From the Guidelines
For vocal cord pain, rest your voice by limiting talking and avoiding shouting or whispering for 1-2 days, as this can help reduce inflammation and promote healing of the delicate vocal cord tissues. To manage vocal cord pain, several strategies can be employed, including:
- Staying hydrated by drinking water daily, as recommended by 1, to keep the vocal cords moist and reduce irritation
- Using amplification in large noisy spaces to reduce voice strain, as suggested by 1
- Resting your voice briefly to prevent voice fatigue, straining, and overuse, also recommended by 1
- Providing indoor air humidification in dry, arid environments to maintain a moist environment for the vocal cords, as advised by 1
- Avoiding irritants such as smoking, alcohol, caffeine, and spicy foods that can worsen inflammation, as cautioned against by 1
- Considering steam inhalation for 5-10 minutes twice daily to provide relief by moistening the vocal cords If symptoms persist beyond 1-2 weeks, worsen significantly, or are accompanied by difficulty breathing or swallowing, it is essential to seek medical attention, as prescription medications like corticosteroids or further evaluation may be needed, in line with the recommendations outlined in 1 and 1. Clinicians should inform patients with dysphonia about control/preventive measures, as stated in 1, and document resolution, improvement, or worsened symptoms of dysphonia or change in QOL among patients with dysphonia after treatment or observation, as recommended by 1.
From the Research
Vocal Cord Pain Recommendations
- Therapeutic breathing maneuvers and vocal cord relaxation techniques are first-line therapy for dyspnea that occurs with vocal cord dysfunction 2
- Management of vocal cord dysfunction requires identification and treatment of underlying disorders, such as asthma, gastroesophageal reflux disease, and postnasal drip 2, 3
- Referral to speech therapists can help teach techniques of throat relaxation, cough suppression, and throat clearing suppression 3
- OnabotulinumtoxinA injections may be helpful for spasmodic dysphonia and for treating dyspnea in certain cases, although evidence is limited 2
- Medications can have direct and indirect effects on laryngeal hydration, vocal fold mucosal integrity, laryngeal muscle function, and laryngeal sensation, and therefore, medical history symptoms should be evaluated to raise suspicion for medication-related vocal changes 4
Triggers and Contributing Factors
- Common triggers for vocal cord dysfunction include exercise, asthma, gastroesophageal reflux disease, postnasal drip, upper or lower respiratory tract infection, and irritants 2
- Gastroesophageal reflux disease and nonallergic rhinitis can contribute to the pathogenesis of vocal cord dysfunction 3
- Postnasal drip and gastroesophageal reflux disease can lead to increased laryngopharyngeal sensitivity and hyperreactivity 3