What are Vocal Fold Nodules?
Vocal fold nodules develop due to trauma of the vocal folds. When you use your voice incorrectly over time, the vocal folds might become swollen. These swollen areas then become nodules that are sometimes called ‘soft nodules’ but as they progress they can be called ‘hard nodules’ and be harder to treat.
Vocal fold nodules are small, benign growths on the vocal cords caused by repetitive vocal strain or misuse. They often affect teachers, singers, actors, and anyone who relies heavily on their voice for work. Understanding causes, symptoms, and treatment options is essential for maintaining healthy vocal function.
What Are Vocal Fold Nodules?
Vocal fold nodules develop when the vocal folds are overused or misused, causing swelling that can become firm over time.
Soft nodules: Early-stage and easier to treat
Hard nodules: More persistent and harder to treat
Nodules usually form in pairs, directly opposite each other, but occasionally appear unilaterally with slight swelling on the opposite cord.
What Causes Vocal Fold Nodules?
The primary cause of nodules is vocal misuse or overuse, including:
Shouting or screaming
Singing incorrectly or excessively
Long periods of speaking or heavy vocal use
Professionals in voice-heavy jobs, such as teachers, singers, or actors, are particularly at risk. Chronic misuse can cause strain, discomfort, and even income-related stress if the voice is impacted.
Symptoms of Vocal Fold Nodules
Common symptoms include:
Hoarseness or breathy voice
Effortful speech with breaks
Lower pitch and vocal fatigue
Throat discomfort or soreness
Frequent throat clearing
Why this happens: Nodules create a gap between the vocal folds, allowing air to escape and causing a breathy or weak voice.
How Are Vocal Fold Nodules Diagnosed in the UK?
Diagnosis is usually made by an ENT (Ear, Nose, and Throat) consultant using endoscopy, a camera inserted through the nose to view the vocal folds. After the examination, your ENT will confirm the diagnosis and discuss the best treatment plan.
What are Treatment Options for Vocal Fold Nodules in the UK?
Voice Therapy is the first-line treatment, focusing on:
Retraining healthy vocal habits
Reducing strain and forceful voice use
Improving breath support and resonance
Surgery is rarely required and is considered only if therapy is ineffective. Post-surgery Voice Therapy is essential to prevent recurrence.
Online Voice Therapy is effective and convenient, allowing patients to receive treatment remotely.
Can vocal fold nodules go away without treatment?
In the acute stages, vocal nodules may resolve with voice rest alone. However, if it is due to repetitive vocal misuse, then Voice Therapy treatment will be required. Voice Therapy is first choice rather than surgery. If surgery is required, Voice Therapy following surgery to prevent reoccurrance is recommended. Online Voice Therapy for Voice is effective for treating nodules.
How long does it take to recover from vocal fold nodules?
Voice therapy takes between 6-8 sessions.
Can I still sing or talk professionally with nodules?
Singing or heavy voice use can worsen nodules. Early therapy focuses on safe vocal technique so you can resume professional voice use as soon as possible.
Is surgery always needed for vocal fold nodules?
No. Most nodules respond well to Voice Therapy. Surgery is reserved for nodules that don’t improve with therapy.
Can online Voice Therapy treat nodules?
Yes. Online Voice Therapy is effective as face to face therapy, allowing patients to learn healthy vocal techniques and practice exercises in the comfort of their own home, reducing travel time and cost.
How can I look after my voice?
Vocal hygiene is very important to look after your voice when you have vocal nodules.
Do you have a waiting list?
No - you can be seeing within one week of your consultation.
Why Choose The Speech Network?
Our UK-based private voice therapists are all Clinical Specialists in Voice, each with a minimum of 12 years’ experience. They currently work, or have previously worked, as Senior Voice Therapists within the NHS.
All our therapists are fully registered and accredited, including:
Health and Care Professionals Council (HCPC)
Royal College of Speech and Language Therapists (RCSLT)
Association of Speech and Language Therapists in Independent Practice (ASLTIP)
Members of the British Voice Association
Our private voice therapy team is highly rated, with outstanding 5-star Google reviews and recognition as a 2024 Quality Business Award winner.
Specialist Training & Accreditation
Myofascial Release manual therapy
Lee Silverman Voice Treatment (LSVT LOUD®)
Advanced Laryngeal Manipulation
Our UK based Private Voice Therapists are Clinical Specialists in Voice with a minimum of 15 years experience Specialising in Voice Therapy. Book a free 15 minute consultation or email us at thespeechnetwork@hotmail.com to enquire about our reasonable fees for Voice Therapy.
Why has my voice changed?
Voice Therapy will explore the reasons in greater depth that you lose your voice frequently. This may be due to the ways in which you use your voice ineffectively, tension within the larynx, reflux or not taking care of your voice in the best way. Voice Therapy the recommended treatment for voice disorders.
Why has my voice changed?
If your voice has suddenly changed, the most common reason for this is Laryngitis, which is a loss of voice, often alongside a cough and/or sore throat. It typically lasts 1-2 weeks. Drinking fluids and voice rest is recommended.
When should I worry about Voice changes?
If you have a hoarse voice that has lasted longer than 6 weeks, its advisable to request your doctor refer you to an Ear, Nose and Throat Consultant (ENT) for an examination of your Larynx (Voice box). A camera is put up your nose to examine your voice box. This procedure is not painful and is safe. ENT will confirm the reason for your voice changes.
What causes Voice changes?
There are many reasons that cause changes in voice. One of the reasons most people are worried about is laryngeal cancer. The earlier it is diagnosed, the easier it is to treat it, and for treatment to be successful.
There are many other reasons that you may experience voice changes. There are many other reasons that you may experience voice changes. These might be due to Muscle Tension Dysphonia (MTD) , Vocal cord Nodules or a Vocal fold palsy.
Muscle Tension Dysphonia (MTD) : A voice disorder characterised by a hoarse voice due to excessive muscle tension in the Larynx. It produces voice symptoms without any physical damage.
Vocal cord Nodules: Swollen areas on the vocal folds caused by using your voice incorrectly over a long period of time. Nodules are typically seen in children or women. People with jobs who use their voice excessively are often affected such as singers, actors and teachers.
Vocal cord Paralysis: Typically, one vocal cord not moving as a result of an infection or damage to the nerve due to surgery results in a breathy, hoarse and weak voice.
Spasmodic Dysphonia: A Neurological Disorder than affects the voice.
Following assessment by ENT, Voice Therapy is recommended for the treatment of Muscle Tension Dysphonia (MTD), Vocal cord Nodules, Vocal cord Paralysis and Spasmodic Dysphonia.
Why do I keep losing my voice?
Voice loss is ‘multi-factorial’. This means there is often not one reason. It is important that ENT diagnose the reason you are losing your voice. Voice Therapy will explore the reasons in greater depth that you lose your voice frequently. This may be due to the ways in which you use your voice ineffectively, tension within the larynx, reflux or not taking care of your voice in the best way. Voice Therapy the recommended treatment for voice disorders.
Why do I have a muscle tightness in my throat?
Voice disorders such as Muscle Tension Dysphonia (MTD) or Vocal Nodules can cause excessive tension in the larynx (the throat area) which results in a sensation of muscle tightness. Sometimes people complain about tension in their laryngeal area with no vocal symptoms or changes in voice.
People may describe an ache, constriction, or a lump in their throat. A sensation of a lump in the throat, where no lump exists, is known as ‘Globus’. You may experience a sensation that you want to clear your throat regularly. These unpleasant changes in sensation can make talking feel very effortful and tiring.
Voice Therapy can help reduce this discomfort minimising the effort you feel when speaking.
Why do I feel like I am straining my voice when I speak?
Voice Disorders can result in excessive tension in the laryngeal area. Often the voice is being used ineffectively, which causes additional strain on the larynx (voice box). You may not be projecting effectively resulting in poor amplification of sound. This is known as resonance. Resonance is how your voice is shaped by your voice box, nose and mouth. You may need to learn how to use your breath more effectively to reduce strain.
You may also need to improve your breath support for Speech so that you can use your voice effectively. Often people with Voice disorders use only the upper part of their chest to breathe. Breathing from the diaphragm provides effective breath for speech and reduces tension in the laryngeal area.
Voice Therapy can help reduce strain and discomfort when speaking, to free your voice and improve your confidence.
Can I have NHS voice Therapy?
Yes - we often see people when they are waiting for NHS voice therapy or there is no service in their area.
How can I look after my voice?
Vocal Hygiene is very important for looking after you voice.
Our UK based Private Voice Therapists are Clinical Specialists in Voice with a minimum of 15 years experience Specialising in Voice Therapy. Book a free 15 minute consultation or email us at thespeechnetwork@hotmail.com to enquire about our reasonable fees for Voice Therapy.
What can I do to look after my Voice?
Advice on how to look after your voice to keep it healthy.
Stop smoking. If you can’t give up, cut down. Smoking irritates and damages the vocal folds. Talk to your GP about advice to support stopping smoking.
Avoid eating spicy foods. Spicy foods can cause stomach acid to move into the throat or oesophagus, causing heartburn or reflux. If you do experience reflux, talk to your GP about possible medications.
Avoid too much coffee, fizzy drinks and alcohol. These can dry out the vocal cords. Try drinking decaffeinated tea or coffee or follow an alcoholic drink with a soft drink.
Avoid shouting and whispering
If your voice feels tired or strained then rest it. This is your bodys way of telling you to rest your voice
Try not to clear your throat unnecessarily. It can create excessive mucous and lead to a further need to clear your throat. Try drinking water instead or swallowing.
Avoid dry and dusty atmospheres as they may dry out the vocal cords. Wear a mask in a dusty environment.
Try to drink 2 litres (3 ½ pints) of liquid a day (not including coffee, alcohol or fizzy drinks). This will prevent dehydration of the vocal cords.
Try steaming to keep the vocal folds hydrated
Our Private Voice Therapists are Clinical Specialists in Voice. Book a free 15 minute consultation or email us at thespeechnetwork@hotmail.com to enquire about our reasonable fees for Voice Therapy.