Spasmodic dysphonia is a condition I’m hearing more and more questions about. People often email describing their symptoms and wondering: “Could this be spasmodic dysphonia?” It’s a valid question, but the answer isn’t always straightforward.
What Is Spasmodic Dysphonia?
Spasmodic dysphonia is a type of laryngeal dystonia, which means there are involuntary spasms in the muscles of the larynx. These spasms interrupt normal voice production, often making the voice sound strained, breathy, or broken.
One of the challenges in diagnosing spasmodic dysphonia is that it can resemble muscle tension dysphonia, which is more common and generally less severe. My own view is that, in some cases, spasmodic dysphonia may actually evolve from chronic muscle tension that becomes more severe and eventually behaves like a spasm.
A Neurological Condition — But More Than That
Research suggests that spasmodic dysphonia is a neurological condition, similar to other types of dystonia that affect the neck, arms, or other parts of the body. In these cases, the brain sends faulty signals that cause the muscles to spasm involuntarily.
But voice is a complex system. It’s not just neurological — it’s also emotional, psychological, and behavioural. Stress, trauma, and long-standing patterns of vocal use or avoidance can all influence how spasmodic dysphonia appears and how it can be treated.
The Two Main Types of Spasmodic Dysphonia
There are two main types of spasmodic dysphonia, based on how the vocal cords behave:
Adductor spasmodic dysphonia: This is the more common type. The vocal cords squeeze together too tightly when trying to produce sound, leading to a strained or strangled voice. Speaking can feel like a physical effort, with words getting stuck or breaking off.
Abductor spasmodic dysphonia: In this type, the vocal cords pull apart too much, causing the voice to sound weak, breathy, or full of gaps. Words may trail off or disappear mid-sentence.
Each type creates its own unique voice quality — and each may respond differently to treatment.
Botox Injections: A Medical Approach
One of the most common medical treatments for spasmodic dysphonia is Botox injections to the muscles of the larynx. Botox can reduce the involuntary spasms by weakening the overactive muscles. This treatment is usually more effective for the adductor type than the abductor type.
However, not everyone responds to Botox in the same way. For some people, it works very well for a period of time, while others may find the effects lessen over repeated treatments. Some people also prefer not to rely on ongoing injections and are interested in exploring other options.
Where Voice Therapy Comes In
Voice therapy can be a powerful tool in managing spasmodic dysphonia — particularly in milder cases or in those who are highly motivated to work on their voice. Even for those who have had medical treatments, voice therapy can be a helpful companion to maintain and improve vocal control between injections.
The key is that voice therapy for spasmodic dysphonia should be tailor-made. There is no one-size-fits-all approach. What works well for one person might not work at all for another. Some clients respond to very specific techniques, while others require more trial and adaptation to find what works best.
A holistic approach often brings the most success. This might include addressing physical voice technique, but also exploring emotional factors such as stress, anxiety, or past vocal trauma that may be influencing the condition.
It Takes Time — But It Can Be Worthwhile
If you’re considering voice therapy for spasmodic dysphonia, it’s important to go in with realistic expectations. This is often a long-term condition that takes time to develop — and time to unravel. A few sessions may not be enough. But for some people, even just a handful of targeted therapy sessions can make a meaningful difference.
Whether or not you pursue Botox or other medical options, voice therapy offers a way to actively engage in your own recovery. It gives you tools, understanding, and greater confidence in how to use your voice — and that can be empowering, especially if you’ve been living with uncertainty about what’s going on. Targeted voice therapy may minimise the dysphonia and related symptoms very successfully. In some cases, symptoms may disappear altogether.