Hoarseness - causes, treatment and naturopathy

Hoarseness - causes, treatment and naturopathy

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Almost everyone suffers from hoarseness at least once in their lives. The cause is usually an acute overload of the vocal cords due to loud talking and screaming or a cold. However, serious illnesses, such as cancer of the larynx, can also trigger the symptoms. If the impairment of the voice does not go away after a few days or if it is accompanied by severe sore throat, swallowing difficulties, shortness of breath and high fever, medical help should be sought urgently.


Hoarseness refers to a voice disorder (dysphonia). A hoarse voice sounds rough, occupied, scratchy to squeaky and loses its tonal power. If the hoarseness increases to such an extent that the voice appears completely toneless, doctors speak of an aphonia.


Hoarseness manifests itself as a partial loss of voice, in which not only the vocal power deteriorates, but also the vocal sound is significantly impaired. Those affected have an increased urge to clear their throat, but this does not resolve the complaints. Depending on the triggers of the voice disorder, further symptoms can be observed, which usually give indications as to whether there is possibly a dangerous illness or whether the voice has just been overloaded.

Symptoms that are more common in connection with hoarseness include sore throat, tightness or lump in the throat, runny nose, cough and body aches.

Fever can occur in conjunction with hoarseness and may be a worrying indication of a more serious disease of the vocal cords or larynx. Swelling and redness in the throat are other possible accompanying symptoms.

Causes of hoarseness

The vocal cords or vocal folds in the upper part of the windpipe generate vibrations when they are exhaled, which form the desired sounds in the so-called vocal tract (oral cavity, pharynx and nasal cavity). The height of the tones depends on the degree of tension in the vocal folds. The tighter they are, the higher the tone. The tension of the vocal folds is largely regulated by the inner and outer larynx muscles. The basic tone generated in the vocal tract is transformed, for example, by the position of the tongue, jaw and lips into the different sounds of the human voice.

Numerous factors can affect the voice, but a distinction must be made between general articulation and speech disorders on the one hand and hoarseness as a specific complaint on the other. A hoarse voice is usually due to impairment of the vocal cords or vocal folds, while a disease of the tongue, for example, causes other forms of articulation problems.

Voice overload

In particular, people who use their voice a lot professionally, such as teachers, barkers or politicians, often have complaints with the vocal cords. Since they often have to speak at high volume for a long time, the vocal cords are strained, bump against each other and then appear red and swollen. The voice appears scratchy and rough due to the swelling of the surrounding mucous membranes.

In the long term, the recurrent swelling and the hoarseness associated with it can contribute to the formation of so-called nodules on the vocal cords, which are accompanied by a significant impairment of the voice. In the worst case, this causes the affected person to become unable to work.

Functional and organic causes of the voice disorder

In the case of voice disorders, a fundamental distinction must be made between functional and organic causes. While functional voice disorders can be attributed, for example, to impairment due to certain speech habits or the type of sound formation, the organic causes of hoarseness include, above all, diseases in the vocal tract. Laryngitis, laryngitis, and laryngeal cancer are examples of these organic triggers.

A hoarse voice is often associated with a cold or flu. The triggering viruses also affect the larynx and cause acute inflammation of the larynx mucosa. The vocal cords are also affected, swell and the voice appears hoarse. Additional symptoms include cough, runny nose, sore throat and difficulty swallowing. In addition to this viral laryngitis, a bacterial infection is also possible as a trigger.

Other potential causes include tissue changes such as vocal cord polyps, cysts, nodules and granulomas that affect vocal cord vibrations. Neurological diseases such as Parkinson's can sometimes be associated with impaired voice. Those affected have difficulty controlling the formation of the sounds. Your voice appears indistinct, monotonous and often hoarse.

Central nervous system disorders such as multiple sclerosis sometimes show recurrent hoarseness as an accompanying symptom. This applies equally to diseases or damage to the brain. Strokes, inflammation of the brain and meninges, brain tumors and brain injuries caused by an accident are often associated with a voice disorder.

Neurological causes of hoarseness

If the nerves that regulate the muscles regulating the vocal folds are damaged, paralysis of the vocal folds can occur, which manifests itself in constant hoarseness and loss of vocal power. It is not uncommon for those affected to suffer from shortness of breath because the paralyzed vocal folds block the airflow. In the worst case, there is a risk of suffocation.

Corresponding paralysis of the vocal folds can often be observed after operations in the neck area, such as a thyroid operation. If the inferior laryngeal nerve (also nerve recurrens) responsible for controlling the internal larynx muscles fails, general articulation impairments and corresponding speech problems can often be observed.

In rare cases, a so-called aneurysm (sagging of the artery) leads to voice disorders. Patients with high blood pressure, hardening of the arteries and weak connective tissue are particularly at risk here. However, only arches in the immediate vicinity of the vocal cords have an effect on the voice. Corresponding aneurysms are often accompanied by a prick in the chest or chest pain.

Tobacco and alcohol are toxic to the voice

In general, smoking and alcohol consumption are said to have an extremely adverse effect on the voice. The toxins in tobacco smoke irritate the vocal cords and damage the nerves. Especially in smokers over the age of 30, tobacco consumption often leads to so-called Reinke's edema. Due to the storage of body fluid, swellings form below the vocal fold mucosa, the voice sounds much deeper and rougher.

For the women concerned, this acoustic change in their voice is often extremely unpleasant, especially since they always sound slightly hoarse and relatively male. In the worst case, the swelling can hinder breathing.

Alcohol has a similar negative effect on the voice as tobacco. The cell poison causes swelling of the mucous membranes, which give a deep, scratchy voice (whiskey voice). Alcohol and tobacco are considered the main risk factors for malignant tumor diseases in the larynx.

Chronic inflammation in the vocal tract and corresponding hoarseness can also result from the inhalation of toxic vapors, chemicals, exhaust gases, fine dust or other pollutants. People who are exposed to such stress for professional reasons tend to redden and swell the mucous membranes with appropriate hoarseness. This is often accompanied by a chronic irritable cough.


On the basis of an initial inspection of the ear, nose and throat and a measurement of the body temperature, the first indications of the cause are usually given. Stroboscopy is used to ensure the diagnosis, with the help of which the function or the vibration behavior of the vocal folds can be assessed. An inserted endoscope transmits images from the inside of the larynx to a monitor, whereby the vibration of the vocal cords becomes visible with the help of targeted flashes of light. The procedure is similar to conventional laryngeal mirroring and is relatively easy to carry out.

However, stroboscopy is not sufficient to determine whether new tissue formation is benign or malignant. It may be necessary to take a tissue sample here. Blood tests can also provide further information on the nature of infections and inflammations in the vocal tract.

Treatment in a hoarse voice

In the case of hoarseness, silence is imperative at first. Those affected should absolutely refrain from talking hoarsely and in a whisper. Adequate indoor humidity must also be ensured. Alcohol and tobacco should be avoided. In order to moisten the mucous membranes, it is advisable to take in a lot of liquid, for example in the form of herbal tea. Depending on the different triggers of the symptoms, further measures are required, which can range from voice training (speech therapy) to operations.

The tried-and-tested home remedies for hoarseness, such as warm potato wrap or sage sweets, have a very promising effect for cold-related voice disorders, but are of little help in many forms of hoarseness.

For example, vocal cord polyps often require endoscopic microsurgical surgery for removal. Surgery is usually also required for a cyst. In particularly severe cases of Reinke's edema, an endoscopic microsurgical intervention is also carried out on the vocal cords. However, this disease can often be successfully countered with the help of speech therapy. Proper breathing, articulation and posture largely prevent the consequences of Reinke's edema. Affected people should urgently give up smoking.

If infectious diseases such as a cold, flu, tuberculosis or diphtheria are the cause of hoarseness, the treatment of this underlying disease comes first. When the disease is defeated, the hoarseness usually disappears.

With neurological paralysis of the lips, however, the actual cause of the complaints can often not be remedied at the current medical level. If the paralysis persists for more than nine months, surgery is often used to restore normal voice function. Afterwards, language or voice training is an essential part of the therapy.

In larynx cancer, surgical removal of the affected tissue with subsequent radiation and / or chemotherapy is usually provided. If the cancer of the larynx is recognized at an early stage, chemotherapy and radiation therapy can be sufficient to achieve a cure. The entire larynx may need to be removed. This results in a total loss of voice for those affected and correspondingly far-reaching consequences. Many are dependent on electronic speech aids all their lives after the treatment.

Naturopathic treatment for hoarseness

In naturopathy, there are numerous options for treating the different causes of a voice disorder. For example, manual therapies such as Rolfing or osteopathy are aimed at eliminating functional impairments of the voice, while homeopathy, Schüssler salts and active ingredients in phytotherapy (herbal medicine) are used to treat the organic causes of hoarseness.

Essential oils, such as peppermint, lavender or thyme, which are placed in a bowl of water for evaporation, can be used to relieve the symptoms. Furthermore, a balanced acid-base balance plays an essential role in the naturopathic treatment of various basic diseases of hoarseness.

Sometimes psychological factors are involved in the occurrence of hoarseness, which is taken into account according to the holistic approach in naturopathy. For example, the voice may lose strength due to excitement or fear and may sound hoarse.

If the voice disorders have a corresponding mental cause, psychotherapeutic treatment is recommended. Because the repeated hoarseness can lead to further complaints regardless of their causes. It promotes the formation of nodules, cysts and polyps in the area of ​​the vocal cords and can be accompanied by significant impairments of the voice outside of the acute phases. People suffering from hoarseness should not hesitate to seek therapeutic help. (fp)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters, Barbara Schindewolf-Lensch


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  • Hermann Ackermann et al .: Neurogenic speech disorders (dysarthria), S1 guideline, German Society for Neurology (DGN), (accessed 04.09.2019), AWMF
  • Otolaryngologists on the net: laryngitis - laryngitis, pseudo croup & epiglottitis, German Professional Association of Otorhinolaryngologists, (accessed on 04.09.2019), ENT
  • Sabine Nospes, Arno Olthoff: S1 guideline on functional diagnostics and therapy of communication disorders in neurogenic speech and voice disorders in adulthood, German Society for Phoniatrics and Pediatric Audiology, (accessed 04.09.2019), AWMF
  • Clarence T. Sasaki: Laryngitis, MSD Manual, (accessed 04.09.2019), MSD
  • Jürgen Strutz (ed.), Wolf Mann (ed.), Practice of ENT medicine, head and neck surgery, Thieme Verlag, 3rd edition, 2017

ICD codes for this disease: R49.0ICD codes are internationally valid encryption codes for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.

Video: Hoarse Voice Remedy for Singers and Voice Users (July 2022).


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