Q: I have a throat problem since a year and a half. Actually, I am not in the habit of speaking too much but had to do so the past year. Nowadays when I speak I get pain in my throat and chest and sometimes a headache too. I took some medicine from 3-4 ENT doctors. They said that there are some spots in my throat and I should take steam and stop speaking so much. Will I get relief?

A:Well it seems like our patient here is a case of vocal overuse (excessive talking, to put it simply) and vocal abuse(i.e indulging in loud talking for prolonged hours). Both these conditions can result in either nodules on the vocal cords or ulceration or both. In the normal course of speech production,our vocal folds repeatedly come in contact with each other and move apart. If there are nodules then this closure remains incomplete and hence more effort is required for talking. This further aggravates the situation and many other symptoms such as headaches, deterioration in the voice quality etc might come in the picture. The first and foremost thing is that he should consult and ENT and get an indirect laryngoscopy done. If he already has done that then he should clearly write to us about the results. If the ENT doctor wants to put him on medication or take him up for surgery (if the situation is really bad), then that will be the first step which will be followed by an INTENSIVE VOCAL HYGIENE program to avoid recurrence of the same. But if the ENT does not prescribe any medication or surgery then he can start with the Vocal Hygiene Program right away. Let him clarify the above and then we can guide him accordingly. If he needs to be guided about the Vocal Hygiene then please let me know and I will reply back.