Hoarseness and voice loss
Hoarseness means that the voice sounds different than normal: for example screaming, rasping, weak, squatting or less clear. In case of more serious complaints, the voice can be partially or almost completely lost. This can occur suddenly during a cold or throat inflammation, but also gradually due to prolonged voice use, irritation or an underlying condition.
The cause determines for an important part which treatment is appropriate. In case of acute inflammation, the approach is different from a voice that becomes more tired, a lot of mucus around the throat or prolonged dryness and irritation.
Within Chinese medicine, therefore, not only the hoarseness itself is considered, but also the course, additional throat and airway complaints, mucus, dryness, energy, digestion and possible influence of tension or emotions.
Possible Western disorders
Hoarseness and loss of voice may occur with:
- acute or chronic laryngitis;
- colds and other respiratory infections;
- functional dysphonia or muscle tension dysphonia;
- vocal cord nodules or vocal bands;
- reflux-related irritation of throat and larynx;
- other conditions or changes in vocal cords.
In case of prolonged or unexplained hoarseness, it is important to exclude a possible structural cause from the vocal cords.
Possible causes
Acute hoarseness often occurs during viral respiratory infection in which the larynx and vocal cords become irritated or inflamed. Also intensive voice use can cause temporary hoarseness or loss of voice.
In recurrent or chronic complaints, long-term voice stress, smoking, dry air, dust and other irritants can play a role. Also reflux can irritate the larynx and vocal cords. In some people tension and emotions clearly affect the use of the voice.
Long-term irritation or overload may also be associated with structural changes in the vocal cords, such as nodules or polyps.
How can acupuncture help with hoarseness and voice loss?
The treatment is tailored to the cause and pattern behind the voice problems. In case of acute hoarseness due to respiratory infection, for example, the emphasis is on a different approach than chronic vocal fatigue, a lot of mucus or a dry, irritated throat.
The treatment may include:
- reduce irritation and swelling of throat and vocal cords;
- treat throat pain and other additional symptoms during acute respiratory infection;
- reduce mucus when this interferes with throat and voice;
- reduce throat and vocal dryness;
- supporting the voice when it is weak and quickly becomes tired;
- reduce tension when stress or emotions clearly affect the voice.
For acute symptoms, temporary treatment can be more frequent. Chronic complaints are more focused on the underlying pattern and usually require a longer course of treatment.
How can Chinese herbal medicine help with hoarseness and voice loss?
Chinese herbs can be used daily between treatments and adapted to the type of voice complaint. A dry, irritated throat, for example, requires a different approach than hoarseness in which many mucus and throat scrapes are at the forefront.
Herbal treatment may include:
- reduce acute irritation, redness and swelling;
- moisten dry throat and dry vocal cords;
- reduce mucus and frequently treat throat scrapes;
- supporting the voice in case of prolonged weakness and fatigue;
- treat the underlying pattern in the event of recurrent complaints;
- adjust the treatment when acute hoarseness passes into prolonged voice complaints.
Acupuncture and herbs can be applied separately, but can also complement each other.
How does Chinese medicine view hoarseness and voice loss?
Within Chinese medicine, the throat and functioning of the voice are primarily linked to the Lung organ system . The Lungs are involved within TCM among other things in the movement of Qi in chest and airways. If this function is disturbed during a cold for example, the voice can suddenly become hoarse or disappear.
In case of long-term complaints, other organ systems may also be involved. The Spleen plays a role in the formation of Qi and the processing of body fluids. When this function is weakened, it is easier to develop mucus and the voice can become less powerful.
The kidney organ system can play a role especially in prolonged dryness and exhaustion. Lung and kidney are both involved within TCM in the feeding and moistening of throat and voice.
The Liver can also be relevant. The Liver is involved in the free movement of Qi within TCM. In case of strong tension, frustration or other emotions, this movement may stagnate. Some people experience a lump or tightness in their throat and notice changes in their voice at the same time.
What is a TCM organ system?
A TCM organ system describes a group of related body functions and is wider than just the anatomical organ with the same name. Read more at TCM basics .
What is a TCM pattern?
A TCM pattern is a recognizable combination of complaints and physical characteristics that indicates which imbalance is likely to contribute to the complaints. Read more at TCM basics .
Below are only the most common patterns discussed. Other patterns are possible and multiple patterns can occur at the same time. This allows you to recognize yourself in different descriptions. Also, someone with a certain pattern does not have to have all the symptoms mentioned. The pattern is determined on the basis of the overall picture of complaints.
Most common TCM patterns
Wind-Cold
Brief explanation
This is an acute pattern that can occur at the beginning of a cold or other respiratory infection. The normal function of the Lungs and throat is temporarily disturbed, so the voice can suddenly become hoarse or weak.
Common symptoms
- sudden hoarseness or loss of voice;
- slight sore throat or tickle in the throat;
- chilliness, possibly mild fever;
- muscle pain and stiff neck;
- clogged nose or clear, aqueous nasal secretion;
- cough with thin, clear mucus.
Examples of Western disorders
This pattern can be recognised in colds, acute viral respiratory infections and acute laryngitis.
Wind-Heat
Brief explanation
Also this is usually an acute pattern during respiratory infection. Compared to Wind-Cold redness, irritation and other heat phenomena are more prominent.
Common symptoms
- sudden hoarseness or loss of voice;
- red, sore or swollen throat;
- fever, possibly with chills;
- headache;
- dry or irritated throat;
- cough, sometimes with yellow or sticky mucus.
Examples of Western disorders
This pattern can be recognised in acute laryngitis, pharyngitis, tonsillitis and other acute respiratory infections.
Wind-Dryness
Brief explanation
In Wind-Dryness, sudden dryness and irritation of throat and voice are at the forefront. This can occur for example in dry ambient air or during an acute respiratory disorder where dryness is clearly present.
Common symptoms
- dry, hoarse or rasping voice;
- dry or tickling throat;
- dry mouth, nose or lips;
- dry cough;
- low mucus or a small amount of tough mucus;
- clear dryness of multiple mucous membranes.
Examples of Western disorders
This pattern can be recognised for acute irritation of throat and voice and respiratory disorders where dryness is clearly at the forefront.
Liver-Qi-stagnation
Brief explanation
With this pattern, tension affects the free movement of Qi through throat and chest. As a result, the voice can become weaker or hoarse without the need for clear inflammation of the throat. The symptoms can vary greatly with stress and emotions.
Common symptoms
- hoarseness or loss of voice during periods of stress or emotional tension;
- a lump or feeling that something is stuck in the throat;
- chest tightness;
- a lot of sighs or effort to take deep breaths;
- irritability or frustration;
- complaints that clearly change with tension.
Examples of Western disorders
This pattern can be recognized in functional dysphonia, muscle tension dysphonia and some forms of functional voice loss.
Phlegm-Heat
Brief explanation
Phlegm-Heat combines mucus and Heat. The mucus can hinder the free movement around throat and voice, while Heat collides with irritation and swelling. This pattern can occur both in acute and longer-standing symptoms.
Common symptoms
- heavy, hoarse or squatty voice;
- frequently scraping the throat;
- Tough, yellow mucus;
- feeling of mucus or throat obstruction;
- red or swollen throat;
- cough or wheezing if necessary.
Examples of Western disorders
This pattern can be recognised in chronic laryngitis and other voice complaints where mucus and irritation are clearly prominent.
Lung- and Spleen-Qi-deficiency
Brief explanation
This pattern mainly lacks power behind the voice. The voice becomes weaker as someone talks or gets more tired. The Spleen plays a role within TCM in the formation of Qi, while the Lung uses this Qi for breathing and voice.
Common symptoms
- chronic weak or soft voice;
- hoarseness made worse by speaking;
- fast tired voice;
- fatigue and low energy;
- shortness of breath;
- low appetite;
- bloating;
- loose stools.
Examples of Western disorders
This pattern can be recognised in chronic voice fatigue, voice problems following respiratory infection or prolonged illness and some forms of chronic laryngitis.
Lung- and Kidney-Yin-deficiency
Brief explanation
This pattern usually occurs with long-term complaints where according to TCM, Yin is not present enough to nourish and moisten throat and voice properly. Dryness is therefore strongly in the foreground.
Common symptoms
- long-lasting dry, grating or weak voice;
- dry and irritated throat;
- Voice getting tired fast;
- dry cough with low mucus;
- dry mouth and mucous membranes;
- sometimes night sweats;
- Sometimes feeling warmth in hands and feet.
Examples of Western disorders
This pattern can be recognised in chronic laryngitis, chronic pharyngitis and long-term voice complaints where dryness and irritation are clearly at the forefront.
When to contact your doctor?
Have persistent or unexplained hoarseness medically assessed, especially if the symptoms persist for more than a few weeks or come back regularly.
Contact us before if you have swallowing problems, coughing up blood, swelling in the neck, unexplained weight loss or increasing breathlessness.
In case of long-term voice complaints, research by a ENT doctor and, depending on the cause, counseling by a logopedist can be useful.
Outlook
The course of treatment depends, inter alia, on the cause, duration and severity of voice complaints, the underlying TCM pattern and any structural changes in vocal cords.
In case of acute hoarseness, for example during a cold or laryngitis, treatment can be used relatively frequently in the first days. Depending on the severity acupuncture can be applied several times a week and sometimes daily. Chinese herbs can be used daily when appropriate and adjusted when the symptoms change.
In the case of chronic hoarseness or vocal weakness, more time is usually needed. One acupuncture treatment per week is a common guideline in the initial phase. If the symptoms decrease and become more stable, the frequency can be reduced.
When structural changes are present, such as vocal cord nodules or polyps, the course depends partly on the underlying cause and possible treatment by a ENT doctor or logopedist.
Contact
Do you suffer from hoarseness, a weak voice or recurrent loss of voice and want to know if acupuncture and/or Chinese herbal medicine can fit in with your complaints? During a first consultation we will discuss your symptoms, possible causes and other relevant symptoms. Based on the overall picture of complaints, we will examine which TCM pattern is likely to be at the forefront and what treatment fits.