What causes muscle tension dysphonia?

Muscle tension dysphonia (MTD) occurs when the muscles around the larynx (voice box) are too tight during speaking, such that the voice box does not work efficiently. A person may use excess tension when speaking, and the voice may feel quite strained.

Some patients complain that the throat feels tight or even feel a muscle ache due to MTD. The voice may sound strained or tight.

Who gets muscle tension dysphonia?

MTD can occur with or without a medical condition of the voice box.

The vocal folds may be completely normal except for the excess tension used to produce voice. Or a patient may have a vocal lesion or a vocal fold paralysis and compensate for a voice disorder by pushing and straining the voice, developing MTD.

What are the common symptoms of MTD?

• Voice that sounds rough, hoarse, gravely, raspy, or coarse
• Voice that sounds weak, breathy, or airy, or is only a whisper
• Voice that sounds strained, pressed, squeezed, tight, or tense
• Voice that suddenly cuts out, breaks off, changes pitch, or fades away
• Voice that “gives out” or becomes weaker the longer the voice is used
• Pitch that is too high or too low
• Difficulty singing notes that used to be easy
• Pain or tension in the throat when speaking or singing
• Feeling like the throat is tired when speaking or singing
• Neck that is tender or sore to the touch

How do you make your voice better?

If you have MTD, voice therapy can help you relax the muscles of the voice box, throat, neck, and face. Therapy can teach you to use adequate breath blow for speech, soon getting you back to using a normal voice.

Before you start voice therapy, you should always have a full evaluation of your voice by an ear, nose and throat (ENT) doctor and a speech therapist.