Having a sore throat is uncomfortable enough, and even more so when accompanied by a sore tongue. Soreness in both throat and tongue isn't a rare symptom of certain health conditions, however, your diagnosis depends on other signs and symptoms you may be experiencing. A painful throat and tongue is typically caused by something visible and obvious, although there are other less obvious reasons you should be aware of that might require a doctor's diagnosis.
Causes of Sore Throat and Tongue
1. Oral Thrush
Oral thrush of the mouth (oropharyngeal candidiasis), is a fungal infection of a yeast called Candida that occurs when there is overgrowth. Candida yeasts are normal, and live on the mucous membranes or skin in small amounts. However, if the conditions in the mouth or throat becomes unbalanced, the yeast can quickly multiply and cause symptoms.
Symptoms may develop slowly or very suddenly, and depending on the underlying cause, they can persist over days, weeks or months. Signs can include:
- A cottony feeling in the mouth
- Creamy white lesions on your gums, inner cheeks, tongue, tonsils, and on the roof at the back of your mouth
- Diminished sense of taste
- Slightly raised lesions clustered together
- Light bleeding when the lesions are scraped or rubbed
In severe cases, the lesions may spread downward into your esophagus, the long, muscular tube stretching from the back of your mouth to your stomach. This may cause sore throat and tongue that makes it difficult to eat or swallow and you may feel like something stuck in throat.
2. Mouth Ulcers
Mouth ulcers are small shallow sores that begin as small, reddish swellings. Then they burst, and the rupture sores are covered with a white or yellow membrane. The edges of the sores are still red and look like a painful red halo. Often, several appear at the same time and may present in clusters.
You might have a mouth ulcer if you have:
- A sore or sores inside your mouth, on the soft palate on the back portion of the roof of your mouth, in the throat, or inside of your cheeks.
- Sores that appear as a whitish, round area with a red border and are painful and sensitive to touch.
In severe cases, you can also experience:
- Physical sluggishness
- Fever
- Swollen lymph nodes
3. Burning Mouth Syndrome
Burning mouth syndrome is a medical term used to describe chronic or recurrent burning in the mouth that doesn't have an obvious cause. The discomfort can affect the throat, tongue, lips, gums, roof of the mouth, the inside of the cheeks, or widespread areas of the whole mouth.
Symptoms include:
- A scalded or burning sensation that typically affects your tongue, but it can also affect your throat, gums, lips, palate, or the entire mouth
- A dry mouth and increased thirst
- Diminished sense of taste
- A bitter or metallic taste
The discomfort from burning mouth syndrome usually has several different patterns. It can:
- Occur daily, with less discomfort when you wake, but become worse as the day progresses
- Start when you wake up and last all day long
- Come and go intermittently
Burning mouth syndrome typically doesn't cause any noticeable physical changes in your tongue or mouth. Whatever pattern of mouth discomfort you have, burning mouth syndrome can last for months to years. In rare cases, symptoms may suddenly become less frequent or go away on their own. Some sensations may be temporarily relieved when drinking or eating.
4. Medication Reaction
Any medication, and even natural remedies, has side effects when used by some people. Sensitivity to medication, allergy, or a reaction to a large dose of medicine can all cause side effects. Symptoms include but are not limited to:
- Burning sensation or bad taste in mouth
- Tight or sore throat and tongue
- Slurred speech
- Difficulty opening mouth
- Nervousness
- Skin blisters
- Cough
5. Allergic Reaction
Immune system is the body's defense against bacteria and viruses. Sometimes, the immune system defends against substances that usually don't present a threat to your body. Some of these substances are known as allergens, and when your immune system reacts to them, it causes an allergic reaction. You could inhale, touch, or eat allergens that cause an allergic reaction, and symptoms vary from mild to severe.
First time exposures to substances typically cause mild symptoms; however, they may get progressively worse with repeated contacts with the allergen. Mild allergic reaction symptoms may include:
- Itchy red spots on the skin (hives)
- Itchy or watery eyes
- Rash
- Nasal congestion (rhinitis)
- Scratchy throat
Severe allergic reaction symptoms can include:
- Swollen or sore throat and tongue, mouth, orlips
- Losing consciousness (fainting), feeling lightheaded or weak, confused, or restless
- Trouble breathing
- Sudden red and raised areas on the skin all over your body
6. Head and Neck Cancer
Head and neck cancer are cancers of the nose, sinuses, mouth, salivary glands, throat, or lymph nodes in the neck. Many begin in the moist tissues that line the nose, mouth, and throat. These cancers may also cause symptoms such as a sore throat and tongue; however, symptoms often persist beyond a few weeks in spite of any treatment. These cancers can also be accompanied by trouble breathing, coughing, hoarseness, ear pain or unexpected weight loss.
Head and neck cancer symptoms may also include:
- Trouble swallowing (dysphagia)
- A lump in the throat, neck, or nose
- Frequent coughing
- Change in voice or hoarseness
- Ear pain or trouble hearing
- Unexplained weight loss
- Headaches
When to See a Doctor
Most mouth sores and irritations disappear within two weeks. However, if your sore throat and tongue returns, or if it lasts longer than two weeks with no sign of clearing, make an appointment with your health care provider.
Take seriously any sore throats that are exceptionally severe, or if accompanied by a fever more than 101, because it might indicate a bacterial infection that requires antibiotic treatment. You may also have a need for more comprehensive treatments for tonsillitis, swollen glands, or a thyroid condition.