What are Vocal Fold Nodules?
Vocal fold nodules develop due to trauma of the vocal folds. When you use your voice incorrectly over time, the vocal folds might become swollen. These swollen areas then become nodules that are sometimes called ‘soft nodules’ but as they progress they can be called ‘hard nodules’ and be harder to treat.
Vocal fold nodules are small, benign growths on the vocal cords caused by repetitive vocal strain or misuse. They often affect teachers, singers, actors, and anyone who relies heavily on their voice for work. Understanding causes, symptoms, and treatment options is essential for maintaining healthy vocal function.
What Are Vocal Fold Nodules?
Vocal fold nodules develop when the vocal folds are overused or misused, causing swelling that can become firm over time.
Soft nodules: Early-stage and easier to treat
Hard nodules: More persistent and harder to treat
Nodules usually form in pairs, directly opposite each other, but occasionally appear unilaterally with slight swelling on the opposite cord.
What Causes Vocal Fold Nodules?
The primary cause of nodules is vocal misuse or overuse, including:
Shouting or screaming
Singing incorrectly or excessively
Long periods of speaking or heavy vocal use
Professionals in voice-heavy jobs, such as teachers, singers, or actors, are particularly at risk. Chronic misuse can cause strain, discomfort, and even income-related stress if the voice is impacted.
Symptoms of Vocal Fold Nodules
Common symptoms include:
Hoarseness or breathy voice
Effortful speech with breaks
Lower pitch and vocal fatigue
Throat discomfort or soreness
Frequent throat clearing
Why this happens: Nodules create a gap between the vocal folds, allowing air to escape and causing a breathy or weak voice.
How Are Vocal Fold Nodules Diagnosed in the UK?
Diagnosis is usually made by an ENT (Ear, Nose, and Throat) consultant using endoscopy, a camera inserted through the nose to view the vocal folds. After the examination, your ENT will confirm the diagnosis and discuss the best treatment plan.
What are Treatment Options for Vocal Fold Nodules in the UK?
Voice Therapy is the first-line treatment, focusing on:
Retraining healthy vocal habits
Reducing strain and forceful voice use
Improving breath support and resonance
Surgery is rarely required and is considered only if therapy is ineffective. Post-surgery Voice Therapy is essential to prevent recurrence.
Online Voice Therapy is effective and convenient, allowing patients to receive treatment remotely.
Can vocal fold nodules go away without treatment?
In the acute stages, vocal nodules may resolve with voice rest alone. However, if it is due to repetitive vocal misuse, then Voice Therapy treatment will be required. Voice Therapy is first choice rather than surgery. If surgery is required, Voice Therapy following surgery to prevent reoccurrance is recommended. Online Voice Therapy for Voice is effective for treating nodules.
How long does it take to recover from vocal fold nodules?
Voice therapy takes between 6-8 sessions.
Can I still sing or talk professionally with nodules?
Singing or heavy voice use can worsen nodules. Early therapy focuses on safe vocal technique so you can resume professional voice use as soon as possible.
Is surgery always needed for vocal fold nodules?
No. Most nodules respond well to Voice Therapy. Surgery is reserved for nodules that don’t improve with therapy.
Can online Voice Therapy treat nodules?
Yes. Online Voice Therapy is effective as face to face therapy, allowing patients to learn healthy vocal techniques and practice exercises in the comfort of their own home, reducing travel time and cost.
How can I look after my voice?
Vocal hygiene is very important to look after your voice when you have vocal nodules.
Do you have a waiting list?
No - you can be seeing within one week of your consultation.
Why Choose The Speech Network?
Our UK-based private voice therapists are all Clinical Specialists in Voice, each with a minimum of 12 years’ experience. They currently work, or have previously worked, as Senior Voice Therapists within the NHS.
All our therapists are fully registered and accredited, including:
Health and Care Professionals Council (HCPC)
Royal College of Speech and Language Therapists (RCSLT)
Association of Speech and Language Therapists in Independent Practice (ASLTIP)
Members of the British Voice Association
Our private voice therapy team is highly rated, with outstanding 5-star Google reviews and recognition as a 2024 Quality Business Award winner.
Specialist Training & Accreditation
Myofascial Release manual therapy
Lee Silverman Voice Treatment (LSVT LOUD®)
Advanced Laryngeal Manipulation
Our UK based Private Voice Therapists are Clinical Specialists in Voice with a minimum of 15 years experience Specialising in Voice Therapy. Book a free 15 minute consultation or email us at thespeechnetwork@hotmail.com to enquire about our reasonable fees for Voice Therapy.
Can you fix a lisp when you an Adult?
Many people that we see ask us whether its too late to change their speech now they are an Adult. Adults we speak with many have low confidence because of the lisp impacting on meetings, presentations, dating and interviews. It may cause them to avoid some of these situations. Some avoid words with the /s/ sound.
Here we share a personal experience of one of our clients ; of the impact of the lisp and their experience of therapy.
Lisping is very common within adults, with varying levels of severity. Some adults who lisp are very self-conscious about it and it affects their self-esteem and confidence to speak, and impacts on their day to day life. They may place themselves under a great deal of pressure to avoid words involving /s/ and /z/ and may even avoid talking because of it. Many adults are keen to correct their speech in order to feel more confident when speaking both socially and in the workplace.
How to correct a lisp in adults?
Every adult is different, and the process of therapy varies from person to person. Whilst some clients only attend a couple of sessions with an experienced Speech Therapist to learn about how to make the /s/ and /z/ sounds, others attend more sessions in order to generalize their /s/ and /z/ into their everyday speech. The initial session will inform us whether the lisp is due to your anatomy and in some instances, we may need to signpost you to other services for further investigation. Sessions cost 90 per session and most people book 1-3 sessions.
Here we share a personal experience of one of our clients in her 50s; of the impact of the lisp and their experience of therapy:
“Speech and Language Therapy might be seen as a luxury but it really shouldn't be because it's a necessity for many people like me. Communication isn't just about uttering words, but a person's ability to make others hear them and understand them. When you struggle with a lisp problem, even though you know what to say, you don't always have the confidence to speak up. As a child, I never put my hand up in school even though I had the answers because I was afraid the other children would make fun of me, which they did whenever they could to hurt my feelings. I avoided arguing with my siblings because whenever I was right, they'd resort to mimicking my lisp as a way to shut me up. I was a very bright student but I purposely sabotaged myself at some point in High School because teachers wanted me to take the lead too often, and I couldn't face people with my lisp. When it came to choosing my career path, I chose a path where I thought that people wouldn't make fun of me because of the way I pronounce my sss and zzs.
Character and personality always play a central role in personal development. Some people may be fine with a lisp and some others not. If you're someone who is uncomfortable with your lisp, then I recommend that if you're able to afford the cost, you should really reach out to the Speech Network. Alison, my therapist, has given me more than just confidence. She has also given me mind comfort - a safe place where I could simply try and see if I could speak differently. For me, it's really that - a safe place for both my mind and body to feel free to give it a try. So I gave it a try, and now, I can speak and enjoy what I sound like, and most importantly, looking at myself in the mirror, I like the way my face looks when I'm talking and my tongue remains in my mouth when I pronounce S and Z. I'm bilingual so I have to work on both languages at the same time, and I'm truly enjoying the process.”
Why choose the Speech Network for lisp therapy?
Our Clinical Specialist has a Specialist Interest in Lisps and regularly works with clients presenting with a Lisp in her clinical practice. As traditional Speech Therapy alone may not work to correct a lisp, Alison is interested in the role of Orofacial Myofunctional Therapy in supporting clients with a Lisp. She is a member of the Orofacial Myofunctional Therapy Clinical Excellence Network.
Health and Care Professionals Council (HCPC)
Royal College of Speech and Language Therapists (RCSLT)
Association of Speech and Language Therapists in Independent Practice (ASLTIP)
Member of the Orofacial Myofunctional Therapy Clinical Excellence Network.
Our private therapy team is highly rated, with outstanding 5-star Google reviews and recognition as a 2024 Quality Business Award winner.
Our UK based Private Therapists are have a Specialist interest in Lisp Therapy. Book a free 15 minute consultation or email us at thespeechnetwork@hotmail.com to enquire about our reasonable fees for Lisp Treatment for Adults and Children.
What is Muscle Tension Dysphonia?
In most cases, Muscle Tension Dysphonia produces vocal symptoms without any actual physical damage. However, if the voice continues to be used ineffectively, it can cause changes to the vocal folds. Voice Therapy is an effective treatment for Muscle Tension Dysphonia.
What is Muscle Tension Dysphonia (MTD)?
Muscle Tension Dysphonia (MTD) is a change in the sound of your voice due to excessive muscle tension in and around the larynx (voice box). Muscle Tension Dysphonia produces vocal symptoms without any physical damage. Commonly, people will have had their Larynx examined by a Ear, Nose and Throat Specialist and have been told that there is no observable physical damage.
Muscle tension dysphonia may be caused by longterm ineffective voice use, voice overuse, irritants (such as Laryngopharyngeal Reflux) , infection or emotional stress. While the initial cause may go away, the voice changes remain because of the ineffective habitual voice use.
How can my job cause Muscle Tension Dysphonia?
Jobs that require lots of talking and projection may result in voice overuse and voice abuse. Professions such as teachers, actors and singers may lose their voices. This can have an impact financially and can feel stressful. Our UK Voice therapists will help you identify the causal factors and put together a bespoke plan to support you in improving your voice.
What are the symptoms of muscle tension dysphonia?
The most common symptoms of muscle tension dysphonia include:
Voice that sounds hoarse or strained
Voice becomes weaker and more effort the longer your voice is used.
Difficulty singing notes that used to be easy.
Pain or tension in your throat
Feeling like there is something in your throat that needs to be cleared.
How is Muscle Tension Dysphonia (MTD) diagnosed in the UK?
Typically, if you are experiencing voice difficulties, your GP will refer you to an Ear, Nose and Throat Specialist (ENT) for an assessment of your voice. Muscle Tension Dysphonia is diagnosed through the evaluation of your larynx using a camera in your nose to view your vocal folds.
What is the Treatment for Muscle Tension Dysphonia (MTD) in the UK?
The treatment for muscle tension dysphonia is voice therapy to reduce muscle tension and focus on effective voice use. You are likely to require 6-8 sessions of voice therapy to improve your voice.
What does Voice Therapy in the UK involve for Muscle Tension Dysphonia (MTD)?
Voice therapy for Muscle Tension Dysphonia in the UK involves:
Bespoke voice exercises
Exercises to reduce laryngeal tension
Improving breath support for speech
Reducing harmful behaviours
Increase vocal stamina
Improving pitch and volume
Improving voice amplification
How long does it take for Muscle Tension Dysphonia (MTD) to go away?
Most people require 6-8 sessions that they typically book weekly. It is very important that you follow the advice and complete the exercises given by the Voice Therapist outside of sessions to assist in your recovery from Muscle Tension Dysphonia.
Why do I have a hoarse voice and a feeling of a lump in my throat?
The tightness of the muscles in your throat due to Muscle Tension Dysphonia (MTD) causes people to feel that they have a lump in their throat, tightness or tension. The medical word for this feeling is ‘Globus’ and it is very common. It can be caused by main factors including anxiety, stress and reflux. It can be very effortful you to speak when they feel tension. Through Voice therapy we examine the factors that are causing you to have this sensation and aim to reduce the tension in this area.
Why do I have a hoarse voice, mucus in my throat and feel like I need to throat clear or cough?
As a result of tension people feel in their throat due to Muscle Tension Dysphonia (MTD) or Globus, people feel that they need to throat clear. Throat clearing often results in a habit of frequently throat clearing which produces more mucous. Throat Clearing is multi-factorial and we aim to reduce throat clearing through a thorough case history and voice therapy strategies.
Is a hoarse voice a symptom of anxiety or stress?
A hoarse voice as a result of Muscle Tension Dysphonia (MTD) may be linked with stress or anxiety. We all feel stress in different parts of our body and some people of vulnerable to holding tension within their laryngeal area. Our Voice Therapists have counselling skills that can support you to understand the emotional causes of your voice problem. If a voice problem is affecting your work, this can be an additional financial stress. Through voice therapy we can support you to improve your voice through vocal techniques to help you feel more relaxed.
Can I have Voice Therapy with the NHS in the UK?
The referral from GP to ENT can be a quick process. Unfortunatly, the wait for NHS voice therapy may take months, which could impact on your work. Our voice therapists are able to see you while you wait for NHS therapy. Voice coaching is not available in the NHS - our Voice Coaches are unique as they are also Clinical Voice Specialists.
Why Choose The Speech Network?
Our UK-based private voice therapists are all Clinical Specialists in Voice, each with a minimum of 12 years’ experience. They currently work, or have previously worked, as Senior Voice Therapists within the NHS.
All our therapists are fully registered and accredited, including:
Health and Care Professionals Council (HCPC)
Royal College of Speech and Language Therapists (RCSLT)
Association of Speech and Language Therapists in Independent Practice (ASLTIP)
Members of the British Voice Association
Our private voice therapy team is highly rated, with outstanding 5-star Google reviews and recognition as a 2024 Quality Business Award winner.
Specialist Training & Accreditation
Our private voice therapists are accredited in:
Myofascial Release manual therapy
Lee Silverman Voice Treatment (LSVT LOUD®)
Advanced Laryngeal Manipulation
Our UK based Private Voice Therapists are Clinical Specialists in Voice with a minimum of 15 years experience Specialising in Voice Therapy. Book a free 15 minute consultation or email us at thespeechnetwork@hotmail.com to enquire about our reasonable fees for Voice Therapy in the UK.
What is Aphasia Therapy?
There are two types of therapy – impairment and functional therapy. Impairment based therapy is usually repeated exercises based on your goals using books or apps. Functional therapy is the focus on real life goals that reflect your everyday communication interactions with others. This might involve training family members in supportive communication skills. As therapists, its important to work on both aspects to support your communication skills
What is Aphasia?
Aphasia is when a person has difficulties with their language (understanding, speaking, reading and/or writing) typically as a result of a stroke or brain injury.
What is Aphasia therapy?
Typically, Aphasia Therapy starts with an assessment of your language. Language can be complex so its important for us to identify your strengths, in order to improve the areas you find difficult. We used standardised communication Aphasia assessments that assess understanding, talking, reading and writing. We discuss the results of these assessments to help you and your loved ones understand your communication difficulties. We provide advice on the best ways to support communication.
Why is Goal setting important in Aphasia therapy?
Many of us set goals in our lives. It might be on new years day when we set a goal to stop eating quite so much chocolate, during sport or part of our working lives. Following a stroke, goals are shown to improve motivation and mood.
Goal setting is a process when we get to know what is important to you as a person, what you might be finding difficult and the impact of your Aphasia. We can involve partners in this process to make it easier. These goals might be remembering family names, using the phone to order a taxi or writing emails. We are all individuals and our goals are unique to each of us.
What is the best therapy for Aphasia?
There are two types of Aphasia Therapy – Impairment and Functional therapy. Impairment based therapy is usually repeated exercises based on your goals, using paper resources or apps. Functional therapy is the focus on real life goals that reflects your everyday communication interactions with others. This might involve training family members in supportive communication skills. It is important to work on both aspects to support your communication.
Does Aphasia improve with therapy?
The treatment for Aphasia is with Speech and Language Therapy. Research shows that Speech Therapy is effective for people with Aphasia following a stroke, compared to no therapy. Research also shows that Aphasia Therapy Online is as effective as face-to-face Aphasia Therapy. You or your family member need to understand to be able to engage in online therapy - we can discuss this further in the free consultation.
How can you help someone with Aphasia?
After an assessment, a Speech Therapist will be able to give you specific advice about the best ways in which to communicate.
Below is some general guidance:
Give the person plenty of time to respond. If a person with Aphasia feels rushed or pressured to speak they may become anxious, which can affect their ability to communicate.
Use short, uncomplicated sentences.
Do not change the topic of conversation too quickly.
Avoid finishing a person's sentences or correcting their errors.
Reduce distractions.
If you don't understand something a person with Aphasia is trying to communicate, don't pretend you understand.
Use visual references, such as pointing, gesturing and objects, to support their understanding.
If they're having difficulty finding the right word, prompt them – ask them to describe the word, think of a similar word, try to visualise it, think of the sound the word starts with, try to write the word, use gestures, or point to an object.
Our Speech and Language Therapists are Clinical Specialists in Aphasia. Arrange a free 15 minute consultation or email thespeechnetwork@hotmail.com
What is a vocal fold paralysis?
Frequently asked questions about vocal fold palsy
What is a vocal fold paralysis?
Vocal fold paralysis occurs when one or both vocal folds fail to open or close properly. Most cases affect only one fold, while bilateral paralysis is rare and serious.
The vocal folds, located in the larynx above the windpipe, vibrate as air passes through to produce voice. If a fold is paralysed, air escapes, resulting in a weak, breathy, or hoarse voice.
What Causes Vocal Fold Paralysis?
Common causes include:
Viral infections (most common)
Nerve damage during surgery (thyroid, chest, or neck procedures)
Trauma or injury
Cancers affecting vocal nerves
Neurological conditions such as Parkinson’s disease, multiple sclerosis, or stroke
Idiopathic cases (unknown cause)
Early diagnosis is important for effective treatment.
What are the symptoms of a Vocal Fold Paralysis?
Typical symptoms include:
Hoarse, weak, or breathy voice
Difficulty projecting your voice
Vocal fatigue
Difficulty swallowing (dysphagia) — a specialist swallowing assessment may be also required
Shortness of breath with exertion
What are the treatment Options in the UK for a vocal fold paralysis?
Voice Therapy is often recommended to:
Strengthen the voice by increasing the movement of the paralysed vocal fold
Improve clarity and projection
Restore normal breathing patterns
Reduce fatigue and strain
Surgery is rarely needed, only in severe or persistent cases.
Private therapy is available for faster access or if NHS services have long waiting times. Online Voice Therapy is also highly effective and accessible throughout the UK.
How long does Voice Therapy take for vocal fold paralysis?
Duration varies depending on severity. Many clients see significant improvements in 6-8 weeks with consistent therapy.
Can online Voice Therapy help for a vocal fold palsy?
Yes. Remote therapy is as effective as face to face therapy and allows patients across the UK to access specialist clinical voice therapy.
Do you have a waiting list?
No - you can be seeing within one week of your consultation.
Why Choose The Speech Network?
Our UK-based private voice therapists are all Clinical Specialists in Voice, each with a minimum of 12 years’ experience. They currently work, or have previously worked, as Senior Voice Therapists within the NHS.
All our therapists are fully registered and accredited, including:
Health and Care Professionals Council (HCPC)
Royal College of Speech and Language Therapists (RCSLT)
Association of Speech and Language Therapists in Independent Practice (ASLTIP)
Members of the British Voice Association
Our private voice therapy team is highly rated, with outstanding 5-star Google reviews and recognition as a 2024 Quality Business Award winner.
Specialist Training & Accreditation
Our private voice therapists are accredited in:
Myofascial Release manual therapy
Lee Silverman Voice Treatment (LSVT LOUD®)
Advanced Laryngeal Manipulation
GOOGLE REVIEWS FOR THE SPEECH NETWORK VOICE TEAM
*****
These voice sessions with Janet were life changing. I had hit a crossroads where teaching full time on zoom gave me such vocal strain I could not speak. Now I am back to teaching, albeit with a little lighter schedule, and have a new way to work with my voice that is healthy and working! - Sarah.
*****
‘I worked with Janet following post-surgery voice damage and subsequent vocal difficulties. She is great, with a kind, empathetic and friendly approach. I really appreciated the understanding she gave me about how my vocal cords (should) work, and how to manage symptoms and look after my voice, improving my confidence along the way. I very much enjoyed our sessions and would highly recommend her’ Phillipa
Book a free 15-minute consultation or email thespeechnetwork@hotmail.com for information on private Voice Therapy fees.
Our Private Voice Therapists are Clinical Specialists in Voice. Book a free 15 minute consultation or email us at thespeechnetwork@hotmail.com to enquire about our reasonable fees for Voice Therapy.