Beware: 4 conditions that can lead to voice problems

Lesley Childs, M.D., showing where the vocal cords are located within the larynx.
Lesley Childs, M.D., showing where the vocal cords are located within the larynx.

The voice is a uniquely human instrument – amazing and still somewhat mysterious. Unfortunately, most people tend not to think too much about their voices until there’s a problem.

Sometimes we can’t do anything to prevent a voice problem, such as with the neurological voice disorder spasmodic dysphonia. But often just a little attention to vocal hygiene can help prevent hoarseness or vocal fatigue.

Here are four conditions you should watch for that can lead to vocal cord irritation or damage.

1. Overuse, misuse, abuse

These three behaviors have to do with how you produce sound.

  • Overuse: All of us can easily fall into overusing our voices, but professional voice users – which can include singers, teachers, call center employees, and ministers – especially need to be aware of this. Our voice team recommends this rule of thumb: For every 90 minutes of voice use, you need 10 minutes of voice rest.
  • Misuse: This can include any type of improper voice use. For example, a recent trend involves speaking in a “glottal fry” or “vocal fry” – which has a low-pitch, monotone, rough sound. The Kardashians and the character Meredith Grey in “Grey’s Anatomy” have made it popular to talk like this.
  • Abuse: This is any type of behavior that strains or injures the vocal cords, such as screaming or frequent throat clearing.

2. Stress

Our chief of speech-language pathology describes the larynx as “the emotional valve that sits between your heart and your head and is ruled by both.” Many people carry their stress in their throat. When you’re about to cry, for example, you often feel tightness in your throat.

This stress can lead to tension in the neck muscles, throw off your posture, and affect how you breathe. We are mechanical beings, so if we’re stressed and it’s causing us to be rigid in the throat and neck area, it’s going to have an effect on how you produce sound.

Along with stress management techniques, we also sometimes recommend myofascial release, which is a more complex version of a deep tissue massage for the neck and shoulder muscles.

3. Dehydration

Hydration is key in properly caring for your voice. Your vocal cords vibrate several hundred times per second when you speak – and even more when you sing. Water helps thin the mucus that then lubricates and protects your vocal cords as they vibrate.

We recommend you drink 64 ounces of water each day. Coffee, soda, and ice tea don’t count because they are diuretics – they actually dehydrate you more. You need pure water. Alcoholic beverages also can dehydrate you, so avoid them or drink in moderation. Be aware that smoking and medications for congestion also can dry out your vocal cords.

Your vocal cords dehydrate quickly, and it takes a long time to rehydrate them, so keep your water intake going throughout the day.

4. Laryngeal irritants such as allergies or reflux

Throat clearing and coughing are traumatic to the vocal cords. If allergies or postnasal drip are irritating your throat, we want to get a handle on that by optimizing your allergy management before you do permanent harm to your vocal cords.

Reflux can be a tricky issue. We sometimes find symptoms that have been labeled previously as related to acid reflux but have nothing to do with acid coming up and affecting the tissues in the larynx. In these cases, we don’t want to medicate you for reflux, but instead want to find the true cause for your throat irritation.

However, conditions such as laryngopharyngeal reflux (LPR) can damage the tissues of the voice box. In those cases, we recommend lifestyle changes such as losing weight, changing your diet, and not eating right before going to sleep. If those changes don’t work, we’ll consider medication.

You only get one voice. Protect it. If you are experiencing vocal problems, request an appointment with a laryngologist or call 214-645-8300.

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