Muscle Tension Dysphonia: Can Stress Cause Hoarseness?

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Muscle tension dysphonia is an abnormal voice that occurs because the small muscles in the vocal cords, the laryngeal muscles, are excessively tense or
strained. Muscle tension dysphonia is a change in the sound or feel of your voice caused by excessive muscle tension in and around the vocal cords. This may involve the vocal cords and other accessory muscles of the larynx. Muscle tension dysphonia is a “functional dysphonia,” in which a pattern of muscle use develops because of irritants, laryngitis, or even stress, among other conditions. Even after the original cause goes away, the voice changes persist because of the excessive squeezing or tension that results from voice use.

What Are the Symptoms of Muscle Tension Dysphonia?

The most common symptoms of muscle tension dysphonia are:

• Feeling that your throat gets tired when speaking or singing.
• A rough, hoarse, raspy, or gravelly voice.
• A weak, faint, breathy voice, or one that comes out only as a whisper.
• A voice that sounds strained, squeezed, pressed, tight, or tense.
• A voice that suddenly cuts out, breaks, changes pitch, or weakens.
• A voice that “fades” or weakens with prolonged use.
• A pitch that is too high or too low.
• Difficulty singing notes that used to come easily.
• Pain or tension in the throat when speaking or singing.

How Is Muscle Tension Dysphonia Diagnosed?

• Muscle tension dysphonia is diagnosed primarily through an evaluation of your voice and vocal cords (with a camera examination) by a voice specialist and/or a speech-language pathologist.
• Muscle tension dysphonia is a diagnosis of exclusion and requires a complete history, an examination, and ruling out other causes by an experienced healthcare provider.

How Are Vocal Cord Disorders Treated?

Vocal cord disorders caused by abuse or misuse of the voice can be easily prevented. In addition, most vocal cord disorders are reversible. Your healthcare provider will determine the best treatment based on:

• Your age.
• Your overall health and medical history.
• How sick you are.
• How well you can handle specific medicines, procedures, or therapies.
• How long the condition is expected to last.
• Your opinion or preference.

Treatment may include any of the following:

• Surgery to remove growths.
• Resting the voice.
• Stopping the behavior that causes the vocal cord disorder.
• Referral to a speech-language pathologist who specializes in treating voice, speech, language, or swallowing disorders.
• Medication.

Treatment of Muscle Tension Dysphonia

Treatment of muscle tension dysphonia primarily involves voice therapy with a speech-language pathologist to reduce throat tension and maximize vocal efficiency. While receiving voice therapy, you may also be asked to use treatments that help relieve tension, such as massage, acupuncture, psychotherapy, or physical therapy. Voice therapy usually consists of several sessions to help reduce the pattern of muscle tension.

Voice therapy usually consists of several sessions to help reduce the pattern of muscle tension.

Your doctor may recommend other medical or surgical treatments to address the underlying causes of muscle tension dysphonia.

Frequently asked questions about muscle tension dysphonia:

Can Muscle Tension Dysphonia Be Caused by Stress?

Stress is one of the main causes of muscle tension dysphonia. When we talk about stress, one of the common expressions used is “feeling tense.” Because stress causes the muscles in the body to tense up, most commonly around the neck and shoulders, hoarseness can occur as a result of tension in the vocal cords, throat, and larynx.

Can Other Psychological Problems Cause Muscle Tension Dysphonia?

Our psychology and emotional state are connected to our voice in some way. The brain region involved in voice is in the frontal lobe, the brain region involved in emotion, and especially emotional stability, is also in the frontal lobe, and there is also a brain region known as the amygdala.

An examination by a doctor is the most reliable way to reach a definitive diagnosis in this regard.

What Happens If Dysphonia Is Not Treated?

In most mild cases, the problem resolves once factors such as overuse of the voice and stress are removed. In severe cases, the voice may get worse over time, and although rare, untreated severe dysphonia can damage the vocal cords. It can lead to the formation of nodules or cysts. In severe cases, we recommend that you consult an ENT specialist.

Which Clinic Should I Go to If I Have Symptoms of Muscle Tension Dysphonia?

If you have mild symptoms, you can initially treat yourself by reducing stress, avoiding overuse of your voice, and avoiding shouting. Massage and regular steam inhalation to help soothe tense muscles may also help.

If your symptoms get worse or last longer than three weeks, we recommend that you consult an ear, nose, and throat (ENT) surgeon.