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Birmingham, AL | ENT Specialists
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What Is a Voice Disorder?

Voice Disorders


Did you know that as many as nine percent of Americans have a voice disorder, but that fewer than one percent seek professional treatment? One possible reason for people not seeking treatment is that voice disorders can take many forms, and they often accompany other illnesses. Sometimes, people may not realize that they have a treatable issue.

Read on to learn about some common causes and symptoms of voice disorders, plus how professional treatment can improve a person’s life.

What is a voice disorder?

The vocal cords are two tiny muscles that are covered in layers of tissue. They’re very delicate and need to be able to vibrate together smoothly. A voice disorder is anything that causes changes to a person’s vocal cords, which can then affect the pitch, loudness, tone, or the level of effort the person must exert to create sounds.

Generally, there are two classes of voice disorders:

  1. Physiological – changes in the body, including problems with the central nervous system
  2. Functional – using the vocal cords improperly or inefficiently

Speech is a very complex and dynamic muscle activity, so small changes in the body or in the way we use our voices can have a dramatic impact on a person’s vocal tone or ability to produce “normal” sounds. 

Causes and symptoms of voice disorders

 Some of the most common causes of vocal disorders are:


 The vocal cords can develop many different kinds of growths ranging from fluid-filled cysts to hard, benign papillomas. Surgeries and throat injuries can cause physical damage, which leaves behind scar tissue. It’s also possible to develop cancerous tumors on the vocal cords. Recall that two tiny muscles create your voice, so even a very small growth can have a dramatic impact on the sound of a person’s voice.


 One of the most common causes of vocal changes is inflammation, especially from illnesses such as colds or other upper respiratory viruses. Excessive stomach acid from GERD (gastroesophageal reflux disorder) can irritate the vocal cords, as can allergies. Other factors that can cause inflammation are smoking, overusing the voice, some medications, and surgery.

 Nervous system disorders

 Since the nervous system controls vocal cord movements, medical conditions that impact the nervous system can also affect the voice. People who suffer from MS, Parkinson’s disease, ALS, or strokes may struggle to use their voice normally.


 The vocal cords are muscles, so they can suffer from improper or excessive use. Talking or singing too much, screaming, shouting, or even excessive coughing and throat clearing can damage the muscles. Some people may develop polyps, which are like small blisters on the vocal cords. In extreme cases, the vocal cords can hemorrhage. 

 Some occupations put people at a greater risk for misuse-induced voice disorders. Teachers, those who work in loud manufacturing environments, salespeople, and singers use their voices more and louder than other people, so they need to be particularly careful to protect their vocal muscles.

 Lifestyle factors

 Things like smoking, excessive alcohol intake, and limited water consumption can affect the vocal cords. Also, a person’s age can cause changes in how well the vocal cords operate.


 Each voice disorder is unique, but some common symptoms are: 

  • Rough, breathy, strained voice
  • Abnormal pitch (too high/low, lots of variation in pitch)
  • Weak, hoarse, lost voice
  • Raspy or shaky voice
  • Needing to use more effort than normal to speak
  • Becoming easily fatigued
  • Running out of breath
  • Tension, pain, or tenderness in the throat
  • Persistent cough or throat clearing

If you exhibit any of these symptoms and they persist for two weeks or more, especially if they’re affecting your quality of life, then it’s time to schedule an appointment.

Diagnosing voice disorders

 To diagnose a throat disorder, a speech-language pathologist needs to be able to see the vocal cords. At ExcelENT, Amy Pittman uses video laryngoscopy to see a person’s throat, larynx, and vocal cords.

The short procedure involves putting a tiny camera through the lower nasal passage to reach the throat. The patient needs to be awake so that he or she can speak, which helps Amy see the vocal cords while they vibrate and move. The procedure isn’t painful and lasts less than one minute.

 The camera helps Amy see if there are any growths or signs of an infection. She also watches how a person uses his or her voice and whether there’s tension in the muscles. Then, she’s able to determine whether the patient would benefit from voice therapy or if they need medical or surgical treatment.

How do you treat a voice disorder?

 Each disorder and individual are unique, so Amy customizes treatment plans to the exact needs of each patient. Treatment may include one or more of the following:

Lifestyle changes

 Sometimes, simple lifestyle changes can have a significant impact on the vocal cords. Drinking more water, quitting smoking, and making diet changes that reduce acid reflux can prevent vocal irritation. Taking time to rest vocal cords and learning how to warm them up before prolonged use can also reduce inflammation and fatigue.

Voice therapy

 When you use your voice, your vocal cords vibrate 100 – 200 times each second. With every vibration, they hit each other, and the impacts can cause damage. People who use their voices a lot, like teachers and singers, sustain more damage than the average person.

It’s possible to learn to use your voice in a way that limits the damage. A speech-language pathologist can teach a patient the proper technique, vocal exercises to strengthen the muscles, relaxation techniques, and even breathing strategies that help him or her use the vocal cords more efficiently.


 Some patients may benefit from medications. Antacids, for example, can help control GERD symptoms. When the vocal cords are exposed to less stomach acid, they’ll be healthier.


 If there are growths on the vocal cords, sometimes a patient needs surgical intervention to remove them. If the growths are cancerous, a patient may also need radiation therapy.

Don’t struggle with a voice disorder alone

Speech is something that most people take for granted until they develop a voice disorder. If you or a loved one is experiencing vocal changes, come in and see our voice specialists for diagnosis and a custom treatment plan.

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