Q. I have a tightness under my jaw and pain under my tongue with a red spot. What is it?

Answered by
Dr. Mousam Chattopadhyay
and medically reviewed by Dr. Preetha J
This is a premium question & answer published on Sep 20, 2020

Hi doctor, I have tightness in my right upper neck area (under my jaw) and there is pain under the right side of the tongue. I found a red spot under my tongue. What is it. I had this pain on and off for a couple of months. Same for the tightness. My neck does not seem swollen and I do not think my lymph nodes are swollen. I had a past history of von Willebrand disease type 3 and was under medication.



Welcome to

I went through your query and the attached images (attachment removed to protect patient identity). I am very sorry for the discomfort.

As a specialist, I am here to help you. As I went through your history, I came across von Willebrand Disease type 3. The Willebrand Factor is absent in plasma. This factor helps in hemostasis. The absence of this factor leads to bleeding disorders such as frequent nose bleeding, easy bruising, excessive bleeding during and after an invasive procedure such as extraction or surgery. The bruising noted under your tongue's right side is due to same cause and leads to pain. The main focus of the treatment that can solve all your issues is,

Replacement of the blood clotting factor either by:

- Blood transfusion.

- Administration of purified Plasma concentration.

I request you to avail of the treatment from your nearest hospital as they require specialized equipment.

For the bruising over the tongue, you can apply any numbing gel such as,

- Rexidin M Forte Gel (Chlorhexidine, Metronidazole, and Lignocaine). At least you will not feel the pain over the area.

The stiffness of the neck region must subside once the treatment is started.

There are some Fibrin sealant topical such as Tisseel VH Kit, Artiss (human thrombin and fibrinogen) that might help control bleeding in small areas in case of emergency.

So I would request you to visit your nearest hospital and get the treatment done to avoid serious complications.

I hope it was helpful to you. If possible, kindly rate positively and oblige.

I pray for your Good health.

Have a Good Day.

Hi doctor,

Thanks for your reply.

I take the Humate-P (Von Willebrand factor) that controls my conditions five to six times per month. I do not think that this is a problem related to my condition. I had this condition since birth. Do you think it is related to infection like swollen lymph nodes or infectious diseases such as HIV (human immunodeficiency viruses)? Could this pain be related to the muscles underneath the tongue like the styloglossus or hyoglossus muscles? The problem I think is in these muscles, but I cannot precisely localize it but certainly underneath my tongue on the right side. I think it is a muscle problem. I have been under so much stress and anxiety during this past couple of months because I had an HIV exposure and everything came back negative. I had severe tension pain in my head and my groin in the past few months from stress, and luckily both have subsided. So maybe this time, pain in my mouth is related to muscle pain.



Welcome back to

Do not worry. The pain in your tongue is just due to bruising that might have been initiated due to brushing the teeth on the same side. As you know, these issues are common in your case. Nothing to worry about pain in muscles; there is no infection noted and no issue with stress and all. These issues are nowhere related to any disease or HIV, to be specific. Bruising will be there with or without your notice, and you can help much to it. Stiffness in the neck is also due to the same reason. You will be highly relieved once you apply the topical anesthetic agent over the area. It might not have considerable effects on the bruising due to clotting difficulties but indeed act over the pain. So, I request you not to worry so much and be relaxed. I am here to help you whenever needed. Please try to work on a healthy lifestyle, add yoga, and listen to music and movies that would uplift your mood and deviate from these worrying thoughts. These minor symptoms will come and go, and they were nowhere related to any infection. I assure you not to worry about anything. For normal bruising or slight bleeding issues, there are some Fibrin sealant topical such as Tisseel VH Kit, Artiss that might help control bleeding in small areas in case of emergency. They might help. Ask your doctor to prescribe if needed. Do not worry as you are already under the Humate P. Just apply the topical gel, and that will be enough for now. I hope I shifted loads of worries from your shoulders. I will try my best to help you whenever needed. Just let me know.

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