Do you ever find that you’re feeling a tightness in your voice that won’t go away, or pain or tenderness? Or feel almost as if you have food caught in your throat?
You may be experiencing vocal strain.
Vocal strain is relatively common and could be caused by a wide range of issues, from illness to excessive cheering at a sporting event or concert.
In most cases, it is temporary and not a cause for concern. But persistent strain and prolonged changes in voice quality should be assessed by a laryngologist, says Benjamin M. Laitman, MD, PhD, Assistant Professor in the Department of Otolaryngology-Head and Neck Surgery in the Mount Sinai Health System.
Benjamin M. Laitman, MD, PhD
“There is always a risk that when you use your voice, you might use it in an inefficient manner or activate the wrong muscles to increase volume in certain situations,” says Dr. Laitman, a member of the Grabscheid Voice and Swallowing Center of Mount Sinai and Mount Sinai’s Institute for Airway Science.
“That can cause phonotrauma, or trauma to the vocal cords, which may be similar to having a callus or blister or even small scar. It can affect the quality of your voice, and that is something that we can address.” In this Q&A, Dr. Laitman explains what you need to know about vocal strain and treatment options.
How do I know if I have vocal strain?
Vocal strain is often associated with a change in the quality of your voice, such as hoarseness. In some instances, that change may be accompanied by a feeling of strain or soreness when speaking and tenderness or pain in the throat when touched. You may also experience a sensation akin to having food caught in your throat. This is a sign of muscle strain or tightness.
Vocal strain can often be treated by resting the voice and speaking at a lower volume for a few days, which will help prevent significant damage to the vocal cords. But it is best to schedule an appointment with a laryngologist if symptoms persist for several weeks.
Are polyps, nodules and cysts caused by vocal strain?
In some cases, polyps, nodules, orcysts may be caused by continuous inefficient use of the voice and associated trauma. This may result in a cycle in which patients compensate for strain, causing further trauma. The presence of a polyp, nodule, or cyst is not necessarily a cause for concern, but it is best to consult with a laryngologist in cases of prolonged hoarsenss to confirm that it is not a cancer.
How can a laryngologist help me?
We typically start by looking at your medical history and then making a recording of your voice so that we have a baseline for analysis and measuring improvements. We will also conduct a stroboscopic examination of the larynx either via the nose or the mouth. This examination involves using an endoscopic camera equipped with a strobe light, which enables us to see the movement of the vocal folds and assess closure patterns, gaps, and the presence of lesions, polyps, or scars that we would otherwise miss. Based on what we observe, we will then discuss possible treatment options.
What are treatment options for vocal strain?
There are two main therapeutic approaches we recommend for patients with vocal strain:
- Voice therapy: We will recommend voice therapy with a speech language pathologist for patients, which may help reduce muscle tension. This may not only provide symptomatic relief but also may shrink the size of benign phonotraumatic lesions, as their cause is often inefficient voice use. Therapy may include techniques such as laryngeal massage or water resistance therapy. This approach can help reduce inflammation and restore normal voice quality.
- Surgery: We will recommend surgery or office-based procedures in cases where we observe a large polyp, lesion, or blood vessel that is contributing to hoarseness, or when patients are not satisfied with the outcome of voice therapy.
We typically perform surgery in an outpatient setting using general anesthesia and microscopic surgical tools to prevent trauma to healthy surrounding tissue. However in cases where the lesion or polyp contributing to vocal strain is very small, we may elect to perform surgery in-office using a laser-equipped scope.
We recommend that patients who undergo surgical treatment rest their voices for a week to promote healing and then follow-up with us to arrange postoperative voice therapy with a speech language pathologist.
Both approaches to treatment are often effective in addressing vocal strain. Regardless, patients should to monitor their health following treatment and contact a laryngologist if they experience recurring or other symptoms of concern. Our goal for patients to be happy with their voices. Whether it is vocal therapy or surgery, we will meet them where they are and work with them to get them where they want to be.