Top 5 Most Common Reasons Patients See Our Speech Pathologists

Top 5 Common Complaints We See:

By Kimberly Brownell, M.A., CCC-SLP

1) Voice Change

Hoarseness or voice changes should be addressed by a professional persisting 2+ weeks

Causes may include:

  • Infections causing pharyngitis or laryngitis
  • Vocal strain or vocal misuse (extended talking, loud talking, yelling/screaming)
  • Vocal cord lesions that may be related to the behaviors named above
  • Vocal cord paralysis (resulting from stroke, surgery, or even a virus)
  • Smoking
  • Throat reflux
  • Cancer/malignant growth on the vocal cord(s)

Therapy may be warranted based on examination of the vocal cords

2) Persistent Cough/Breathing Issues

A cough is considered chronic when it lasts for 8+ weeks. Patients with chronic cough typically gain minimal relief from medications or other treatments. The cough is usually dry and can be triggered by strong smells

Signs of upper airway breathing issues:

  • Tightness sensation near the upper chest/lower throat area
  • Unresponsive to inhalers or other asthma or allergy treatments
  • May be triggered by exertion, strong smells, or stress

Therapy may help control both chronic cough and upper respiratory breathing issues

3) Swallowing Difficulty or Discomfort:

Whether patients have mild discomfort swallowing or choking and coughing during meals, a swallowing evaluation should be performed.

Difficulty swallowing can be caused by a number of issues including:

  • Throat infection
  • Neurologic disorders including stroke, Parkinson’s, and Alzheimer’s
  • Cancer of the head and neck
  • Intubation
  • Medications
  • Surgery
  • Therapy can help improve swallow safety and strength

4) Lump in the Throat Sensation:

Feeling like you have a "lump in the throat" is a common symptom often related to throat reflux, which is differentiated from the more typical GERD, which is characterized by a burning sensation in the chest. 

  • Lump in the throat sensation related to reflux:
  • May be associated with throat clearing 
  • May be associated with phlegm 
  • Often occurs more in the morning 
  • Often felt more when swallowing saliva vs. during meals 
  • Reflux management may help lesson this lump sensation 

Lump in the throat sensation should also be evaluated to rule out any anatomical or physiological changes, which may include:

  • Throat infection (pharyngitis or laryngitis)
  • Cancer of the head/neck
  • Complications from intubation
  • Complications from head/neck surgery
  • Medications

Your doctor may refer you to the Speech Pathologist for further assessment of your lump in the throat sensation using stroboscopy, FEES, or Restech exams.

5) Occupational Voice/Singing Voice Issues:

Anyone who uses their voice for work (singers, actors, coaches, preachers, teachers, lawyers, call center operators, etc.) is considered an occupational voice user. Depending on the voice issue and diagnosis, these individuals may benefit from voice therapy tailored to meet their occupational needs.

Common professional voice or singing voice complaints include:

  • Vocal fatigue with use
  • Decreased vocal range
  • Large breaks in vocal registers
  • Decreased volume in speaking or singing voice
  • Therapy may be warranted based on examination of the vocal cords

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