Abby Barnes, M.S., CCC-SLP
Most of us have had mild laryngitis at some point, temporarily losing our voice after an illness or repetitive coughing. But what if your throat hurts or your voice feels different for weeks, without a known cause?
Voice dysphonia refers to a change in the feeling or sound of your voice. You may be dealing with dysphonia if you have any of these symptoms:
Pain or tightness in the throat
Running out of air while speaking
A strained, hoarse, or tired sounding voice
Difficulty projecting
If you’re experiencing symptoms like these and they don’t go away after two weeks, it’s important to seek a diagnosis. Your voice is an essential part of who you are. For many people, it's an important part of their job, too. And the right treatment and therapy can help you get your authentic voice back.
What causes changes in the voice?
There are several factors that can potentially affect the voice. They include:
Increased vocal load, or using your voice more often
Exposure to harmful toxins, chemicals, smoke, allergens, or environmental or temperature changes
Muscle tension or tightness
Inflammation of the voice triggered by an illness, chronic coughing, or chronic throat clearing
Neurological disorders such as Parkinson’s disease, ALS, spasmodic dysphonia, multiple sclerosis, and essential tremor
Aging
Professional voice users have a greater risk of developing a voice disorder because of the high level of vocal load needed to thrive in their job! A professional voice user is anyone whose voice is essential for their job, such as singers, actors, comedians, fitness instructors, broadcast personalities, podcasters, or teachers. Experiencing a voice disorder can be debilitating for anyone, but it can affect the livelihood of occupational voice users. Most voice disorders are treatable when diagnosed properly, which is why seeking medical care is the right first step.
How to get your voice problem diagnosed
If you’ve been having problems with your voice for more than two weeks, it’s a smart idea to visit an otolaryngologist. Otolaryngologists are doctors trained in the ear, nose, and throat. A specific type of otolaryngologist, called a laryngologist, specializes in the voice. It’s helpful to see a laryngologist if you have one local to your area.
After discussing your voice concerns, the doctor will likely complete a videostroboscopy. This is a quick but detailed visual exam that helps evaluate the movement, efficiency, and symmetry of your vocal folds (another name for vocal cords) as you speak or sing. An endoscope, which is a small tube with a tiny camera attached, is inserted into your nose or mouth. A flashing strobe light allows the doctor to examine your voice in slow motion.
Don’t worry, the videostroboscopy only takes a couple minutes–it will be over in no time! This exam is minimally invasive and is considered the “gold standard” in laryngeal examinations, providing valuable information. It allows the doctor to assess and rule out any swelling, inflammation, muscle tension or tightness, lesions, paralysis of the vocal folds (when one or both of the vocal cords do not close), or incomplete closure of the vocal folds. It’s the best way for your doctor to reach an accurate diagnosis and develop a treatment plan for your voice.
Who should be a part of my vocal care team?
An otolaryngologist is usually the first step in your vocal healing journey. This is where you can get an accurate visualization of your voice and diagnosis. Depending on the diagnosis, your doctor may recommend voice therapy from a trained speech-language pathologist who specializes in the voice and voice disorders.
If you are a singer, you may want to ask the voice therapist if they have specialized training working with singers. Or you can seek additional care from a singing voice specialist, which is a singing voice teacher equipped to work with singers recovering from vocal injury. Keep in mind, if you have a vocal injury, working with a voice teacher should always be done in conjunction with the care of a licensed voice therapist.
Voice therapy may be done alongside physical therapy, massage therapy, counseling, nutrition therapy, or voice coaching, depending on the nature of your holistic needs.
What to expect in voice therapy
Your speech therapist will start by conducting a voice evaluation. This includes a review of your laryngoscopic exam results and measurement of your voice and airflow in order to determine the right treatment plan for your vocal recovery. The voice therapist may give you exercises to complete right away to offer some immediate relief.
Voice therapy will teach you about vocal health and hygiene, along with techniques to help you speak or sing in a healthy, efficient way.
Voice therapy will teach you about vocal health and hygiene, along with techniques and tools to help you speak and/or sing in a healthy, efficient way.
Therapy sessions will include exercises to help heal your voice and prevent further vocal injury. The therapist may offer guidance on posture, breathing, and reducing tension in your upper body, if needed.
Above all, you’ll learn vocal techniques that can be carried over and used in your everyday speaking or singing.
Common questions and answers about voice therapy
“I’m a professional singer or speaker. My voice is my livelihood. Do I have to give up my beloved career?”
Absolutely not! In fact, the goal of voice therapy is getting you back to doing what you love. Your speech therapist will conduct a comprehensive assessment in order to understand your occupation, vocal load, daily vocal needs, and postural alignment needs during your performances or presentations. Your speech therapist will also teach you specific techniques and strategies to use during your performances. Your daily functional needs are a key part of voice therapy sessions.
Voice therapy is to vocal performance as physical therapy is to athletic performance. Professional voice users are considered to be vocal athletes!
“I’m not a professional singer or speaker. Is voice therapy necessary for me?”
Your voice matters, no matter what your occupation is.
The voice is housed within the neck, in front of the spinal cord. It’s connected to hundreds of blood vessels, muscles, and nerves. But in addition to the body, the voice is connected to our mind and spirit. Your career, relationships, social life, and overall health and wellness can all be impacted by voice loss.
Since the voice can’t be seen by the human eye, it’s important to seek help from an otolaryngologist to rule out any underlying conditions. Voice therapy may be critical to heal the voice, prevent further vocal injuries, and help you access your authentic voice.
“If the doctor doesn’t find anything, but my voice is still bothering me, should I still pursue voice therapy?”
Yes! There is always an underlying reason for voice changes, even if the doctor doesn’t diagnose a problem. It’s possible that your voice could be affected by upper body tension, posture, breathing, stress, anxiety, emotional health, or even the foods you eat! Your voice therapist will help you get to the root of it all and develop a treatment plan specifically for your needs.
“Can my voice heal?”
Yes, your voice has the capacity to heal! Following your doctors’ and speech-language pathologist’s recommendations for vocal rest, practice, and carryover is critical in your healing. Your voice therapist will be there to support you every step of the way.
