Many of us might not give our voices much thought — unless we experience difficulty or pain when talking. As an otolaryngologist (an ear, nose, and throat specialist, or ENT), I see the ways in which voice problems can affect a wide range of daily activities, including activities as simple as talking to a friend or co-worker, reading a bedtime story to a child, or just singing in the shower. That’s even more true for patients who rely on their voices for work or hobbies. My patients are often relieved to learn that there are steps they can take to manage, or even prevent, voice problems.
What ‘losing your voice’ really means
When patients ask me why they lost their voice and what they can do to protect it, I start by explaining how the voice works.
The human voice is produced by air moving through the vocal cords, the two folds of tissue inside the larynx. These folds vibrate when they come together as air coming out from the lungs passes through them. The result is sound which is then shaped by the throat, tongue, and lips, and results in someone talking or singing. Problems can occur when the vocal folds aren't able to move or vibrate properly. The voice might sound rough, breathy, weak, strained or unusually high or low in pitch. Vocal problems can also cause throat tension or pain, or a feeling like there's a lump in the throat when swallowing.
What causes voice loss?
One common cause of voice problems is overuse, which is why people who use their voices extensively — whether that's professionally, such as a teacher in a classroom, or as a hobby, such as singing in a local choir — tend to experience trouble with their voice more often than others.
Excessive talking, singing, or shouting can strain the vocal folds, causing them to develop blisters (called polyps) or nodules (small calluses) that change the sound of your voice.
But overuse is not the only cause of voice problems. Infections, injuries, and other health conditions, such as thyroid problems or cancer, can affect the voice in a variety of ways. For example, acute laryngitis, a swelling of the vocal folds that can disrupt vocal fold vibration and lead to hoarseness, is often triggered by an upper respiratory infection. Exposure to environmental irritants like smoke, chemicals, allergens, or dust can also cause the vocal folds to become inflamed.
In many cases, laryngitis improves in a week or so, but it can be long-lasting. When that happens, it’s known as chronic laryngitis. Sometimes asthma inhaler use or acid reflux can lead to chronic laryngitis too.
Protecting your voice
Many of my patients want to know what they can do to help their voices recover quickly. I tell them that lifestyle measures can often be enough to ease hoarseness or voice loss caused by overuse or laryngitis. And these healthy habits may help them avoid future problems with their voice. Here are some of my most recommended strategies:
- Don't strain your voice. Try to avoid extended periods of shouting or trying to talk loudly over noise. If it's too loud to vocalize comfortably, use nonverbal cues or grab a microphone. Sometimes it can be as simple as lowering the volume on the television!
- Give your voice a rest. If you do get hoarse, speak as little as possible until your voice comes back. Soothe your throat with warm, non-caffeinated liquids or throat lozenges.
- Drink plenty of water. It keeps your vocal folds hydrated. Aim to drink half of your body weight in ounces of water each day. (For example, a person who weighs 150 pounds should try to consume 75 ounces, or about 9 cups, of water.) Limit your consumption of caffeine and alcohol. Both can dehydrate you.
- Warm up before singing or extended speaking. Try humming or gliding from low to high tones. It's like stretching before exercising.
- Try not to cough or clear your throat excessively. Both can stress your vocal folds. If you find yourself frequently coughing or clearing your throat, let your doctor know.
- Wear a face mask around allergens or environmental irritants. Masks can filter out particles that can irritate your vocal cords.
- Pay attention to your posture. Avoid slouching or bending over when speaking or singing.
- Don’t smoke. Cigarettes, cigars and other inhaled substances can irritate your vocal cords and lead to inflammation.
- Practice vocal exercises. Simple activities like reading or singing aloud give your vocal cords a workout and help them stay strong.
Treatments for vocal disorders
Sometimes it takes medical attention to get a damaged voice back in shape. While treatment for vocal disorders depends on the cause and a patient's individual symptoms, common options include:
- Vocal therapy. A speech language pathologist can teach exercises and breathing techniques to optimize or improve your vocal technique. Voice therapy is often a good choice for those dealing with voice overuse and patients with vocal fold damage from things like acid reflux, nerve trauma, cancer treatment, or surgery.
- Medication. Medicines, when prescribed by your doctor, are helpful for addressing vocal problems caused by an underlying condition, like antacids for acid reflux or hormones for thyroid problems.
- Injections. Muscle spasms in the throat can often be managed with filler injections like Botox.
- Surgery. In some cases, if a vocal cord growth is causing voice problems, it can be removed surgically.
Your voice matters
If a person experiences hoarseness, vocal changes, or throat pain that persists for more than a few weeks, I encourage them to see an otolaryngologist specializing in voice disorders for further evaluation. You can schedule an appointment with our Temple's Voice, Airway & Swallowing Center by calling 800-TEMPLE-MED, or requesting an appointment online.
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