What Does It Mean When You Have Bumps on the Back of Your Tongue

It’s important to remember that these symptoms might be caused by other less serious conditions. But it’s best to check symptoms with your GP just to make sure.

What is tongue cancer?

Tongue cancer is a type of head and neck cancer. Cancer is when abnormal cells start to divide and grow in an uncontrolled way. Symptoms can include a spot or lump on your tongue that doesn’t go away.

The main risk factors are smoking, drinking a lot of alcohol and infection with the human papilloma virus (HPV).

The tongue

The tongue has 2 parts:

the oral tongue (also called the body of the tongue)
the base of the tongue

Cancer can develop in either part.

The oral tongue is the part you see when you poke your tongue out at someone. This is the front two thirds of your tongue. Cancers that develop in this part of the tongue come under a group of cancers called mouth (oral) cancer.

The base of the tongue is the back third of the tongue. This part is very near your throat (pharynx). Cancers that develop in this part are called oropharyngeal cancers (pronounced oar-o-farin-gee-al).

What are the types of tongue cancer?

The most common type of tongue cancer is squamous cell carcinoma (SCC). Squamous cells are the flat, skin like cells that cover the lining of the mouth, nose, larynx, thyroid and throat. Squamous cell carcinoma is the name for a cancer that starts in these cells.

What are the symptoms of tongue cancer?

The symptoms of tongue cancer might include:

a red or white patch on the tongue that won’t go away
a sore throat that doesn’t go away
a sore spot (ulcer) or lump on the tongue that doesn’t go away
painful or difficulty swallowing
numbness in the mouth that won’t go away
pain or burning feeling over the tongue
problems moving your tongue or speaking
a lump in the neck
unexplained bleeding from the tongue (that’s not caused by biting your tongue or another injury)
pain or hearing loss in one ear
weight loss

It’s important to remember that these symptoms might be caused by other less serious conditions. But it’s best to check symptoms with your GP just to make sure.

The photos below give you an idea of what tongue cancers can look like, but remember that they might appear differently from this. Contact your GP or dentist if you notice anything abnormal.

This picture shows cancer on the side of the tongue.

And below is a picture of a red patch underneath the tongue.

What are the risks and causes of tongue cancer?

We don’t know the exact causes of most head and neck cancers, but several risk factors have been identified.

smoking tobacco (cigarettes, cigars and pipes)
regularly drinking a lot of alcohol
infection with a virus called human papillomavirus (HPV)

HPV is a type of virus that infects the skin and cells lining the inside of the body. For most people, the infection will get better on its own and they will never know they had it.

This is a common virus that causes no harm in most people. But in some people, the virus can cause changes in the mouth and tongue that can increase the risk of cancer in that area.

Having a risk factors means that your risk is increased. But it does not mean that you will definitely develop cancer.

How is tongue cancer diagnosed?

Your doctor will examine you. They might look at the back of your throat using a small mirror that they put into your mouth. They will check for swollen lymph nodes in your neck.

A biopsy

The only way to confirm a diagnosis of cancer is to take a small amount of tissue (biopsy) from the abnormal area. A specialist doctor examines it under a microscope. They might test your cancer cells to check for HPV infection.

An examination under anaesthetic

You might have an examination and biopsy under a general anaesthetic. The doctor uses a tube and camera called a panendoscope to look into your throat.

A nasoendoscopy

You might also have a nasoendoscopy (sometimes spelt nasendoscopy). You have this in the outpatient department of the hospital. During this procedure the doctor looks:

inside your mouth
at the back of the tongue and throat
at the voice box (larynx)

Your doctor passes a flexible tube called a nasoendoscope through your nose. The tube has a camera and a bright light at the end so they can check for any abnormal looking areas.

It can be a bit uncomfortable, so your doctor may use an anaesthetic spray to numb your throat first. But if you have the anaesthetic spray you can’t eat or drink until it wears off, so you may choose not to have it.

If the specialist sees an abnormal area, they will take a biopsy from that area. This is usually arranged for another time.

You will also have one or more of the following tests:

MRI scan
CT scan
PET-CT scan
blood tests
dental check
ultrasound scan

What are the stages of tongue cancer?

The stage of your cancer tells you how big it is and whether it has spread. It helps your doctor decide what treatment you need.

The stage of your cancer depends on:

how far your cancer has grown into local tissues
whether it has spread to nearby lymph glands
whether it has spread to any other part of the body

Doctors use different staging systems. The staging system they use for you depends on where your cancer starts:

Tongue cancer that starts in the front two thirds of your tongue (the oral tongue) is staged as a mouth cancer.

Tongue cancer that starts in the back third of your tongue (the base of the tongue) is staged as oropharyngeal cancer.

What is the treatment for tongue cancer?

The treatment for tongue cancer depends on:

the stage of your cancer
where the cancer is on your tongue
your general health

References

Head and Neck Cancer: United Kingdom National Multidisciplinary Guidelines, Sixth Edition
J Homer and S Winter
The Journal of Laryngology and Otology, 2024. Volume 138, Number S1
Cancer of the upper aerodigestive tract:assessment and management in people aged 16 and over The National Institute for Health and Care Excellence (NICE), 2016, (updated 2018)
Head and neck cancer M Mody and others The Lancet, 2021. Volume: 398, Issue 10318, Pages: 2289 to 2299
Tongue Cancer M Gonzalez and A Riera March In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024
Treatment of stage I and II (early) head and neck cancer: The oral cavity N Gross and others UpToDate website Accessed September 2024
Treatment of early (stage I and II) head and neck cancer: The oropharynx A Eisbruch and others UpToDate website Accessed September 2024
The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. If you need additional references for this information please contact [email protected] with details of the particular risk or cause you are interested in.

What Does It Mean When You Have Bumps on the Back of Your Tongue?

Your tongue has bumps on the back called papillae that are part of its normal anatomy; do nothing if you have no other symptoms. New or different bumps or masses can be caused by infections or other conditions.

Bumps on the tongue (papillae) contain taste buds, temperature receptors, and a good blood supply. Different types of papillae are scattered over the top and sides of the tongue, with most being on the tip.

Bumps on the tongue are normal and you should not be able to feel them most of the time. Most bumps on the tongue are relatively flat, pink, and not very obvious.

What Are Symptoms of Bumps on the Back of Your Tongue?

Depending on the condition that causes the bumps, other symptoms that may accompany bumps on the back of the tongue include:

Pain when eating or swallowing
White patches lining the cheeks, on the tongue, or on back of the throat
Redness inside the mouth without white patches
Cotton-mouth
Bleeding from the bump
Trouble speaking or moving the tongue
Mouth or tongue pain
Lump in the neck
Swelling in the neck
Fever
Body aches
Feeling ill (malaise)

What Causes Bumps on the Back of Your Tongue?

Some common causes of bumps on the back of the tongue include:

Transient lingual papillitis
- Very common
- Commonly caused by local irritation or trauma to papillae
- Other possible triggers may include stress, hormone fluctuations, gastrointestinal upset, and certain foods
- Open sores (ulcers) in the mouth or on the tongue
- White or yellow in the middle, and red around the edges
- Certain foods, infections, and biting the tongue or inside of the cheek can make canker sores more likely to develop
- May be referred to as a yeast infection of the mouth and throat
- An infection caused by a fungus called “candida”
- Painful blisters that form on or near the lips and inside the mouth
- Caused by infection with herpes simplex virus type 1
- White or gray patches inside the mouth or on the tongue
- May be caused by irritation in the mouth, smoking, or chewing tobacco
- Small, benign (non-cancerous) growths in squamous cells (thin, flat cells) of the tongue
- Caused by infection with the human papillomavirus (HPV)
- Occurs when normal cells in the tongue change into abnormal cells and grow out of control
- May occur in people with leukoplakia
How Are Bumps on the Back of Your Tongue Diagnosed?

The cause of bumps on the back of the tongue is diagnosed with an oral exam.

Tests that may be used to diagnose the cause of bumps on the back of the tongue include:
- Swab along the tongue or cheek to collect fluid
- Biopsy of the bump
What Is the Treatment for Bumps on the Back of Your Tongue?
- Transient lingual papillitis
  - Most of the time, no treatment is needed as the bump will go away on its own within hours to days
  - Salt water mouth rinse
  - Drink cold fluids
  - Topical antiseptics
  - Anesthetic mouthwash
  - Topical steroids
  - Most heal on their own within a few weeks
  - Over-the-counter pain relievers
  - Topical gel anesthetics
  - Salt water gargle
  - Avoid eating or drinking hot and spicy foods
  - Prescription mouthwash or medicine for severe symptoms
  - Prescription mouth rinse or a lozenge
  - A tablet that sticks to the gums
  - A pill to kill yeast (for severe infections)
  - Treatment is usually needed the first time cold sores occur but once they have happened before, if symptoms are mild treatment may not be needed
  - Antiviral medicines
  - Pain-relieving pills and gels on the mouth
  - Avoid the cause (smoking , chewing tobacco , or another oral irritant)
  - Surgery to remove the abnormal patches
  - They are usually not painful and often do not require treatment
  - Surgical removal if needed
  - Surgery
  - Chemotherapy
  - Radiation therapy
  How Do You Prevent Bumps on the Back of Your Tongue?
  
  Some causes of bumps on the back of the tongue may be able to be prevented.
  - Canker sores
    - Take care not to accidentally bite the cheek while chewing
    - Avoid toothpaste that contains sodium lauryl sulfate, an abrasive chemical that can cause canker sores in some people
    - Vitamin B-12 supplements may eliminate canker sore recurrence
    - Ketogenic diet , a type of low carbohydrate diet, may reduce or eliminate canker sores in some patients
    - Practice stress reduction techniques
    - Practice proper oral hygiene
    - For people who wear dentures , clean them every night and give your mouth some time without the dentures
    - Don’t smoke or use chewing tobacco
    - Make sure dentures are properly fitted
    - Don’t smoke or use chewing tobacco
    - If you are diagnosed with leukoplakia, make sure it’s treated