QUESTION: Please help if you can! Several years ago I had laryngitis and had to continue talking (retail work). As a result, I ended up with muscle tension dysphonia that went incorrectly diagnosed for several years. Finally, I got a diagnosis and 2 years of speech therapy have improved things, but I still can’t sing and, at the end of each day, my throat is tight and painful. I desperately want to be able to sing again. There MUST be a way to reverse what is really just a habitual muscle tightening around the voicebox. Can you suggest anything? Hypnotherapy? ANYTHING. Please.
Thanks, Arjun Johnston
ANSWER:
Thank you for your question.
There are many different factors that are important in allowing us to have full use of our voice. Obviously, overuse, either through yelling or speaking incorrectly is one major factor.
However, in order for one’s voice to be normal, it is important to look at hormonal factors (thyroid functions and well estrogen/androgen) as well as the possibility of inflammation from reflux, chronic sinus infection and scarring of the thin layer protecting the vocal fold muscle.
Lastly, there can be damage to the nerves controlling the voice box- either after an upper respiratory tract or other throat infection.
It seems unlikely that muscle tension is the only cause of your problem. This frequently will be a counter-productive adaptation that you are doing because of another underlying issue.
I hope this clears things up.
Robert L Pincus MD
NY Otolaryngology Group
Muscle tension dysphonia is a voice disorder caused by excessive muscle tightening around the voice box, often resulting from overuse or incorrect speaking techniques. It can cause symptoms like throat tightness, pain, and difficulty speaking or singing. Proper diagnosis is essential to distinguish it from other underlying issues affecting the voice.
Yes, muscle tension dysphonia can often be improved or reversed with targeted speech therapy to correct voice use habits. However, treatment should also address any underlying factors such as hormonal imbalances, inflammation, or nerve damage that may contribute to or cause the muscle tension. Multidisciplinary approaches often yield the best results.
Hormonal factors such as thyroid function and levels of estrogen or androgens can influence voice health and contribute to voice problems. Ensuring these are within normal ranges is important when diagnosing and treating voice disorders, as imbalances may lead to or exacerbate symptoms like muscle tension around the vocal folds.
Yes, chronic inflammation from conditions such as reflux, sinus infections, or scarring of the vocal fold lining can worsen or mimic symptoms of muscle tension dysphonia. Treating these inflammatory causes is crucial to successfully manage voice issues and reduce compensatory muscle tension.
Nerve damage to the muscles controlling the voice box, potentially caused by upper respiratory or throat infections, can lead to voice problems resembling muscle tension dysphonia. Identifying nerve involvement is important as it requires specific management alongside muscle tension therapy.
While muscle tension dysphonia primarily involves physical muscle overuse and possible underlying medical factors, hypnotherapy is not a standard or proven treatment. Speech therapy and medical evaluation for inflammation, hormonal imbalances, or nerve damage are typically more effective.
Muscle tension can develop as a compensatory response to underlying voice issues such as inflammation or nerve damage, which causes the muscles around the vocal folds to tighten habitually. This tension often exacerbates the problem rather than resolving it, so treating the root cause is essential for improvement.
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