe cases, for example, when a patient may suddenly choke on food, tongue dystonia can provoke the development of more serious health problems.

According to observations, musicians who play wind instruments are more susceptible to spasms of the mouth muscles.

Symptoms of tongue cancer

In many cases, tongue cancer is discovered by patients themselves, who complain of non-healing ulcers, nodules or papillomas. These tumors gradually increase in size and begin to interfere with the patient's chewing and swallowing. Speech may also be impaired. [4]

Malignant tumor of the tongue

Depending on the clinical picture, three forms of tongue cancer are distinguished:

• Ulcerative. It appears as a non-healing ulcer that grows in size, may bleed, and eventually begins to emit a foul odor.
• Knotty. Cancer looks like a dense nodule with clear edges. There may be white spots on its surface.
• The papillary form has the appearance of a dense plaque that rises above the surface of the tongue.

According to the nature of growth, there is an exophytic form of cancer, which grows in the oral cavity, and an endophytic form, spreading into the thickness of the tongue, as well as a mixed one. The exophytic form often looks like cauliflower growths that can ulcerate and bleed. The endophytic form is more characterized by compaction of the tongue tissue, which upon palpation looks like a dense infiltrate without clear boundaries. [1]

In later stages, the following symptoms may occur:

• Pain of varying degrees of intensity, which can radiate to the ear, temple, and back of the head. Some patients mistake it for a sore throat or pharyngitis.
• Increased salivation - hypersalivation. Occurs due to irritation of the mucous membrane by cancer breakdown products.
• Bad breath. It is the result of infection of the tumor or its disintegration. [5]

Tongue hurts on the sides: causes and treatment

This usually looks like an outwardly noticeable change in the surface of the tongue, cheeks, and gums. The affected area hurts and turns red.

We suggest you read: How to properly care for removable dentures

A very interesting symptom that requires careful diagnosis is pain in the oral cavity, in particular when the tongue hurts on the sides.

The pain is severe, constant, intensifies when eating, smoking, talking and takes a very long time to pass. The process itself can be chronic or acute.

This symptom can be observed in a number of diseases of different organs and systems, or may not be associated with the disease at all. First things first.

What does it look like

In diagnosis, great importance is attached to the appearance of the affected organ. The tongue, the pathological process in which is accompanied by pain, also changes its appearance depending on the cause.

If there are disorders of the pancreas, for example, pancreatitis or diabetes, the tongue becomes dry, cracks may form, and even swelling may appear.

In case of liver diseases, in which the tongue hurts, a phenomenon such as a teeth imprint on the lateral surfaces of the tongue may appear.

In addition, in a number of pathologies of an infectious nature, the tongue may appear “polished” - it becomes bright and shiny, and a white border appears along the edge of these red zones - a common occurrence in endocrine disorders.

If allergic pain occurs, the sensation is usually more like itching and swelling. This can be eliminated by taking antihistamines.

Of course, appearance alone is not enough - you need to find out the real cause of this problem and undergo a full course of treatment.

Causes

The most common reason why the tongue hurts is traumatic injury. But there may be other reasons. For ease of understanding, it is worth dividing the reasons that cause such pain into two groups:

• caused by diseases;
• caused by external influences.

The first group includes:

• inflammatory processes of the oral mucosa (stomatitis, gingivitis);
• dental diseases (caries, pulpitis);
• diseases of the gastrointestinal tract (gastritis, gastroduodenitis);
• blockage of the salivary glands;
• viral or bacterial glossitis (inflammation of the tongue);
• allergic reactions (mainly food allergies);
• oral oncology;
• anemia.

The second group implies the presence of such factors:

• frequent smoking;
• mechanical damage by the sharp edge of teeth affected by caries;
• eating garlic, onions, spicy and sour foods.

This is due to the fact that the oral cavity has particularly high enzymatic activity and is constantly exposed to irritation - during speaking, eating, even breathing.

It is especially difficult to restore your integrity under such loads. The lateral surfaces of the tongue are constantly in contact with the teeth, which makes the healing process even longer and the pain more intense.

Where to contact

You should start looking for the reasons why your tongue hurts by going to the doctor, of course. Self-treatment of tongue pain can be either ineffective or lead to serious complications. It is better to devote a few hours to your health and be sure that it is in the hands of a specialist.

Specialists in the following medical fields are suitable for this purpose:

• dentist - this is where you should start;
• gastroenterologist;
• therapist;
• surgeon;
• hematologist;
• endocrinologist;
• dermatologist.

Pathology from the field of each doctor listed may be the root cause or consequence of a tongue disease.

The doctor, having heard such a complaint, must carefully examine the patient’s oral cavity, determine whether there is a source of damage in it in the form of sharp tooth edges or stomatitis. If no such pathologies were found, the doctor must prescribe a number of mandatory clinical studies to find out the causes of the pathology in the tongue:

• general and biochemical blood test;
• Analysis of urine;
• level of gastric secretion;
• fibroesophagogastroduodenoscopy (FEGDS);
• hormonogram (in particular, pancreatic hormones);
• Ultrasound of the abdominal organs;
• X-ray of the stomach with contrast.

Based on the research results obtained, the doctor can make the correct diagnosis. Treatment of the manifestations themselves in the form of pain does not solve the problem - it is necessary to cure the cause itself.

Methods for diagnosing tongue cancer

Examination of the tongue and oral cavity
Diagnosis of tongue cancer involves a comprehensive examination, which includes the following manipulations:

• Examination of the oral cavity.
• Palpation of the tumor and areas of regional lymph nodes.
• Verification of diagnosis using cytological examination. To do this, a puncture biopsy and/or impression smears from the tumor are taken.
• MRI - evaluates the soft tissues of the head and neck, as well as the degree of tumor invasion in them.
• CT with contrast - helps to evaluate the presence of cancer growth in the bones, in particular in the lower jaw.
• Ultrasound examination of the area of ​​regional metastasis can identify metastases.

According to indications, endoscopic examination of the pharynx, chest x-ray and other diagnostic methods can be performed, which are aimed at clarifying the extent of the malignant process and detecting distant metastases. [3.6]

Effective treatments

The treatment regimen is determined by the doctor in each case individually. Medicines are selected depending on the patient’s age, diagnosis and the presence of chronic diseases. The patient may be prescribed the following medications:

• broad-spectrum antibiotics;
• antifungal agents;
• antiseptic solutions for mouth rinsing - Miramistin or Furacilin;
• It is recommended to treat problem areas of the tongue with sea buckthorn oil;
• Vitamin and mineral complexes may be prescribed to strengthen the immune system.

In addition to drug treatment, alternative medicine recipes may be recommended:

1. Cultivated peony leaves are brewed at the rate of 4 tablespoons of plant material per liter of water. Leave for half an hour and use as a mouth rinse.
2. A tablespoon of propolis alcohol tincture is diluted in a glass of boiled water. Rinse the mouth with the resulting mixture 3 times a day.
3. Brew oak bark in the amount of 1 tablespoon of plant material per 0.5 liter of water. Infuse the decoction for 20 minutes, then filter and use for rinsing the mouth.

For the sanitation of the oral cavity, decoctions of sage and chamomile can be recommended. You can gargle with such solutions every 2-3 hours.

Treatment of tongue cancer

The following methods are used to treat tongue cancer:

• Surgical intervention.
• Radiation therapy.
• Chemoradiation therapy.

Surgery is the main radical treatment method. In this case, preference is given to organ-preserving operations so that a person can talk, chew food and swallow it. The extent of the operation will depend on the size of the tumor and the involvement of surrounding tissues in the process. In some cases, it may be necessary to remove tissue from the floor of the mouth, resection of the jaw, and even complete removal of the tongue. If metastases are present, the lymph nodes in the neck are removed at the same time. To cover the resulting defects, skin flaps are used; for jaw plastic surgery, fragments of ribs, fibula, or artificial implants are used.

Surgery for tongue cancer

For large tumors or in the presence of unfavorable histological factors, combined interventions are performed. In such cases, radiation therapy is performed after surgery. In some situations, it is possible to carry out radiation therapy as an independent treatment method. In this case, the irradiation zone includes the tumor itself and the area of ​​regional metastasis.

In the presence of distant metastases, positive resection margins, perineural invasion and other unfavorable factors, chemoradiotherapy is performed after surgery. [8]

When carrying out systemic therapy followed by chemoradiotherapy, the following chemotherapy drugs are used:

1. Cisplatin (preferably) as monotherapy.
2. Cetuximab as monotherapy.
3. Carboplatin + fluorouracil.
4. Fluorouracil + hydroxyurea.
5. Cisplatin + paclitaxel.
6. Cisplatin + fluorouracil.
7. Carboplatin + paclitaxel.

If simultaneous chemoradiotherapy is indicated, cisplatin + radiation therapy to the primary lesion of at least 70 Gy is used.

For anti-relapse chemotherapy, the following combinations of drugs can be used:

• Docetaxel + cetuximab. In the absence of progression, therapy with cetuximab is continued.
• Paclitaxel + carboplatin + cetuximab. In the absence of disease progression, treatment is also continued with cetuximab.

2nd line chemotherapy may include one of the regimens listed above, and it is also possible to add nivolumab, pembrolizumab, afatinib. [1]

Symptoms

Diseases accompanied by pain in the root of the tongue are characterized by specific symptoms. The gradation of symptoms allows one to distinguish one disease from another.

Tonsillitis

The disease has another common name for hearing – sore throat. It is a mistake to believe that the disease is caused by a cold. It occurs as a result of the penetration of a staphylococcal or treptococcal infection. Pathogenic microorganisms settle on the tonsils of the oral cavity. Their waste products cause inflammation.

For persistent pain in the root of the tongue, combined with the sensation of a foreign body in the throat when swallowing food or saliva, an MRI examination should be performed first.
Such signs may indicate the development of a tumor process in soft tissues.

Dentist

Novikova Olga Alexandrovna

8 years of experience

Tonsillitis is characterized by:

• sore throat (constantly want to cough);
• painful sensations when swallowing;
• redness and swelling of the larynx;
• a hoarse voice if the infection has affected the vocal cords;
• increased temperature ;
• reaction of the lymph nodes to the source of inflammation;
• yellow or white coating on the tonsils and base of the tongue;
• the formation of purulent ulcers (with purulent sore throat).

Inflammatory processes occurring in the lingual tonsil

The appearance of pain at the base of the tongue indicates the development of an inflammatory process in the lingual tonsil.

Signs of pathology:

• swelling of the tongue, preventing food from being pushed into the larynx;
• increase in temperature indicators;
• increased pain when protruding the tongue;
• problems with pronunciation of sounds;
• yellow or white plaque on the tonsil.

The disease carries a risk of death. If treatment is not started in time, the swelling spreads to the larynx, which causes suffocation. Therefore, if you experience pain at the root of the tongue and swelling, you should immediately seek help from a specialist.

Consequence of sore throat - abscess

An abscess develops as a result of damage to the peritonsil tissue. The lesion usually occurs on one side. Less commonly, an abscess develops to the left and right of the tongue.

Symptoms of an abscess include:

• change position : tilting to the affected side;
• feverish condition;
• headache ;
• problems with swallowing and pronouncing words;
• swelling of the tongue;
• putrid odor from the mouth caused by purulent processes.

Glossitis

Glossitis is an inflammation of the soft tissues of the tongue. When the mucous membrane is damaged, a burning sensation, the appearance of a white coating, and tissue soreness are noted.

The spread of infection to soft tissue is characterized by swelling and discoloration of the tongue, the appearance of a feeling of a foreign object in the throat, making it difficult to swallow and speak.

Injury

In addition to inflammation, pain in the root of the tongue occurs as a result of mechanical and chemical damage.

Causes of injury include:

• damage caused by caustic fumes (for example, professional activities involving mercury);
• acid entering the oral cavity , causing a burn;
• eating hot, cold or spicy foods;
• injuries to the head and jaw (for example, an accident, beating, robbery);
• poor-quality work by the dentist, which resulted in injury to the soft tissues and mucous membrane of the tongue;
• biting and swallowing the tongue during epileptic seizures;
• mechanical damage (bone getting stuck, swallowing small objects).

Nerve damage

Neuralgia of the glossopharyngeal nerve occurs among the adult population, especially in men over 40 years of age.

Signs of the disease include:

• the appearance of lumbago during chewing, yawning and opening the mouth wide;
• pain radiating to neighboring organs (ears, eyes, neck);
• the appearance of a feeling of foreign object in the throat, interfering with the normal functioning of the tongue;
• problems with identifying tastes (inability to distinguish tastes or their distortion).

Causes of neuralgia include:

• hypothermia of the body;
• compression of the head of the glossopharyngeal nerve by tumor formations;
• inflammatory pathologies of the central nervous system;
• infectious diseases of the oral cavity or adjacent organs (ears, nose).

Tumor

Signs of oral tumors include:

• prolonged aching pain that cannot be blocked by anti-inflammatory drugs;
• problems associated with chewing, pushing food down the throat, pronouncing words;
• feeling of a foreign body in the throat.

Prevention

Prevention of tongue cancer involves reducing exposure to risk factors and regular dental checkups. In order to minimize the likelihood of developing this disease, it is necessary to give up smoking and alcohol abuse, as well as the use of chewing mixtures. Monitor your oral health carefully. Chronic injury to the tongue should not be allowed; teeth must be treated and dentures adjusted in a timely manner. If long-term (more than 2 weeks) formations are detected, you definitely need to consult a doctor as soon as possible. [1.7]

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Bibliography:

1. Clinical recommendations. — Malignant neoplasms of the oral cavity. Ministry of Health of the Russian Federation. — 2022.
2. MM. Soloviev. — Practical Oncology • T. 4, No. 1 – 2003, Cancer of the mucous membrane of the oral cavity and tongue (reserves for improving treatment results), 2003
3. A.L. Yudin. — Cancer of the tongue and floor of the mouth: modern aspects of diagnosis — Bulletin of Radiology and Radiology No. 5, 2015.
4. Clinical protocol for diagnosis and treatment. — Malignant neoplasms of the oral cavity. The Republic of Kazakhstan. — 2015.
5. Malignant tumors of the organs of the mucous membrane of the oral cavity and tongue. Educational method. manual./O.P. Chudakov, L.E. Moiseichik, T.B. Lyudchik, L.G. Bykadorova. - Mn.: BSMU, 2007. - 39 p.
6. V.A. Soloviev. — Possibilities of ultrasound diagnosis of tumors of the tongue and floor of the mouth. — Oncology. Journal named after P.A. Herzen, 4, 2015. doi: 10.17116/onkolog20154418-21.
7. A.R. Gevorkov. – Independent conservative and combined treatment of tongue cancer. – Oncology. Journal named after P.A. Herzen, 4, 2014.
8. Rodrigo Arrangoiz. — Oral Tongue Cancer: Literature Review and Current Management. - Сancer Rep Rev, 2022. - Volume 2(3): 1-9. - doi: 10.15761/CRR.1000153.

Disadvantages of self-treatment

If the tongue hurts or there is a sore throat, patients often prefer to treat themselves at home using traditional medicine. This can cause generalization of the process and progression of malignant diseases. It is better to contact the nearest medical facility.

If you experience pain in your tongue and throat, do not do the following:

1. Do not consult a doctor for a long time, eliminating only the symptoms.
2. Use folk remedies that erase the picture of the disease.
3. Select medications based on advertising and media.
4. Taking antibiotics without identifying the cause of the disease. Patients often take medications that are not intended to treat a specific pathogen.
5. Use a large number of symptomatic drugs that can harm internal organs.
6. Treat children independently without consulting a doctor.