Your voice can change for many different reasons. Sometimes it’s hard to know what’s causing a voice problem just by listening, because different voice conditions can sound similar.
Voice problems can happen slowly or suddenly.
Symptoms
The list below gives some common symptoms of voice problems:
- having a raspy, scratchy or hoarse voice
- often having a raw, strained, or sore throat
- feeling like it’s an effort to talk
- feeling like you don’t have control of your voice
- feeling like your voice gets weak and tired the more you talk
- having trouble singing high notes you could sing before
- needing to clear your throat a lot
- feeling like you have a lump in your throat
- having symptoms for more than 2 or 3 weeks
Causes
Things that can cause voice problem or make voice problems worse include:
- using your voice in ways that strain it, like speaking at a pitch that’s too high or low, talking a lot, or screaming
- tense muscles
- respiratory (breathing system) infections like colds or bronchitis, especially if you’re coughing harshly and often
- breathing problems
- acid reflux (stomach acid backing up into your throat)
- neurological problems, like stroke, brain injury, Parkinson’s Disease
- cancer of the throat, thyroid, or lung
- surgery
- accidents
- some medicines
- stress and mental health conditions
Voice problems can also be related to vocal fold lesions. Lesions are non-cancerous bumps on the edges of vocal folds. The most common types are:
- nodules: callus like bumps on both vocal folds
- polyps: blister like bumps on one vocal fold
- cysts: fluid filled sacs on a vocal fold
Voice problems may also involve vocal fold paralysis (no movement) or vocal fold paresis (reduced movement) in one or both vocal folds. This can be a result of surgery, tumours, infections, neurological conditions, trauma, or sometimes unknown causes.
Assessment
Voice problems are usually assessed by a speech-language pathologist and an otolaryngologist.
The assessment includes:
- talking about your symptoms, voice use, and medical history
- listening to how your voice sounds
- looking at your vocal folds using a small camera (laryngoscopy or stroboscopy)
- doing simple voice measurements, like how long you can hold the sound “ah” or how high and low your voice can go
These steps help your healthcare team understand what is causing your voice problem and decide on the best way to help.
Treatment
Treatment depends on the cause of the voice problem and may include:
- voice therapy with a speech-language pathologist
- keeping your voice healthy (hydration, reducing strain, managing reflux)
- medical treatment for conditions such as infections or reflux
- surgical intervention in few cases, like removing lesions
- counselling or support for stress-related voice issues
Where to get help
If you have concerns about your voice, visit your healthcare provider.
Speech-language pathologists and audiologists can help with speech, language, and hearing concerns. Ask your healthcare provider or visit Adult Community Rehabilitation or Pediatric Rehabilitation to learn more.
