The habit of speaking with strain in the throat is closely linked to a condition known in modern medicine as muscle tension dysphonia. Muscle tension dysphonia refers to a functional voice disorder that occurs when the muscles involved in producing sound become excessively tense or are used abnormally, even though there is no specific structural abnormality in the vocal cords themselves. Put simply, applying more force than necessary to produce sound causes the muscles around the neck and vocal cords to knot and stiffen.
Psychological factors such as stress, anxiety, and depression serve as major causes. When our brain experiences stress, it activates the sympathetic nervous system, placing the body in a state of tension, during which muscles around the larynx also contract unconsciously. Chronic stress entrenches this muscle tension, manifesting as constriction and pressure on the vocal cords during phonation. Much like the qi stagnation spoken of in Donguibogam, the obstruction of energy flow caused by stress can be seen as manifesting as physical muscle tension.
Furthermore, it commonly appears in people who use their voices extensively for their profession, such as teachers, singers, and counselors, or who have improper vocal habits. While it starts with a hoarse or rough voice, it can worsen so that the voice cracks, making high notes difficult, and the voice can even cut out entirely. It is also accompanied by a constant sensation of pressure around the neck, a foreign body sensation in the pharynx, known as globus sensation, where it feels like something is lodged in the throat, or a chronic dry cough.
Diagnosis is mainly performed by a voice specialist using laryngoscopy to examine the movement of the vocal cords and tension in surrounding muscles, alongside vocal aerodynamic tests to analyze qualitative changes in the voice. Treatment fundamentally centers on voice therapy. Voice therapy is a process where patients work with a professional therapist to correct poor vocal habits and learn various techniques to relax the muscles around the larynx. This may include abdominal breathing training, relaxation exercises, resonant voice therapy, and semi-occluded vocal tract exercises.
If necessary, botulinum toxin injections may be used to temporarily relax excessively tense muscles, or medication such as antianxiety agents or antidepressants may be combined. What matters most is a thoughtful mindset of reflecting on whether you are currently overusing your voice or whether mental stress is creating physical illness. The voice is not simply an instrument for making sound, but a vital indicator revealing the health of both our body and mind.
