The inferior longitudinal muscle of the tongue is a thin sheet of muscle fibers running along the underside of the tongue. It plays a key role in shaping and moving the tongue, which is essential for speaking, swallowing, and maintaining oral health. When this muscle becomes diseased or dysfunctional, people can experience a range of problems from speech difficulty to pain.
Anatomy of the Inferior Longitudinal Muscle
Structure & Location
The inferior longitudinal muscle is one of the intrinsic muscles of the tongue. It lies just beneath the mucous membrane on the underside (ventral surface) of the tongue. Its fibers run lengthwise from the tip to the base, forming a thin sheet that blends with other intrinsic muscles.
Origin & Insertion
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Origin: The muscle begins near the root of the tongue, close to where the hyoglossus and genioglossus muscles attach.
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Insertion: Its fibers extend forward and insert into the tip (apex) of the tongue.
Blood Supply
Small branches from the lingual artery (a branch of the external carotid artery) supply oxygen-rich blood to this muscle. These vessels run along the underside of the tongue.
Nerve Supply
The hypoglossal nerve (cranial nerve XII) provides motor signals that allow the muscle to contract and relax.
Functions
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Shortening the Tongue: Contracts to make the tongue shorter and thicker, aiding in speech.
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Curling the Tip Downward: Pulls the tongue’s tip downward, important for pronouncing certain sounds.
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Flattening the Tongue: Works with other muscles to flatten the tongue during swallowing.
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Assist in Retraction: Helps retract the tongue into the mouth.
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Shape Control: Modifies the tongue’s shape for precise movements in speech and eating.
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Fine Motor Control: Provides subtle adjustments necessary for articulation.
Types of Disorders Affecting the Inferior Longitudinal Muscle
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Myalgia: Muscle pain due to overuse or strain.
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Atrophy: Wasting away of the muscle, often from nerve damage.
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Hypertrophy: Unusual enlargement, sometimes from chronic overuse.
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Spasm: Involuntary contractions causing discomfort.
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Fibrosis: Scar tissue replaces healthy muscle, reducing flexibility.
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Myositis: Inflammation from infection or autoimmune reaction.
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Inclusion Body Myositis: Chronic inflammatory condition seen in older adults.
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Peripheral Nerve Injury: Damage to the hypoglossal nerve affecting muscle function.
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Tumors: Rare growths (benign or malignant) within the muscle.
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Congenital Hypoplasia: Underdevelopment present from birth.
Causes
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Overuse: Repetitive tongue movements strain muscle fibers.
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Trauma: Biting or direct injury damages the muscle.
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Surgical Injury: Accidental nerve or muscle damage during neck surgery.
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Stroke: Reduced brain signals weaken tongue muscles.
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Hypoglossal Nerve Lesions: Disease or trauma damaging the nerve.
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Radiation Therapy: Head/neck cancer treatment injures muscle tissue.
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Autoimmune Disease: Conditions like polymyositis attack muscle fibers.
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Infections: Viral (e.g., influenza) or bacterial infections invade the muscle.
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Nutritional Deficiency: Lack of vitamin D or protein impairs muscle health.
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Aging: Natural loss of muscle mass (sarcopenia).
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Chronic Alcohol Use: Alcohol myopathy weakens muscles.
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Diabetes: Poor circulation and nerve damage lead to atrophy.
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Hypothyroidism: Low thyroid hormone slows muscle metabolism.
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Medication Side Effect: Statins or steroids can cause myositis.
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Genetic Myopathies: Inherited diseases like muscular dystrophy.
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Neurological Disorders: ALS or MS affects nerve supply.
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Tumor Infiltration: Cancer invades muscle tissue.
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Allergic Reaction: Severe allergy causes localized swelling and damage.
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Dehydration: Low fluid impairs muscle elasticity.
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Smoking: Poor oxygen delivery weakens muscles.
Symptoms
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Tongue Pain: Aching or sharp pain beneath the tongue.
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Difficulty Speaking: Slurred or unclear words.
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Swallowing Trouble: Feeling of sticking or choking on food.
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Tongue Weakness: Reduced strength when pushing against a tongue depressor.
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Muscle Twitching: Small, involuntary movements under the tongue.
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Tongue Deviation: Tip pulls to one side when stuck out.
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Atrophy: Visible thinning of the tongue’s underside.
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Stiffness: Reduced flexibility when moving the tongue.
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Burning Sensation: Tingling or burning on the ventral surface.
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Swelling: Local puffiness under the tongue.
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Ulceration: Sores from constant friction or reduced blood flow.
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Change in Taste: Altered or reduced taste sensation.
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Dry Mouth: Insufficient saliva due to nerve involvement.
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Saliva Dribbling: Loss of control over saliva flow.
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Speech Fatigue: Tiring quickly when talking.
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Choking Cough: Frequent coughing while eating.
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Snoring: Airway changes leading to noisy breathing at night.
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Sleep Apnea: Blocked airway due to tongue position.
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Ear Pain: Referred pain to the ear area.
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Facial Pain: Discomfort spreading to jaw or cheek.
Diagnostic Tests
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Clinical Examination: Inspect tongue shape, movement, and strength.
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Palpation: Feel for tender or firm areas under the tongue.
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EMG (Electromyography): Measures muscle electrical activity.
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Nerve Conduction Study: Assesses hypoglossal nerve function.
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MRI Scan: Visualizes soft tissue, muscle inflammation, or tumors.
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Ultrasound: Real-time imaging of muscle structure.
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CT Scan: Detailed cross-sectional images, especially for bone involvement.
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Muscle Biopsy: Tissue sample to detect inflammation or fibrosis.
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Blood Tests: Check muscle enzymes (e.g., CPK) and inflammatory markers.
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Autoimmune Panel: ANA, anti-Jo-1 for myositis.
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Viral Serology: Tests for common muscle-invading viruses.
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Thyroid Function Tests: TSH, T3, T4 for metabolic causes.
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Vitamin D & B12 Levels: Nutritional assessments.
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Electrolyte Panel: Sodium, potassium for muscle function.
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Lipid Profile: Statin-induced myopathy check.
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Glucose Tolerance Test: Diabetes screening.
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Sleep Study (Polysomnography): For sleep apnea.
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Flexible Endoscopy: Direct view of tongue base.
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Biopsy of Lesions: If tumors are suspected.
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Allergy Testing: Identify allergic causes.
Non-Pharmacological Treatments
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Warm Compresses: Apply warmth to relax muscles.
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Cold Packs: Reduce inflammation after acute injury.
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Tongue Stretching Exercises: Improve flexibility and strength.
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Massage Therapy: Gentle massage under the tongue.
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Speech Therapy: Retrain tongue movements for speech.
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Swallowing Therapy: Exercises to aid safe swallowing.
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Myofascial Release: Specialized manual therapy.
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Ultrasound Therapy: Deep heat treatment.
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TENS (Transcutaneous Electrical Nerve Stimulation): Pain relief.
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Biofeedback: Monitor and improve muscle control.
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Acupuncture: Traditional technique for pain reduction.
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Yoga & Meditation: Reduce stress-related muscle tension.
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Hydrotherapy: Gentle water exercises.
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Diet Modification: Soft foods to reduce strain.
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Hydration: Maintain fluid balance for elasticity.
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Ergonomic Eating: Proper posture when eating.
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Oral Appliances: Night guards to prevent clenching.
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Mouthguards: Protect against accidental biting.
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Heat-Cold Contrast Baths: Alternate hot and cold packs.
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Laser Therapy: Low-level laser to reduce inflammation.
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Craniosacral Therapy: Gentle manual therapy.
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Chiropractic Adjustments: For related neck tension.
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Mindfulness: Reduce unconscious tongue tension.
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Vibration Therapy: Stimulate blood flow.
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Relaxation Techniques: Progressive muscle relaxation.
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Positional Sleeping: Elevate head to reduce snoring.
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Support Groups: Sharing coping strategies.
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Nutritional Counseling: Ensure adequate protein and vitamins.
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Avoid Alcohol & Smoking: Prevent muscle toxicity.
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Regular Oral Care: Prevent infections that can inflame muscle.
Drugs
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NSAIDs (Ibuprofen): Reduce pain and inflammation.
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Acetaminophen: Pain relief without anti-inflammatory effect.
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Corticosteroids (Prednisone): Suppress severe inflammation.
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Muscle Relaxants (Cyclobenzaprine): Relieve spasms.
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Antiviral (Acyclovir): For viral myositis.
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Immunosuppressants (Methotrexate): Treat autoimmune myositis.
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IVIG (Intravenous Immunoglobulin): For inclusion body myositis.
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Statin Alternatives: Switch from high-risk cholesterol drugs.
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Vitamin D Supplements: Correct deficiency.
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Vitamin B12 Injections: Improve nerve and muscle health.
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Thyroid Hormones (Levothyroxine): Treat hypothyroidism.
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Antiepileptics (Gabapentin): Neuropathic pain relief.
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Botulinum Toxin: Reduce muscle hyperactivity in spasm.
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Antibiotics (Doxycycline): For bacterial myositis.
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Biologics (Rituximab): Severe autoimmune cases.
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Bisphosphonates: Improve bone support in severe atrophy.
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Saline Infusions: For acute dehydration.
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Statin Lowering Agents (Ezetimibe): Manage cholesterol without myopathy.
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ACE Inhibitors: Improve microcirculation.
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Antioxidants (Coenzyme Q10): Support muscle energy.
Surgical Treatments
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Muscle Biopsy: Diagnostic and sometimes therapeutic.
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Nerve Decompression: Relieve hypoglossal nerve entrapment.
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Tumor Excision: Remove benign or malignant growths.
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Genioglossus Advancement: For severe sleep apnea.
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Lingual Frenectomy: Release tight tissue restricting movement.
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Microvascular Repair: Reattach damaged vessels after trauma.
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Free-Flap Reconstruction: Restore lost muscle tissue.
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Neurotization: Rewire nerve supply in denervated muscle.
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Scar Tissue Release: Remove fibrotic bands.
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Cryoablation: Targeted freezing of hyperactive muscle fibers.
Prevention Strategies
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Proper Hydration: Keep muscles supple.
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Balanced Diet: Adequate protein, vitamins, and minerals.
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Regular Oral Exams: Early detection of abnormalities.
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Gentle Tongue Exercises: Maintain strength and flexibility.
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Avoid Excessive Alcohol: Prevent myopathy.
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Quit Smoking: Improve blood flow.
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Safe Eating Practices: Prevent accidental biting or trauma.
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Protective Mouthguards: For sports and bruxism.
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Manage Chronic Diseases: Control diabetes and thyroid disorders.
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Stress Reduction: Prevent tension-related muscle problems.
When to See a Doctor
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Persistent Pain lasting more than two weeks
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Difficulty Speaking or Swallowing that interferes with daily life
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Visible Tongue Deformity or mass under the tongue
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Sudden Weakness or Deviation of the tongue tip
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Unexplained Weight Loss with muscle atrophy
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Signs of Infection: Fever, redness, swelling
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Breathing Difficulty or severe snoring
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New Ulcers or Growths under the tongue
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Severe Spasms unrelieved by home care
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Any Worsening Symptoms despite basic self-care
Frequently Asked Questions
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What is the inferior longitudinal muscle of the tongue?
It’s an intrinsic tongue muscle that runs along the underside, helping to shorten and curl the tongue tip down. -
Why does my tongue hurt underneath?
Pain can come from strain, infection, or inflammation of the inferior longitudinal muscle when overworked or injured. -
Can tongue exercises help?
Yes. Gentle stretching and strengthening exercises improve flexibility and reduce pain. -
How is muscle atrophy in the tongue treated?
Treatment focuses on addressing the cause (e.g., nerve injury) and includes therapy, nutrition, and sometimes surgery. -
Are tumors in this muscle common?
No, tongue muscle tumors are rare. Any persistent lump should be evaluated by a doctor. -
What tests diagnose muscle disorders of the tongue?
EMG, MRI, ultrasound, and blood tests are commonly used to identify muscle and nerve problems. -
Can dehydration cause muscle spasms in the tongue?
Yes. Lack of fluids can lead to muscle cramps, including in the tongue. -
Is tongue muscle fibrosis reversible?
Early fibrosis can be managed with therapy, but longstanding scar tissue may require surgical release. -
What drugs relieve tongue muscle pain?
Over-the-counter NSAIDs like ibuprofen help reduce pain and inflammation. -
Can allergies affect the tongue muscle?
Severe oral allergies can cause inflammation, which indirectly stresses the muscle. -
How long does recovery take after tongue muscle injury?
Minor strains heal in days to weeks; severe injuries or surgeries may take months. -
Is speech therapy necessary?
Often yes—therapists teach exercises to restore precise tongue movements. -
Can vitamin supplements help?
Correcting deficiencies in vitamins D and B12 supports muscle health and nerve function. -
Will quitting smoking improve my tongue muscle function?
Yes. Better blood flow from quitting helps muscle recovery and reduces atrophy risk. -
When is surgery recommended?
Surgery is reserved for tumors, severe fibrosis, nerve entrapment, or functional reconstruction needs.
Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.
The article is written by Team Rxharun and reviewed by the Rx Editorial Board Members
Last Updated: April 23, 2025.
