Bumps on Back of Tongue: Causes and Treatment of Large Bumps

Medically Reviewed By Nicole Leigh Aaronson, MD, MBA, CPE, FACS, FAAP
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Bumps on the back of the tongue are natural and healthy. However, certain medical conditions can lead to abnormal bumps on the tongue. Bumps on the tongue, called papillae, are usually present and help with eating. However, some medical conditions can irritate the bumps, causing them to enlarge and lead to an uncomfortable sensation in the mouth.

This article will discuss medical conditions that can cause bumps on the back of the tongue.

What are bumps on the back of the tongue?

Person sticking out their tongue
Jordi Mora igual/Getty Images

Bumps on the back of the tongue are common and usually not a cause for concern. The medical term for these bumps is “papillae.”

Papillae give your tongue a rough texture. They also contain taste buds and temperature sensors, which play a role while eating.

Usually, the bumps are unnoticeable. However, some medical conditions, irritation, or injury can cause them to enlarge. You may notice an uncomfortable feeling inside your mouth when they get larger.

What are the causes of large bumps at the back of the tongue?

Many conditions can cause large bumps on the back of the tongue, including:

  • allergies
  • canker sores
  • leukoplakia
  • oral herpes (cold sores)
  • oral thrush
  • oral squamous papilloma
  • scarlet fever
  • tongue cancer

Allergies

Allergies to food or medications can cause bumps to form on the back of the tongue. When allergies are severe, you can experience anaphylaxis.

Bumps on the tongue that swell severely or cause the tongue to swell can cause trouble with breathing or talking. Seek medical assistance or call 911 if you or someone you are with experiences signs of anaphylaxis, such as:

  • red, itchy rash with hives
  • a swollen tongue, throat, or other body areas
  • wheezing
  • trouble breathing

Canker sores

Canker sores are the most common cause of bumps on the back of the tongue. The sores are usually red, white, or yellow and are painful. The bumps can form on the back of the tongue or inside the lips. Canker sores that become too large can cause problems with talking or eating.

A canker sore is not the same thing as a cold sore. A viral infection causes a cold sore.

Causes of canker sores include:

  • biting the tongue
  • mouth injury from dental work
  • stress

Leukoplakia and erythroplakia

Leukoplakia are white patches on the tongue and sometimes the cheeks or gums. Unlike oral thrush, which can be removed, leukoplakia cannot be removed or scraped off.

The patches are usually slightly raised, irregular in shape, and painless. Smoking and excess alcohol consumption can make leukoplakia worse. Smoking is the most common cause of leukoplakia.

If the patches do not go away, contact a doctor. A doctor may take a biopsy of the patch. You may then need surgery to remove the patches. Surgery is typically done if there is a risk of the leukoplakia becoming cancerous. The best way to prevent leukoplakia is to:

  • avoid smoking
  • practice good oral hygiene
  • visit your dentist regularly
  • eat a balanced diet

Like leukoplakia, erythroplakia are painless patches that cannot be wiped away. Erythroplakia, which appear as firm red patches, are thought of as premalignant lesions and may occur with leukoplakia. Treatment for erythroplakia includes biopsy and surgery to remove the patches.

Oral herpes (cold sores)

The herpes virus causes oral herpes, commonly known as cold sores. The painful bumps typically form on the lips but can also occur inside the mouth on the cheeks or tongue. They look like a red blister that erupts and crusts over. After the sore has crusted over, the virus is no longer contagious.

Herpes can spread from person to person, such as through kissing. The virus can also spread indirectly by touching shared items that have been in contact with the herpes virus.

The herpes virus is dormant in the body but may cause cold sores during stressful times or illness.

Oral thrush

A fungal infection in the mouth causes oral thrush. It is not contagious. Treatment involves antifungal medications. Oral thrush is more common in people who have been on long-term antibiotics, use inhaled steroids, wear dentures, have poor oral hygiene, or receive chemotherapy.

Symptoms of oral thrush include:

  • white patches on the tongue that can be wiped off
  • redness inside the mouth and throat
  • cracks at the corners of the mouth
  • loss of taste
  • burning sensation in the mouth

Oral squamous papilloma

The human papillomavirus (HPV) causes oral squamous papillomas. The lesions appear mostly on the tongue and soft palate. They are usually a small, soft, pink, red mass with numerous finger-like projections. Things that can affect oral squamous papilloma include:

  • smoking
  • hormonal changes
  • infections
  • dietary deficiencies

The lesions associated with oral squamous papilloma are benign and typically painless. Surgical excision is the best way to remove the lesions. Recurrence of the lesions is uncommon.

Scarlet fever

The Streptococcus bacteria group causes scarlet fever, a mild infection. The infection is spread via talking, coughing, or sneezing.

Scarlet fever is more common in children 5–15 years old. Doctors treat scarlet fever with antibiotics to decrease the risk of rheumatic fever.

Symptoms of scarlet fever include:

  • red, sore throat
  • fever
  • whitish coating on the tongue
  • “strawberry” (red and bumpy) tongue
  • swollen glands in the neck

Tongue cancer

Tongue cancer can occur in the front or base of the tongue. Though tongue cancer can affect anyone, it is most common in people who smoke and drink alcohol heavily.

Doctors diagnose tongue cancer by taking a biopsy of the tongue. Imaging tests can also show how deep the cancer is and if it has spread.

Common symptoms of tongue cancer include:

  • a sore throat that will not go away
  • an ulcer or lump on the tongue that does not go away
  • red, white, or dark patches on the tongue
  • pain when swallowing
  • numbness in the mouth
  • bleeding from the tongue

When should you see a doctor?

You should contact a doctor if you see signs of infection. Your doctor will want to check for a bacterial or viral infection. Infection symptoms include:

  • fever
  • sore throat
  • coughing
  • sneezing

Seek immediate medical attention (call 911) for signs of an anaphylactic reaction, including:

Notify your doctor if you have bumps on your tongue that do not go away or if the bumps are painful or cause your tongue to bleed. These could be signs of tongue cancer, which should be treated as early as possible.

In general, avoiding smoking and reducing alcohol intake can protect the health of your tongue.

Summary

Bumps on the back of the tongue and natural. Still, some medical conditions can cause them to become enlarged or cause patches, ulcers, or lesions on the tongue. Contact your doctor if bumps on the tongue do not go away or if they lead to signs of infection or a serious allergic reaction. Treatment for bumps on the tongue will depend on what is causing the bumps.

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Medical Reviewer: Nicole Leigh Aaronson, MD, MBA, CPE, FACS, FAAP
Last Review Date: 2022 Sep 29
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