Vocal Pain, TMS?

Hi,

The discovery of TMS and this forum proved very helpful to me over the past month. Many of my issues (Carpal tunnel like symptoms, shoulder pain, Achilles tendon discomfort) are subsiding, even though I'm not 100% there yet , I'm usually 50% pain free, and on good days up to 80%, and improving. Very impressive for a four week span.

Here's the deal though, the last issue so to speak.

About two and a half years ago I've decided to learn to sing. For about a year I took lessons, however one day when I was playfully barking with my dogs, I felt a slight burning pain in my throat, around the larynx region. I mostly disregarded it at that point, making a mental note to take a short break from singing. Over the course of two months, it slowly evolved, becoming a little more severe with each passing week. After two months, I caught myself shutting up in the middle of a conversation with a friend, and not speakingat all for two days. I experience a severe burning sensation in my throat every time I speak more than a few sentences, needing frequent breaks.

At around the same time, a little bit before the drastic escalation, I had a very stressful day. I went out on a night out with an ex-girlfriend, whom I had a very nasty breakup after a three year relationship, after which we were completely out of touch for two years. I strongly remember that day, especially stress I felt before I left the house to meet her. I was shivering and breathing heavy, I had to actually lay down and gather my thoughts before I left the house.
I suspect this might be the source for the issue, however I found no material regarding TMS and vocal issues on this site or in Sarno's books. Which is why I'm here.

I've pursued treatment for my issue. I've had a laryngoscopy which showed no physiological findings on my vocal cords. I was told that the condition came to be because suddenly, I'm not using my vocal cords the right way (the singing lessons were my personal explanation at the time. I taught myself to speak wrong), so I was sent to vocal therapy which didn't help. A few months later I went for another laryngoscopy to get a second opinion, this time the doctor observed a small granuloma on one of my vocal cords. The diagnosis didn't change though - muscle tension dysphonia. In other words, I'm not using them right. After another bout of vocal therapy and exercises, which didn't help, I went for a third opinion. The third laryngoscopy showed that I have slight redness on my vocal cords, nothing major. I was given steroids, which helped for a little while.

Now I'm back at square one, this time armed with knowledge of TMS. However, I haven't found anything on the web to support the connection.
I'm hoping some of you may have a clue on this...

Daniel.

 

Hi Daniel,

Welcome to the Forum! If you put the terms "vocal issues" or "singing" into the search box at the top right of the page, you will find some threads discussing these problems that others on the Forum have had. There is a TMS connection. Our own @Forest (Forum moderator) had vocal issues at one time.

So I think you'll benefit from treating it as TMS. Keep us posted on how you're doing.

 

It will be very difficult to find similar stories around the web because your case is really specific.
What I'd concentrate on is that you have a history of pressure/muscular-related issues.

You mention RSI (I overcame that five years ago myself), and other tension related pains and strains. That's the first pointer towards a TMS personality. You seem, like many of us, to vent through pressure in your muscles.

So, why do I state the obvious? You kow what makes the vocal cords move when we sing and speak and even breathe? Muscles. Most promintent, the musculus vocalis is the inner muscle in the larynx. If it contracts, your vocal cords "close" the rima glottidis in your larynx. It works together with another muscle, outside, to create sounds. You say your doctors call it "muscle tension dysphonia". That is it. Your muscles are tense, and it puts a strain on your vocal cords. Thus, you feel discomfort and pain.

You can become accustomed to pain. You feel it, whether there's a physiological cause there or not. It becomes ingrained in your neural pathways. It's then that your first go-to reaction becomes pain.
It doesn't mean that you are damaged. Yet, that's the first thing we think. And it's crazy difficult to get out of that pattern of thinking.

A granuloma is most commonly found in singer's cords. But we are talking people who do this kind of thing for decades! On volumes you don't want to achieve in a non-professional setting. You "are not using them right". Well - usually, we know how to use our bodies. It's innate.

Your discomfort should've healed with rest by now, that's what most logical people would say.
You might've tired your vocal cords a bit, at the beginning. You felt slight discomfort. But then, you rested. Had therapy lessons to reduce tension and strain. Yet, no improvements?
Sounds fishy.

When we first establish a mental connection - cause and effect - between pain and an activity, that's where we begin to enter the dangerous zone of symptom obsession. It seems beyond our control, doesn't it?
I believe that we can put strain on our bodies. Tired muscles from working out, for instance. But that'll clear up. There's no reason not to, especially if there are no ruptures or anything observed!

Somehow, we enter a cycle. We try to protect oruselves by prescribing ourselves more rest than most doctors would do. To no avail.
It is scary, isn't it? The thought of never be able to use your voice again. Your arms, Go out for running. Bending, lifting.

That fear, that's the core of TMS, I think.
You don't sing anymore, do you?
I think it was an activity you enjoyed. It seems so, from reading your text. Yet, you had to give that up.
You gave up an activity that brought you joy and focused your attention elsewhere. Now, you can't hekp but forcus on this specific issue - your discomfort in your vocal cords. Some days, your life basically revolves around this and nothing else.

Your psyche is distracting you, and it chooses the most powerful venues it can find. Robbing you of your pleasures, instilling you with fear of crippling disability. I know this very well. This has been me, for so long. It's my go-to reaction to stress.
Negative thoughts. Overthinking your future. Anxiety.

You mention noticing how stressed out you where when you met your ex-gf. Why did you meet her in the first place after so long? Who suggested to meet up? She's probably a chapter you haven't quite closed but rather turned the page over before achieving closure. That's what I could think is causing some of your discomfort.
It might be a good idea to sift through your mind and emotions. What is causing you emotional pain - pain, that is so dangerious to your inner self that it prefers to let it out in physical form?

This is all I can say about it. I am struggling myself. I am sure that the body reacts to the mind. In some people, that connection is more fine-tuned, stronger. Yet, it's so fine we often overlook it. It's a two-way-street. And you can take the first step and recognize that we're a unit. I don't really think mind and body are seperate. It's one entity, working together always, and if one part is hurting, so is the other.

I wish you all the best.

 

Hi, DVH. I've found that vocal pain can be caused by psychological stress, which is pure TMS.
Our subconscious is telling to work on our repressed emotions and/or a perfectionist or "goodist" personality.

Meeting a former girlfriend could cause vocal problems.

I hope you will start the Structured Educational Program, free in one of the subforums here,
to help you learn about and deal with the causes of your TMS.

 

I found some references to throat issues with Sarno and Steve O. In Healing Back Pain, Dr. Sarno refers to laryngitis being of emotional origin. In The Mindbody Prescription Sarno indicates that he believes spastic dysphonia to be psychogenic because the patients he sees had back pain. In Steve O's book, he says he had a squeezing throat (globus pharyngitis) which left with TMS healing and is a TMS equivalent. I also remember a show with Shania Twain (singer). The got spastic dysphonia after her husband left her for her best friend. The show was on the Oprah Network, anyway, there were 4 episodes and she was trying to deal with the emotional factors involved with loosing her voice. She got it back and has been performing in Vegas for some time. I don't if you can relate to those maladies or not.

I have throat issues as well. Most of the time I think it is the replacement from having a sore back. My sore back went away, so now this is coming up. To me it seems more tricky to diagnose as TMS, mostly because there aren't as many people on the forum talking about it. I treat it like TMS, gather my facts and create an evidence sheet, evidence that it's emotionally based. After all that, I wait for time to pass and journal, or follow one of the programs. The SED program is a good place to start. Currently I am doing the Mindbody Workbook, just to have some direction in my writing.

Hopefully you can find some connection between TMS and your throat problems.

 

While it doesn't exactly describe your particular problem, it's so similar and related to the same structures I thought reading this might help you:
http://www.unlearnyourpain.com/blog...-finding-your-voice-and-reclaiming-your-life/

 

"- muscle tension dysphonia." * * * & * & * & * * * Tension Myositis Syndrome (TMS).

You've been examined numerous times and fortunately nothing serious was found!

For symptomatic relief I would recommend honey.

 

I suggested it. I felt bad about the way things ended. I felt that she hated me and the thought of someone bearing ill will towards me because of things that are my fault, however far that person is from me, bothered me.
I suggested the meeting.
For the most part it was a good evening, we managed to talk about some of the key points and at the very least, it brought us to speaking terms again.
But by the end of the night I still felt like there's some hurt still left between us, and we went our separate ways, not completely healed, at least on my part.
She went on to a happy relationship, as did I by the way, and I'm very happy for her.

The goal of the meeting though, was achieved, but only partially.
I didn't think about it in the following months at all, until the vocal issues really started "shining".

Is it a chapter that I haven't quite closed? Yes. Do I have any clue, whatsoever, on how to deal with this, so many years down the line? No.

Daniel.