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The finding that 5 of 11 vitamin B 12 deficiency patients without a history of gastrectomy complained of tongue pain in the absence of any significant pathologic oral signs suggests that blood examinations, including vitamin B 12 measurements, are mandatory for patients with glossodynia

[10] suggested that removing a herniated disc or bone spur could lead to a potential risk of motor paralysis due to excessive retraction, while retraction without discectomy could increase the risk of transient root injury

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However, it is important to put this into perspective

The majority of cases result in mild symptoms and are due to FBCM, while pernicious anaemia is much rarer nowadays but is associated with severe deficiency