What is a voice problem?

A voice problem is an unexpected change in the sound or feeling of your voice which doesn’t suit your vocal needs.

Symptoms include:

Huskiness, hoarseness, lowered pitch, decreased pitch range, difficulty projecting voice, voice breaks, throat discomfort (tickling throat clearing, pain), voice fatigue or decreased stamina.

When to seek help:

  1. When symptoms persist in the absence of an illness longer than two to three weeks or earlier if you need your voice to be in better condition.
  2. Immediately if you have throat pain not associated with a cold/flu or if you are coughing up blood or have a lump in the throat.
  3. If you have a complete loss or severe change in voice lasting longer than a few days.
    • If ignored, the problem can become chronic, more severe and may lead to development of pathologies like cysts or nodules.
    • Rarely due to cancer unless you have been a smoker and a heavy drinker.
    • Is commonly misdiagnosed as laryngitis and may be inappropriately managed with cortisone/steroids, repeated antibiotics or long-term use of throat gargles.

Common causes of voice problems:

  • Heavy vocal load (occupational and/or social)
  • Voice use patterns (for e.g. faulty, misuse, abuse or disuse)
  • Irritants – smoking (cigarettes, marijuana)
    • dust/pollutants
    • asthma medication.
  • Allergy
  • Gastro-oesophageal or laryngopharyngeal reflux
  • Stress
  • Medication
  • Vocal injury:- trauma to larynx (intubation, external hit to the neck etc)
  • Health issues/diseases: eg. Asthma, thyroid dysfunction, arthritis, hormonal imbalance or neurological problem.
  • Upper respiratory tract infections/inflammation
  • Others:

Some realities about voice problems:

  • Majority of voice problems don’t need surgery.
  • The majority of voice problems are avoidable and remediable.
  • Even the most accomplished highly trained singer can develop a voice problem (same as an elite athlete is still susceptible to injury)
  • Voice problems can have a huge psychological impact and can also be caused by psychological distress.
  • You don’t realise how crucial your voice is until you lose it.
  • Other people can be unsympathetic about voice problems and tend to comment more readily than they would if someone limped, stuttered or was in a wheelchair, e.g. “Have you got a cold?” or “That’s a sexy voice”. Often people will raise their own volume assuming the person with a voice problem also has a hearing problem.
  • 2/3 of voice problems are due to faulty use and can lead to pathology such as swelling, nodules, cysts or bleeds in the cords.