How often do you clear your throat?
Allergy expert Dr. Brian Rotskoff of the Clarity Allergy Center in Chicago believes that too much habitual throat clearing harms the throat and vocal cords if left untreated.
Throat clearing can range from a low-key "ahem" to a loud throat straining that hocks up phlegmy mucus.
Rotskoff, who specializes in a variety of throat conditions like asthma, nasal allergies, and sleep apnea, often sees chronic throat clearers and coughers whose voices are affected.
"Throat clearing is a symptom, not a condition," said Rotskoff in a statement to Reuters.
"Often it's the spouse of a throat clearer that pushes them in my door. It's like chronic snoring - because it's pain-free, those around you are the most bothered."
While annoying, there's a lot more to frequent throat clearing than just irritating noise. The need to clear your throat usually begins with causes like a cold or upper respiratory infection, but sometimes patients are unclear of the onset and can remember always having a constant tickle around their voicebox.
Like a chronic cough and sometimes nasal congestion, throat clearing results from something affecting the throat or airways. It can either be caused by something actually being stuck in the back of your throat, but the sensation often tickles the throat without anything actually being there.
When you need to constantly clear your throat for more than three months, however, the condition becomes chronic throat clearing and can gradually alter your voice.
Once you get used to the throat clearing, it becomes behavioral. The more you clear your throat, the more you'll feel like you need to clear it. "It's hard to know when it crosses that line," Dr. Phillip Song, a laryngologist at Massachusetts Eye and Ear Infirmary in Boston, told NBC News.
"Your throat and vocal cords take repeated abuse with constant clearing," said Rotskoff, "The resulting inflammation only reinforces the urge to clear and the cycle continues. Even if you don't feel discomfort there can be lasting damage to your throat and voice."
Throat clearing culprits that can cause voice damage can include:
- Seasonal allergic rhinitis (hay fever) causing post-nasal drip, thickened mucus, or itchy throat
- Chronic sinus infections
- Acid reflux (also known as gastroesophageal reflux (GERD)
- Side effects from blood pressure medication (ACE inhibitors)
- Behavioral habituation
- Laryngeal sensory neuropathy
If throat clearing is caused by asthma, allergies, or chronic sinus infections, the underlying conditions need to be treated to help prevent the symptom. There are medications to help calm acid reflux, allergies, and asthma, and voice therapy can help break the habitual throat-clearing cycle of there are no other underlying causes.
Laryngeal sensory neuropathy is a common cause of a chronic cough and throat clearing, says Dr. Rotskoff.
"Essentially, the nerves leading to the voice box and larynx become hypersensitive and the cough or clearing are more frequently triggered. When this happens patients may need medication to calm the nerves and allow healing in order to break the cycle.
"Patients may look at the list of throat clearing causes and think they can diagnose themselves, but often conditions are intertwined and it can be difficult to isolate the treatment needed to quell the constant clearing."
If you can't stop clearing your throat after a few months, you should see a doctor. If time doesn't heal, the right treatment can help prevent throat clearing from causing long-lasting damage to your voice.
Duke Health offers the following tips to eliminate causes of habitual throat clearing and help decrease wear and tear on your voice without medications:
- Dry swallow: Swallowing saliva closes the vocal folds and can rid them of mucus.
- Drink plenty of water (six to eight glasses per day)
- Take small sips of water throughout the day
- Use a "silent cough or silent throat clear." Use your breath support to push air through the vocal folds. The strong airflow blows the mucus off the vocal folds.
- Pant lightly, then swallow.
- Hum lightly.
- Laugh gently, then swallow.
- Talk through the mucus. The natural vibration of the vocal folds may rid the folds of secretions.
- Singers may try to vocalize lightly on five note scales in a comfortable range on /oo/, slide up an octave softly on /oo/, and crescendo (get louder).