Hoarseness

Hoarseness is a general term that is used for abnormal voice changes that affects the ability to speak. The hoarseness is used to describe the changes in voice quality i.e. breathy, raspy, harsh or strained voice or there maybe changes in volume (loudness) or pitch of voice.

CAUSES

Hoarseness is caused due to disorders related to the vocal cords, which are the sound-producing part of the larynx or the voice box located in the throat. It is seen that generally most of the causes are not serious and tend to subside in a short period of time. The various causes of hoarse voice are:

• Acute laryngitis or inflammation of the vocal cords which in turn is most often caused by an upper respiratory tract infection.
• Voice abuse like using voice too much, too loudly or improperly over extended periods of time.
• Benign vocal cord nodules, polyps or cysts.
• Paralysis of vocal cords.
• Gastroesophageal reflux (GERD) i.e when the contents from the stomach come up and irritate the vocal cords.
• Allergies
• Inhalation of respiratory tract irritants
• Smoking
• Thyroid disorders
• Rheumatoid arthritis
• Trauma to the vocal cords
• Neurological condition (such as parkinson’s disease and strokes)
• Cancer of the larynx

DIAGNOSIS

For the diagnosis of the exact cause of hoarseness evaluation of the voice quality as well as general health of the patient is done. Further examination of the larynx is done using an instrument called laryngoscope. Depending on the assessment of the general health lab tests such as biopsy, x-ray, or thyroid function tests may be done. Evaluation of the voice quality suggests the following:

• If the voice is breathy it may be due to poor vocal cord function. This is most likely caused by a benign tumor, polyp or larynx cancer.
• If the voice is raspy it is either due to thickening or paralysis of the vocal cord. The thickening of vocal cord occurs from swelling and inflammation due to infection, chemical irritant or voice abuse.
• A high, shaky or a soft voice suggests there is difficulty in getting enough breathing force or air.

SIGNS AND SYMPTOMS

Common symptoms of hoarseness are:

• Tickling sensation in throat.
• Sensation of a foreign material in the throat.
• Inability to produce clear sounds.
• Change in voice i.e harsh, raspy or breathy voice with or without pain.
• Pain or difficulty in swallowing.

GENERAL MANAGEMENT

Hoarse voice can be managed by observing the following steps:

• Quit smoking and also avoid second hand or passive smoke.
• Avoid agents that dehydrate the body such as caffeine and alcohol.
• Drink plenty of water to keep the body hydrated.
• Eating healthy, well balanced diet and avoiding spicy food.
• Avoid using voice too long or too loudly. If need be make use of microphone if possible.
• Keep the surrounding air humidified.
• Voice therapist maybe helpful in certain cases to help individuals with vocal training and voice modification.

HOMEOPATHIC MANAGEMENT

Homeopathy provides the best and safe treatment option for hoarse voice. It provides immediate relief in the present symptoms of the patient and shortens the period of suffering. At the same time homeopathy also eliminates the tendency to have future episodes of hoarse voice by strengthening the immune system. For this a trained homeopathic physician takes a detailed case record of the patient to elicit the cause and effect of hoarse voice pertaining to both the mental and physical sphere.

Best homeopathic medicine for hoarse voice is the one most similar to the disease manifestation in each individual case.

Commonly indicated homeopathic medicines for hoarseness are:

Argentum Nitricum- It is indicated when there is rawness in the throat along with hoarseness. There is much thick mucus in the throat which causes hawking. There is sensation of splinter in the throat on swallowing. High notes cause cough. There is strangulated feeling and suffocative cough as if hair in the throat. The person needing this remedy may have a fear of public speaking and suffer with anticipatory anxiety.

Arnica Montana- It is indicated if the hoarseness is brought on after excessive shouting, singing or screaming. As Arnica is a great remedy whenever there is associated bruised feeling whether physically or mentally it can be prescribed when the hoarseness is caused by vocal cords getting bruised and exhausted.

Arum Triphyllum- It is indicated when there is inflammation of mucus surfaces and destruction of tissue. Acridity is the keynote of the kind of action characteristic of Arum. The throat feels constricted and raw with burning pain. There is constant hawking and expectoration of much mucus. The voice becomes uncertain and uncontrollable. Clergyman’s sore throat. There is aggravation of symptoms on talking and singing.

Causticum- There is hoarseness of voice with pain in chest. Aphonia with sore larynx. Cough causes soreness in chest. Expectoration is scanty and must be swallowed due to weakness of the respiratory muscles to expectorate the phlegm produced in the chest. Cough may also cause pain in the hip, especially the left. Voice echoes i.e own voice roars in ears and distresses. Useful in difficulty of voice of singers and public speakers. Cough is better from drinking cold water. Hoarseness of voice is worse in the morning.

Phosphorous- It is indicated when the larynx is painful and prevents speech. There is violent tickling in larynx while speaking. Hoarseness and aphonia is worse in the evening and with rawness. The person can’t talk on account of pain in larynx. Cough is worse in cold air, reading, laughing, talking and going from warm room into cold air. Patient as a person is tall, slender and narrow chested. There is great tendency to external impressions such as light, sound, odors, touch, electrical changes and thunderstorms.

Rhus Toxicodendron- It is indicated when as a general modality of rhus tox the hoarseness is worse in the beginning of the speech and then gets better after talking for a while. This hoarseness is often caused by overstraining of the voice. There maybe associated swelling of cervical glands and sore throat causing dry, teasing cough from midnight until morning , during a chill or when putting hands out of bed.