My voice sounds hoarse and strained

Muscle tension dysphonia is a commonly used term amongst ENT (Ear Nose & Throat) consultants / Otoloryngologists and voice specialist Speech & Language Therapists. It is often used as an umbrella term encompassing vocal hoarseness or voice difficulty relating to vocal strain.

Vocal hoarseness/voice difficulty can occur for a wide range of reasons. Typically, the external and/or internal muscles of the larynx become tense and adopt sub optimal working patterns which ultimately lead to vocal strain and fatigue.

The sub optimal voicing pattern may impact breathing, cause vocal hoarseness and ultimately lead to vocal cord pathology such as vocal nodules. In other cases, it may be that vocal cord structural changes e.g. vocal cord scar or cyst cause the individual to develop a muscle tension dysphonia on top of their structural vocal cord issue.

It is very common for symptoms to worsen with the passage of time if treatment is not sought or there is a long delay accessing diagnosis. Very often, in spite of vocal hoarseness lasting more than 2 or 3 weeks, a referral to ENT is not made/ delayed. Unfortunately, the Covid-19 pandemic exacerbated not only delays accessing ENT assessment but also more cases of vocal hoarseness. Another challenge for clients is accessing appropriate and effective treatment once they are diagnosed.