Discovering bumps on your tongue, especially at the back, can be concerning. While many causes are harmless and resolve on their own, understanding the potential reasons can ease your mind and guide you on when to seek medical advice. This article explores the common culprits behind these bumps, helping you differentiate between minor irritations and conditions that might require attention.
Common Causes of Bumps on the Tongue (and Back of Tongue)
Several factors can lead to the appearance of bumps on your tongue. Here are some of the most frequent causes:
Enlarged Papillae
Papillae are small, nipple-like projections that cover the surface of your tongue, giving it its rough texture. Sometimes, these papillae can become enlarged or inflamed, appearing as noticeable bumps. While less common on the very back of the tongue, papillae are present throughout, and irritation can cause them to swell anywhere on the tongue’s surface. In rare cases, certain medications like imipenem, an antibiotic, can cause enlarged papillae as a side effect. Often, enlarged papillae are simply a temporary nuisance.
Canker Sores
Canker sores are small, shallow ulcers that can develop on the soft tissues in your mouth, including the tongue. They are characterized by a grayish-white center surrounded by a red, inflamed border. While canker sores are more commonly found on the inside of the cheeks and lips, they can also appear on or under the tongue, potentially extending towards the back. Unlike cold sores, canker sores are not contagious. Triggers for canker sores can include stress, fatigue, illness, and certain food sensitivities, although the exact cause remains unknown.
Cold Sores (Fever Blisters)
Cold sores, also known as fever blisters, are caused by the herpes simplex virus (HSV-1). These fluid-filled blisters typically appear on the lips, but they can sometimes occur on the tongue as well. While less frequent on the back of the tongue, cold sores can develop anywhere on the oral mucosa after initial or recurrent HSV-1 infection. Cold sores are highly contagious and spread through close contact like kissing, sharing utensils, or saliva.
Anaphylaxis (Severe Allergic Reaction)
Anaphylaxis is a severe and potentially life-threatening allergic reaction. When someone with a severe allergy is exposed to an allergen, their body can react intensely. One symptom of anaphylaxis can be the sudden appearance of bumps on the tongue, accompanied by swelling of the tongue, lips, and face, as well as hives, rash, itching, and difficulty breathing. Anaphylaxis requires immediate medical attention. If you suspect you are experiencing anaphylaxis, call emergency services (9-1-1 in the US) right away.
Transient Lingual Papillitis (Lie Bumps)
Transient lingual papillitis, commonly known as “lie bumps,” is a condition characterized by the sudden appearance of small, inflamed bumps on the tongue. These bumps can be painful or simply noticeable and often disappear on their own within a few days. Lie bumps can occur anywhere on the tongue, including the back, sides, and tip. While the exact cause is unknown, they are thought to possibly be related to stress, irritation, or viral infections. There are different forms of transient lingual papillitis:
- Classic Form: The most common type, causing red and white painful bumps, often on the sides and tip of the tongue but can occur elsewhere.
- Papulokeratonic Form: Appears as white or yellowish spots across the tongue, usually painless but can be persistent.
- Eruptive Form: More common in children and may be contagious, sometimes accompanied by fever and swollen lymph nodes.
- U-Shaped Form: Characterized by a U-shaped pattern of bumps, often associated with tongue swelling, and has been observed in some COVID-19 patients, possibly linked to the virus itself, oxygen therapy, or poor oral hygiene during illness.
Syphilis
Syphilis is a bacterial infection primarily spread through sexual contact. Oral syphilis can manifest as sores called chancres in the mouth, lips, or tongue. These chancres can appear anywhere in the oral cavity, including the back of the tongue. Syphilis is contagious and can be transmitted through oral sex or deep kissing with someone who has an oral syphilitic chancre.
Human Papillomavirus (HPV)
Human Papillomavirus (HPV) is another sexually transmitted infection. Certain types of HPV can cause bumps or lesions in the mouth and throat, including on the tongue. Often, oral HPV infections are asymptomatic and clear up on their own. However, some types can persist and lead to the development of warts or other lesions in the oral cavity, potentially including the back of the tongue.
Oral Cancer
While less likely to be the cause of common tongue bumps, oral cancer is a serious consideration if bumps persist or exhibit certain characteristics. Oral cancer can develop anywhere in the mouth, including the tongue. Bumps or growths associated with oral cancer are more concerning if they are located on the side of the tongue rather than the top surface, are painless, and feel hard or fixed in place.
When to Be Concerned and Seek Medical Advice
Most bumps on the tongue are benign and will resolve on their own. However, it’s important to be aware of signs that warrant medical attention. Consult a doctor or dentist if you experience any of the following:
- Persistent bumps: If bumps on your tongue last for more than two weeks without improvement.
- Bumps on the side of the tongue: Bumps in this location have a slightly higher risk of being associated with more serious conditions.
- Hard, painless bumps: Especially if located on the side of the tongue, these could be a sign of oral cancer and require prompt evaluation.
- Pain that doesn’t improve: While canker sores and lie bumps can be painful, persistent or worsening pain should be checked.
- Difficulty swallowing, speaking, or moving the tongue: These symptoms could indicate a more significant issue.
- Other concerning symptoms: If you have bumps accompanied by fever, swollen lymph nodes, unexplained weight loss, or red or white patches in your mouth, seek medical advice.
Conclusion
Finding bumps on the back of your tongue can be alarming, but in many cases, the cause is benign, such as enlarged papillae, canker sores, or lie bumps. Understanding the potential causes can help you monitor your symptoms and know when it’s necessary to seek professional medical evaluation. If you are concerned about bumps on your tongue, especially if they persist, are painful, or are accompanied by other worrying symptoms, don’t hesitate to consult with a healthcare provider for proper diagnosis and guidance.
