Voices vary widely, and there’s no definition of a “normal” voice.
However, you know when your voice sounds a bit off. It could be due to any number of reasons – from overuse to a cold virus to a more serious chronic condition.
Often, you can just wait it out and your voice will return to normal, but there are times when it’s important to see a doctor for hoarseness or throat pain.
What is a “frog in the throat”?
“Frog in the throat” is not a medical term. It commonly describes hoarseness, roughness or a gravelly voice, sometimes accompanied by throat irritation or soreness when speaking.
What causes voice changes or a frog in the throat?
Voice changes or disorders may be related to conditions in the nose, lung, brain, or gastrointestinal tract. That’s why a thorough evaluation is important to determine the underlying issue.
Some of the most common causes of temporary voice changes:
- upper respiratory infections, especially viral infections
- laryngitis
- voice overuse or misuse
- lesions
- inflammatory conditions, such as allergies or asthma
- acid reflux (heartburn) affecting the throat
- tobacco use
- medication side effects
Causes of longer-term voice changes:
- vocal cord lesions
- age-related vocal fold atrophy, or weakness
- muscle tension disorders of the larynx
- tremors or spasms
- vocal fold paralysis or paresis, in which one or both vocal cords don't move due to a neurologic condition
- injury or narrowing to the windpipe
Voice and throat misuse and overuse explained
Some examples of overusing or misusing the voice:
- yelling
- speaking over loud background noise
- excessive teaching or coaching
- improper microphone use
- singing outside one’s trained vocal range
- using the voice heavily while ill
Lesions and growths of the vocal cords
The most common lesions found on vocal cords are benign: nodules, calluses, polyps, cysts, granulomas and papillomas.
Ulcers may occur with chronic coughing, uncontrolled inflammatory disorders or acid reflux.
Tumors or cancers can also occur, often related to tobacco or vaping.
The impact of stress and anxiety on the throat and voice
Anxiety and stress can lead to excessive muscle tension in the throat, causing a tight, strained voice even when the vocal cords appear normal and healthy. Voice therapy is often helpful, as is treating the anxiety or alleviating stressors.
Lingering throat and voice issues connected to the COVID-19 pandemic
During and after the COVID-19 pandemic, there was a spike in patients treated for breathing and cough disorders. Many also had hoarseness or voice and airway disorders, largely related to a cough that could persist for weeks to months.
We still see the impact of those COVID-19 infections, just as we see the impact of all forms of viral and bacterial illnesses that affect the airway and lead to chronic cough.
How long throat issues and voice changes last
Temporary problems are usually infectious or inflammatory and resolve within weeks. For example, acute laryngitis usually resolves within seven to 14 days.
Certain chronic conditions – such as vocal fold paralysis or changes due to neurological conditions or injuries – may not resolve on their own. However, therapy or surgery can often significantly improve voice quality and function.
When to see a doctor for voice changes or ongoing throat trouble
Voice changes lasting longer than two weeks should be evaluated by a health care provider or a specialist called an otolaryngologist. Also see a doctor for any voice changes that occur without illness.
Diagnosing voice disorders when throat symptoms persist
Clinicians assess voice quality using descriptive measures (roughness, breathiness, strain, weakness) and patient reported changes and impact on quality of life.
Evaluation includes listening to the voice, voice analysis and a visual exam of the vocal cords using telescopes. This allows us to measure changes in the frequency of the voice, compare the level of roughness or hoarseness to population norms and evaluate for vocal cord function, swelling and lesions.
New patients are often seen by both a physician and a speech language pathologist.
There is sometimes a domino effect from certain disorders that don't necessarily start in our throat, so we also collaborate with physicians in many fields to determine any underlying causes of the voice issue.
Treatment for voice disorders and stubborn throat discomfort
Most voice disorders are treated with medication, vocal rest and voice therapy. Some patients benefit from office based procedures, such as injections or laser therapy.
Surgery may be used to address large or suspicious lesions or when other treatments fail to resolve symptoms.
When urgent or emergency care may be needed for severe voice or throat changes
Some red flags that indicate you need to consult a health care practitioner right away:
- complete voice loss
- breathing difficulties
- noisy breathing, such as wheezing or stridor
- coughing up blood
- inability to swallow food or liquids
Tips for a healthy voice and preventing a frog in the throat
- Stay well hydrated by drinking around 60 ounces of water daily.
- Understand your daily vocal limits.
- Avoid tobacco, vaping and marijuana.
- Manage reflux and chronic cough.
- Rest the voice when strain or roughness develops.
- Use a microphone when in noisy or large spaces.
Singers and other performers should avoid heavy voice use when ill, pay attention to early warning signs and prioritize long term vocal health – even if it means canceling performances.
Left untreated, some issues could lead to vocal cord injury and voice loss for a prolonged period.
Having trouble speaking, singing or breathing?
See a specialist at central Ohio’s only Voice and Swallowing Clinic.
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