Muscle Tightening Around the Voicebox - Diagnosis and Treatment

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.

Muscle Tension Dysphonia Treatment

Thanks, Arjun Johnston


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