Muscle tension dysphonia involves abnormal tension and use of the muscles surrounding the vocal folds when producing voice. As a result, the coordination of breathing and voicing becomes imbalanced, leading to changes in the sound and sensation of voice production. 

Causes of Muscle Tension Dysphonia

Muscle tension dysphonia may arise following an upper respiratory infection, in conjunction with acid reflux, as a result of heightened stress or anxiety, or even due to heavy vocal demands. This voice condition may also present as compensation for an underlying problem, such as vocal fold paresis/paralysis, vocal fold atrophy, or benign lesions of the vocal folds

Example of muscle tension dysphonia.

Normal vocal fold position at rest.

Example of muscle tension dysphonia.

Example of muscle tension dysphonia.


Muscle tension dysphonia is often characterized by a strained quality. Patients may report vocal fatigue and a sensation that the voice is effortful to produce, which may be more noticeable with extended voice use over the course of a day. The voice quality may be hoarse/raspy and unpredictable. In some cases, voicing may result in throat or neck pain. In more severe cases, patients are unable to produce voice much above a whisper.  


Our voice care team at the Voice and Swallowing Center has the advanced training and skills necessary to diagnose this voice condition. During the initial visit, you will be assessed by one of our laryngologists and likely, an additional session with one of our voice pathologists. We use cutting-edge diagnostic tests to determine the cause of your voice disorder and to develop your plan of care. Following a thorough discussion of your symptoms and medical history, be expected to undergo the following assessments: 

  • Video Laryngostroboscopy: Using a small camera inserted through the nose or mouth, our specialists are able to assess the health and function of your larynx (voice box) and assess for compression of the muscles surrounding the vocal folds during voicing tasks.

  • Perceptual, Acoustic, and Aerodynamic Voice Evaluation: This is a comprehensive assessment of multiple voice parameters completed by the voice pathologist. 

Non-Surgical Treatment for Muscle Tension Dysphonia

Voice therapy is the gold-standard treatment for muscle tension dysphonia. Voice therapy techniques increase the patient’s ability to produce voice more efficiently with improved coordination of breathing and voicing. Other techniques may include tension reduction strategies such as head/neck stretching and circumlaryngeal massage (massaging the muscles surrounding the larynx). If muscle tension dysphonia is due to another underlying problem in the larynx, treating the underlying voice condition may be necessary for improvement.