Speech Therapy for Vocal Nodules

Vocal nodules may be small, but these bilateral masses can make a big impact on the way your voice sounds. Thankfully, speech therapy for vocal nodules is a treatment option that can help you regain your voice and keep it healthy.

Keep on reading to find out more about what causes vocal nodules and how they can be treated with voice therapy.

What Are Vocal Nodules?

Vocal nodules are small, bilateral masses that appear on the tissue of your vocal folds (or vocal cords as you may know them!). Nodules tend to occur at the midpoint of the vocal folds, where the folds most frequently come together when you are talking. These small ‘bumps’ make a large impact when they develop – causing the person’s voice to change and sound rough, hoarse, breathy, unstable, and lower in pitch than normal.1 

What Causes Vocal Nodules?

While at first it may feel like your vocal nodules appeared suddenly, upon further reflection you may recall instances where you’ve pushed your voice to its limits. Vocal nodules are a common type of voice disorder caused by vocal abuse, misuse, and overuse.2 This can include things like frequently yelling, talking, screaming, throat clearing, coughing, or using a pitch or volume that strains your vocal folds over time. Vocal nodules can also be caused by inhaling irritants or smoking. 

In many cases, vocal nodules occur in people who use their voice a lot for work – teachers, singers, referees, auctioneers, receptionists, etc. This happens because in these professions, the voice is used for long periods of time with high effort. Below is a visual to help you visualise what is happening.

When you are at rest (breathing and not talking) your vocal folds (the white lines) are open, allowing air to pass through to your lungs easily. When you are talking, the vocal folds come together to help shape your breath into sounds that you use to form words when speaking audibly. 

If you are shouting or singing loudly, your vocal folds will come together harder than they would normally. This increased tension and pressure when the vocal folds come together can cause vocal nodules – it’s similar to how blisters form when something is rubbing against your skin. 

If vocal nodules go untreated, they can cause long-term damage to your vocal folds and your voice. That’s why it is so important to see your doctor and get a referral to a specialist for support as soon as you can. 

How Can Vocal Nodules Be Treated?

In most cases, vocal nodules can be treated with voice therapy conducted by a certified practising Speech Pathologist. This is generally recommended after you’ve received a diagnosis from an Otolaryngologist (Ear Nose and Throat Doctor) who will conduct a Functional Laryngoscopy procedure to confirm the cause of the changes in your voice. This is an important step that must be completed before commencing voice therapy. 

What is Involved in Speech Therapy for Vocal Nodules?

Speech therapy for vocal nodules is an essential part of treatment and recovery. While there are strategies and therapy activities that are commonly prescribed by Speech Pathologists for individuals with vocal nodules, each individual will receive a tailored treatment plan based on their presentation and the causes for their vocal nodules. 

As we’ve mentioned earlier, vocal nodules are often caused by vocal abuse and are more common in people who use their voice a lot as part of their job. When you meet with a Speech Pathologist for the first time about your vocal nodules, they’ll ask you about how you use your voice and what activities you do professionally and personally that involve voice use. This will help your Speech Pathologist to develop a treatment plan that is relevant to your lifestyle and activities that will help you to get back to your preferred vocal activities and maintain a healthy voice after your treatment concludes. 

The main goal of vocal nodule voice therapy will be to reduce muscle tension and hyperfunction while changing how you use your voice to avoid ongoing vocal abuse. This may include therapy activities that target your breathing and respiration, use of pitch and loudness, and more.3 Voice therapy has been shown to be highly effective in decreasing the size of nodules and improving voice quality in individuals with this voice disorder.4

If you use your voice for work and are experiencing a lot of stress around taking time off due to your vocal nodules, you may want to consider intensive voice therapy. This involves coming to the clinic or participating in telehealth voice therapy sessions more frequently than typical, however research shows that taking an intensive approach to voice therapy helps individuals to achieve better vocal communication and return to work faster.5

We hope you’ve found our article on speech therapy for vocal nodules helpful. For more information on voice disorders and how Speech Pathologists can help, visit our dedicated website page here

If you are based in Brisbane, consider enquiring about voice therapy with Speak and Swallow Speech Therapy. Our clinic is based in Burpengary East and we provide in-clinic, telehealth, and home visit appointments (to the North Brisbane area).