The floor of the mouth is a complex region housing muscles, ducts, and connective tissues. Experiencing sharp pain when lifting the tongue often signals irritation or injury to one of these underlying structures. This discomfort indicates that the movement is placing strain on sensitive tissue or compressing an already inflamed area. Understanding the anatomy involved helps determine whether the symptom requires medical attention.
Pain Related to Movement and Structure
The most direct cause of pain when lifting the tongue is usually irritation or strain of the lingual frenulum, the thin band of tissue connecting the underside of the tongue to the floor of the mouth. This structure is highly sensitive and is stretched taut when the tongue is elevated, causing immediate discomfort if it is damaged or inflamed. Minor physical trauma is a frequent source of frenulum pain, often caused by accidentally biting the area, irritation from sharp pieces of food, or friction from orthodontic devices. The resulting soreness often manifests as a sharp, localized pain during movement, such as speaking or swallowing, when the frenulum is under tension.
Muscle Strain and Restriction
In rare cases, the pain can relate to a deep muscle strain in the mylohyoid or geniohyoid muscles, which form the supportive floor of the mouth. Overuse or sudden, forceful movements can lead to myalgia in the area. If discomfort relates to restricted movement, a naturally short frenulum, known as ankyloglossia or “tongue-tie,” may be a factor, restricting mobility and causing chronic tension.
Issues Affecting the Salivary Glands
A common cause of pain under the tongue is a problem with the salivary glands, particularly the submandibular glands, whose main ducts open into the floor of the mouth. The pain often originates from sialolithiasis, a condition where calcified mineral deposits, called salivary stones, form within the duct and obstruct the flow of saliva. Lifting the tongue can compress this blocked duct, leading to a surge of sharp pain as the trapped saliva has nowhere to go.
This pain frequently intensifies just before or during eating, when salivary production increases rapidly. This stimulation, combined with tongue movement, causes a painful backup of saliva within the gland, which may also present as a noticeable swelling under the jaw or tongue. If the blockage leads to a bacterial infection (sialadenitis), the pain becomes constant, accompanied by persistent tenderness and visible redness. Simple home care measures for non-infected stones include staying hydrated and using sour foods to stimulate salivary flow, which can sometimes help dislodge a small stone.
Surface Injuries and Inflammatory Causes
Pain can also stem from superficial lesions or generalized inflammation on the mucosal lining of the floor of the mouth, which are aggravated when the tissue is stretched. The most frequent culprit is the aphthous ulcer, commonly known as a canker sore, which appears as a small, round lesion with a white or yellow center and a surrounding red border. These ulcers can form under the tongue and cause intense, localized pain when the tongue is moved, stretching the inflamed tissue.
While the exact cause of aphthous ulcers is often unclear, they are frequently triggered by minor local trauma, such as a scrape from a sharp chip or a slip of a toothbrush, or by periods of emotional stress or nutritional deficiencies. Other inflammatory conditions, such as generalized stomatitis or viral lesions, can also make the entire sublingual area tender. These surface irritations typically heal on their own within 7 to 14 days.
When to Consult a Healthcare Professional
While most instances of pain under the tongue are benign and temporary, certain warning signs indicate the need for prompt medical evaluation. Consult a healthcare professional if the pain is severe, persistent, and does not improve after seven to ten days of home care. A rapidly growing lump or swelling under the tongue or jawline is concerning, especially if accompanied by a fever, which may signal a serious infection of the salivary gland.
Urgent Symptoms
Immediate attention is necessary if the pain is accompanied by:
- Difficulty swallowing (dysphagia)
- Trouble breathing
- Inability to fully open the mouth (trismus)
- Symptoms pointing to a deep-space infection