Want to sing, but without the pain.
June 25, 2013 12:35 PM Subscribe
I've had a long term singing problem that has been difficult to solve. I have been to a medical voice clinic and had some of the fancy tests and vocal cord images, and I will be going back, but I have a new idea to float to the MD and I wonder if anyone has encountered this issue.
Flashback: about 25 years ago, youngster about 13, I had a really bad cold... stuffed up with thick mucus. I of course blew my nose vigorously trying to get it out, and using a lot of pressure. One day during that cold, during a high pressure effort, I felt a little protrusion on one side of my throat, it was high on the neck, kind of at the corner of the tongue base. I could push it in and it made kind of a squishy sound. It was kind of like something becoming detached. After the first, it happened every time I blew my nose during that period. I went to the family doctor, he gave me medicine for the cold and told me to stop blowing so hard. It hasn't been a super noticeable thing ever since, a small touch of discomfort every great once in a while, maybe a feeling of dryness at that spot when sick (possible red herring), not even enough to think about.
Singing: In music college I took up singing as a serious pursuit. At first, everything was great... strong resonant voice, lot of potential... but the practicing every day thing and frequent choir practices started taking its toll very quickly. I lost the feeling of resonance shortly into practices, pain in the throat later. I didn't progress, and for the most part abandoned my efforts.
Years later, looking to perform more on a semi-pro level... I don't sing even close as often. I don’t think I’m over-singing either. But sometimes the pain comes back, and it seems to be in that same area as the "protrusion episode". Can't really tell if it’s in the trachea, or back of throat near the tonsil area. Always the same side.
Theory to float: Something about singing causes one of my tonsils to swell... some kind of physical thing with air pressure and singing maybe. As it swells, I start losing the feeling of resonance. Afterword, when the swelling goes down... I feel a bit of pain in that area.
Does that make any kind of sense? Or other ideas? Even if I don't have the body part right, I have a strong feeling that there is some kind of connection that particular cold when I was 13.
Don't worry... I'll tell this story to my doctor too. Thanks for reading.
Flashback: about 25 years ago, youngster about 13, I had a really bad cold... stuffed up with thick mucus. I of course blew my nose vigorously trying to get it out, and using a lot of pressure. One day during that cold, during a high pressure effort, I felt a little protrusion on one side of my throat, it was high on the neck, kind of at the corner of the tongue base. I could push it in and it made kind of a squishy sound. It was kind of like something becoming detached. After the first, it happened every time I blew my nose during that period. I went to the family doctor, he gave me medicine for the cold and told me to stop blowing so hard. It hasn't been a super noticeable thing ever since, a small touch of discomfort every great once in a while, maybe a feeling of dryness at that spot when sick (possible red herring), not even enough to think about.
Singing: In music college I took up singing as a serious pursuit. At first, everything was great... strong resonant voice, lot of potential... but the practicing every day thing and frequent choir practices started taking its toll very quickly. I lost the feeling of resonance shortly into practices, pain in the throat later. I didn't progress, and for the most part abandoned my efforts.
Years later, looking to perform more on a semi-pro level... I don't sing even close as often. I don’t think I’m over-singing either. But sometimes the pain comes back, and it seems to be in that same area as the "protrusion episode". Can't really tell if it’s in the trachea, or back of throat near the tonsil area. Always the same side.
Theory to float: Something about singing causes one of my tonsils to swell... some kind of physical thing with air pressure and singing maybe. As it swells, I start losing the feeling of resonance. Afterword, when the swelling goes down... I feel a bit of pain in that area.
Does that make any kind of sense? Or other ideas? Even if I don't have the body part right, I have a strong feeling that there is some kind of connection that particular cold when I was 13.
Don't worry... I'll tell this story to my doctor too. Thanks for reading.
I am not an SLP (speech language pathologist), which I think is who you need to see. I'm a singer. I think, however, that you may have soft tissue damage to one of the muscles supporting your larynx, possibly the lateral cricoarytenoid, which name I pulled by looking at a picture of the musculature of the larynx and trying to correlate it with your pain. But I am not a doctor, and a doctor is who you need to see -- not an ENT, an SLP, preferably one who works with singers.
posted by KathrynT at 1:06 PM on June 25, 2013
posted by KathrynT at 1:06 PM on June 25, 2013
1) Since you studied singing, this might go without saying, but for the record: are you sure you're supporting well? This helps with a lot of problems. Your issue isn't one I've ever heard of before, and might not have anything to do with support, but this is one thing to address in any conversation.
2) The book "The Structure of Singing" has a lot of diagrams and images of the throat and vocal cords, along with technical terminology. It might be worth checking out.
I have heard of random blood vessels getting irritated, and that sometimes it's easy to address this by, I don't know, lasering them or something.
If you haven't already, it's worth finding an otolaryngologist who specializes in treating singers. Ask at the local medical center practice, ask some prominent voice teachers -- there's usually one or two in a city that take care of "their singers".
posted by amtho at 1:06 PM on June 25, 2013
2) The book "The Structure of Singing" has a lot of diagrams and images of the throat and vocal cords, along with technical terminology. It might be worth checking out.
I have heard of random blood vessels getting irritated, and that sometimes it's easy to address this by, I don't know, lasering them or something.
If you haven't already, it's worth finding an otolaryngologist who specializes in treating singers. Ask at the local medical center practice, ask some prominent voice teachers -- there's usually one or two in a city that take care of "their singers".
posted by amtho at 1:06 PM on June 25, 2013
Yeah, seconding that if you are feeling a 'loss of resonance,' that is unlikely to be your tonsils, which are actually relatively high in your throat. It's certainly true that your oral cavity is used a resonating chamber (and what gives your voice it's timbre), but the feeling of pain in your throat and the sensation of losing is resonance sounds much more to be like a larynx issue.
I guess my non-medical, non-SLP guess would be either a laryngocele, a node, or maybe it's just that the muscles of your vocal folds are very easily taxed and swell abnormally easily. I doubt it has anything to do with the incident from childhood, and that the timing is mere coincidence. My suggestion would be to see an ENT and perhaps have a modified barium swallow or similar test done while you are singing.
posted by Lutoslawski at 1:50 PM on June 25, 2013
I guess my non-medical, non-SLP guess would be either a laryngocele, a node, or maybe it's just that the muscles of your vocal folds are very easily taxed and swell abnormally easily. I doubt it has anything to do with the incident from childhood, and that the timing is mere coincidence. My suggestion would be to see an ENT and perhaps have a modified barium swallow or similar test done while you are singing.
posted by Lutoslawski at 1:50 PM on June 25, 2013
Nthing getting yourself into the office of someone who actually diagnoses and treats singers. What you want is video stroboscopy of the larynx while singing, and while singing enough to produce the symptom.
There are way too many possibilities for what this could be to offer any kind of useful advice.
One thing I am not clear on is what you mean by "that feeling of resonance." Maybe you could explain that a bit better.
Generally speaking, most any time someone describes throat pain from singing, it is because they are using a much too forceful closure of the vocal folds, which is traumatic to the voice instrument and causes swelling, edema, loss of flexibility, etc. This can be exacerbated by acid reflux issues, polyps on or within the vocal folds, vocal nodules, vocal hemorrhage, badly healed vocal hemorrhage, laryngeal hernia (aka internal laryngocele) or just a painful throat as a result of singing with poor technique.
posted by slkinsey at 1:51 PM on June 25, 2013
There are way too many possibilities for what this could be to offer any kind of useful advice.
One thing I am not clear on is what you mean by "that feeling of resonance." Maybe you could explain that a bit better.
Generally speaking, most any time someone describes throat pain from singing, it is because they are using a much too forceful closure of the vocal folds, which is traumatic to the voice instrument and causes swelling, edema, loss of flexibility, etc. This can be exacerbated by acid reflux issues, polyps on or within the vocal folds, vocal nodules, vocal hemorrhage, badly healed vocal hemorrhage, laryngeal hernia (aka internal laryngocele) or just a painful throat as a result of singing with poor technique.
posted by slkinsey at 1:51 PM on June 25, 2013
Response by poster: Thanks so far folks. I am seeing a voice specialist (MD), and am also working with a coach who was referred by the doctor that has gone through a series of training to deal with problematic singing issues.
My new question for the doctor is a result of the fact that I have only been doing daily lip trills for the past month (some days off) as part of a start up approach to the problem. After a few days in a row, I felt a distinct tightening in that area... and a very minor amount of that discomfort in the days following, but really I was barely vocalizing.... but there was the air pressure in the system waiting to be released through the lips. I wasn't doing anything particularly taxing, or at the edges of my comfortable range. This is where my swelling hypothesis is coming in... as it occured after a couple of days of doing the small exercise I was given.
*The feeling of resonance that I am describing is that sort of head buzz. When I have it, the voice seems to be moving right. There is certainly some potential for misunderstanding for what this is supposed to be like.
*When I'm feeling off, my voice doesn't feel hoarse... not even always fatigued (although sometimes after a long practice, sure). Just not in the zone, and not feeling quite right.
posted by shimmer at 2:40 PM on June 25, 2013
My new question for the doctor is a result of the fact that I have only been doing daily lip trills for the past month (some days off) as part of a start up approach to the problem. After a few days in a row, I felt a distinct tightening in that area... and a very minor amount of that discomfort in the days following, but really I was barely vocalizing.... but there was the air pressure in the system waiting to be released through the lips. I wasn't doing anything particularly taxing, or at the edges of my comfortable range. This is where my swelling hypothesis is coming in... as it occured after a couple of days of doing the small exercise I was given.
*The feeling of resonance that I am describing is that sort of head buzz. When I have it, the voice seems to be moving right. There is certainly some potential for misunderstanding for what this is supposed to be like.
*When I'm feeling off, my voice doesn't feel hoarse... not even always fatigued (although sometimes after a long practice, sure). Just not in the zone, and not feeling quite right.
posted by shimmer at 2:40 PM on June 25, 2013
I'm a speech-language pathologist. It would be unethical of me to give you any advice based on incomplete information from the internet and without poking at your neck a bit/taking a look at your vocal folds.
That said, this is what SLPs who focus on voice do. Ask your voice specialist for a referral to a voice therapist/vocologist, if they're not already working with one. The larynx is a funny place, and there's an exciting range of muscle tension/behavioral problems that can go wrong (I AM NOT SAYING THAT'S THE CASE WITH YOU). If there wasn't anything found during your videostroboscopy, it could be something along those lines.
Best of luck to you. Voice problems can be really tricky and scary, and I hope it's resolved to your satisfaction.
posted by a hat out of hell at 5:26 PM on June 25, 2013
That said, this is what SLPs who focus on voice do. Ask your voice specialist for a referral to a voice therapist/vocologist, if they're not already working with one. The larynx is a funny place, and there's an exciting range of muscle tension/behavioral problems that can go wrong (I AM NOT SAYING THAT'S THE CASE WITH YOU). If there wasn't anything found during your videostroboscopy, it could be something along those lines.
Best of luck to you. Voice problems can be really tricky and scary, and I hope it's resolved to your satisfaction.
posted by a hat out of hell at 5:26 PM on June 25, 2013
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Also make sure you tell them about the hoarseness and pain on prolonged singing - that usually indicates a problem with the way you are using your voice, and a voice therapist (a sub-specialty of speech and language therapy) would be able to help. However, laryngeal pathology must be excluded first.
Your tonsil theory is not likely because if your tonsil was swelling enough to affect the resonance in your oral cavity it would affect your breathing as well. The singer's concept of 'resonance' actually doesn't have so much to do with actual resonating spaces but more to do with how you use your larynx. When your voice feels a bit flat and breathy it's usually because your vocal cords are puffy and not coming together that well.
posted by kadia_a at 12:56 PM on June 25, 2013