Understanding Hoarseness

We’ve all been there. You wake up, get dressed, and head to work only to find your voice has been reduced to a gravely whisper. You don’t feel ill, but you sound like you’re getting over an awful cold. You’ve got dysphonia—more commonly known as being hoarse.

In general, “hoarseness” refers to any change in vocal capability. This can mean the presence of a number of symptoms, including roughness, breathiness, weakness, or straining to speak. It’s usually painless and always disruptive. And it often seems to appear for no reason.

It’s commonly assumed that hoarseness is simply “laryngitis.” Hoarseness can certainly be a symptom of laryngitis, which is inflammation of the larynx (voice box) usually caused by viral infection. In this scenario, swelling of the mucus membranes causes swelling of the vocal cords. Your voice becomes deeper and rougher because the vocal cords don’t vibrate as they should. Sometimes they swell so severely they stop vibrating altogether. So you lose your voice.

While acute viral laryngitis is certainly the most common cause of hoarseness, it is not always so. So what’s going on when we lose our voice but have no other symptoms?

In addition to the common cold, typical culprits of throat irritation include seasonal allergies, sinusitis, smog, and wildfires. Virus or no, throat irritation can cause vocal cord swelling. And if the vibrations of our vocal cords are disturbed enough by environmental factors, hoarseness can result. Alternatively, hoarseness also can stem from plain old-fashioned overuse. Think: yelling at a concert or ball game. Voice-use-related hoarseness is common in certain professions, including the music industry, teaching, call centers, and more. Other, rarer causes of voice change include benign or malignant tumors and neurological conditions such as Parkinson’s disease.

So what should we do if we experience hoarseness? Because there’s typically no pain involved in voice use, even when we have a cold, we often continue to speak as if nothing is different. What we should be doing is “voice rest”—that is, trying to speak minimally until the condition resolves. Continued vocalization aggravates the swelling and can potentially result in greater injury to the vocal cords. So, in addition to typical self-care like hydration, steam baths, and rest, it’s also a good idea to pipe down!

Hoarseness usually gets better within 7-10 days. If yours persists more than 2 weeks, get evaluated by an otolaryngologist—also known as an “ear, nose, and throat” doctor—to rule out more worrisome (and rare) diagnoses like laryngeal cancer.

The Ear, Nose & Throat Program at Casa Colina Hospital and Centers for Healthcare offers specialized medical and surgical treatment for conditions of the ears, nose, throat, sinuses, and larynx. For more info visit casacolina.org/ENT or call 909-596-7733, ext. 3800.