6 Signs of a Voice Disorder: What You Need to Know

Have you ever cheered too loudly for your favorite sports team? Was your voice hoarse or raspy the next day? How about a cold that left you with a weak voice, or perhaps no voice at all.  Voice problems are common. Most of the time they are short lived, but for some they can be longstanding. Voice disorders can have a serious impact on your quality of life.

Who gets voice disorders?

Anyone can develop a voice disorder, but certain factors increase your risk:

• Age and sex: Being a woman (or assigned female at birth) over 50.

• Lifestyle: Smoking, alcohol use, and drug use can damage your lungs, larynx and vocal cords.

• Occupation: Teachers, singers, telemarketers, and other people with professions that require a lot of speaking or voice use.

• Other diseases and disorders: Having Parkinson’s disease, multiple sclerosis (MS), laryngeal cancer, or laryngopharyngeal reflux (LPR). 

Between 3% and 9% of the U.S. population have a voice disorder at some time, though less than 1% of these people seek treatment. Teachers are by far the most at-risk population. In one study of nearly a thousand teachers, about 57% had a voice disorder.

6 signs of voice disorders

Symptoms of voice disorders vary widely depending on their cause. You may experience:

1. increased vocal effort associated with speaking,

2. decreased vocal endurance or onset of fatigue with prolonged voice use,

3. variable vocal quality throughout the day or during speaking,

4. running out of breath quickly,

5. frequent coughing or throat clearing (may worsen with increased voice use), and

6. excessive throat or laryngeal tension/pain/tenderness.

Examples of voice disorders

·        Laryngitis: Laryngitis is when your vocal cords swell. Your voice may sound hoarse, or you may not be able to speak at all. There are several types of laryngitis, and treatment may depend on the cause.

·        Acute laryngitis is usually caused by a virus in the upper respiratory tract. Symptoms can appear suddenly but they usually last just a few weeks. Treatment is to rest the voice and drink plenty of fluids.

·        Chronic laryngitis is when the swelling lasts for a long time. Common causes include a chronic cough, using inhalers for asthma, and GERD.

·        Vocal cord paralysis: This is the result of your vocal cords becoming fully or partially paralyzed. Depending on how severe your diagnosis is, symptoms can range from having a weak, breathy voice, to difficulty breathing. Vocal cord paralysis can be caused by a variety of factors, including a viral infection that affects your vocal cord nerves or an injury to a nerve during surgery, stroke, or cancer. While some people naturally get better over time, in some cases the effects can be permanent. Surgery and voice therapy may help improve the voice.

·        Spasmodic dysphonia: This is a nerve problem that causes the vocal cords to spasm, making your voice sound tight, quivery, or jerky. At times, your voice may sound completely normal. Other times, you may not be able to speak at all. 

·        Vocal nodules: Vocal nodules are often caused by vocal abuse. They are a common problem for professional singers or others who routinely push their voice to the limits. Vocal nodules can make the voice sound hoarse or low or breathy. They are noncancerous growths on the vocal cords, and are often small and callous-like, growing in pairs.  

·        Vocal polyps: These are also noncancerous and can cause the voice to be low and breathy. Vocal polyps look and feel similar to a blister.

Diagnosis and Treatment of Voice Disorders

Your healthcare provider may refer you to a laryngologist who can diagnose voice disorders. They perform a thorough exam that may include use of a laryngoscope (a thin, flexible tube with a camera attached) to examine the back of your throat. During this test, they may also perform a biopsy of nodules, polyps, or cysts.

Following diagnosis of a voice disorder, the laryngologist will refer to a speech therapist. A speech therapist will

• establish appropriate vocal hygiene routines/practices;

• capitalize on strengths and address weaknesses related to underlying structures and functions that affect voice production;

• improve self-awareness of voice quality and kinesthetic factors (e.g., tension);

• facilitate the individual’s activities and life participation by assisting the person in acquiring new communication skills and strategies;

• modify contextual factors to reduce barriers and enhance facilitators of successful communication and participation; and

• provide appropriate accommodations and other supports as well as training in how to use them.

Voice disorders affect your ability to speak clearly. Sometimes, voice problems are due to overuse and resolve once you rest your voice. Other times, voice problems are the result of more complex health conditions. If you notice a change in your voice that lasts longer than a few weeks, contact your healthcare provider. If the time comes to see a speech therapist, The Speech & Language Center is ready to help.