Vocal health: managing post-nasal drip

Post-nasal drip can be a singer's nightmare. I have recently sent several students to ear-nose-and-throat (ENT) doctors for allergies issues, which I suspected were causing vocal problems. In both cases, their throats were so swollen from post-nasal drip that their vocal cords couldn't fully close! Below are a few tips on combatting symptoms. 

Use a nasal rinse

Many singers use neti pots, but I recently discovered two options that I like even better:  

Each of these kits comes with squeeze bottle and small packets of salt mixed with soothing aloe. You dissolve the salt in warm distilled water, squirt it up one nostril, and it flows out the other. Repeat on the opposite side.

As with a neti pot, the saline rinse cleans out the nasal passages by loosening and removing debris, allergens, and mucus. However, unlike a neti pot, the bottles gently squirt a stream of solution into the nostril allowing it to pass through quickly. If you hate the feeling of salt water up your nose, you'll want to trade in your neti pot! These kits do the job better and get it done more quickly!

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Use a nasal spray

Your physician may prescribe a steroid nasal spray like Flonase or Nasonex (prescription only) or Nasacort (over-the-counter). Steroid sprays work by reducing inflammation in the nose. They are safe for the vocal cords, as they are non-drying.

If you'd prefer a natural alternative, I like Pretz Nasal Spray. It will help thin out nasal mucus, although it will not flush out the nasal passages as well as a nasal rinse can. However, I consider it a good alternative for people who strongly dislike nasal rinses.

Avoid antihistamines

Antihistamines are generally considered a first line treatment for allergies, and they are used in many allergy pills and nasal sprays. (In sprays, they are sometimes combined with corticosteroids.) However, antihistamines are drying and can therefore pose problem for singers. (Dry vocal cords are particularly prone to injury.) For that reason, singers may be better off using steroid sprays or getting allergy shots. 

Seek treatment

If you are having vocal trouble and you think you may have allergies, seek advice from an ENT who can examine your vocal cords and see how allergies may be affecting them. (See my post on finding a voice doctor.)

Please do not assume that allergies will resolve on their own, and do not attempt to sing through them if they affect the quality of your sound. It may simply not be possible for you to improve your voice until your allergies are under control. If your throat or your vocal cords are swollen, you may end up straining to produce sound. These bad habits can be difficult to correct even after your voice is healthy. So get your allergies treated before bad habits set in!

Disclaimer: This blog post does not constitute medical advice, professional diagnosis, opinion, treatment, or services. It simply provides general information for educational purposes only. This information is not a substitute for medical or professional care, and you should not consider it a substitute for a consultation with a physician or other healthcare provider.

Vocal health: tips and resources for keeping your voice healthy

I recently had several students come to me who I suspected might have vocal nodules. With fall allergies on the rise and flu season around the corner, I thought now would be a good time to revisit some thoughts on keeping the voice healthy. 

vocal health tips

Drink plenty of water. Aim for 64 ounces (or eight 8-ounce glasses) daily. Caffeinated beverages do not count towards this total, but the following beverages do: juice; decaffeinated coffee, soda, and tea; herbal tea; and milk. 

Get 7-8 hours of sleep each night. We tend to fall back on bad habits when we’re tired. Getting enough rest will keep your body energized so that it can properly support your voice. 

Practice nasal irrigation: use saline drops or a neti pot. This is especially important if you are prone to allergies or sinus infections. 

Avoid speaking over background noise. We easily learn to “tune out” background noise, but speaking over other sounds can fatigue the voice. Common examples of background noise include talking at parties or restaurants and traveling by car. 

Maintain proper humidity. If the humidity levels in your home or office fall below 40 percent, consider using a humidifier, especially at night. (It is important to use a humidifier that can easily be cleaned, as the bacteria build-up can make you sick.)

Practice healthy and efficient speaking habits.

Avoid clearing your throat. 

Get acid reflux treated. Stomach acid can literally burn the vocal cords. See a doctor if you experience reflux several times a week.

Rest your voice when it feels fatigued. Listen to your body. Warm up your voice before speaking extensively or before singing.

Avoid excessive use of Aspirin and non-steroidal anti-inflammatory drugs (Advil, Ibuprofin, Motrin, Anaprox, Naproxin, etc.) 

Practice relaxation techniques if you tend to experience physical tension. Examples include meditation, yoga, visualization, and hypnosis.

Keep your body strong and flexible and maintain optimal posture. There are many physical disciplines that can help: yoga, Pilates, tai chi, Alexander technique, dance, etc.)

Seek medical attention. See a doctor if you are experiencing vocal problems and are not otherwise ill. (Read more information on the reverse page.)

vocal health resources

when to see a voice doctor

Vocal problems can develop at any time, but they most often occur following an illness or after times of extended voice use. However, the voice generally recovers on its own within a week or two. See doctor if you are experiencing the following symptoms and are not otherwise ill:

• change in vocal quality, such as hoarsness, breathiness, vocal fatigue, loss of volume, or decreased vocal range (high or low)

• throat pain or discomfort

• recurring voice loss (full or partial)

finding a voice doctor

Look for a doctor with experience working with “professional voice users.” Other specialists - even ear, nose, and throat (ENT) doctors - may not fully understand voice use or vocal problems common to people who speak or sing frequently. If you’re looking for a voice doctor, or are curious about problems related to the voice, I highly recommend www.voiceproblem.org. 

voice doctors in the Philadelphia region

These two highly-experienced teams of ENTs and speech therapists specialize in treating professional voice users.

Joseph Spiegel Thomas Jefferson University
925 Chestnut Street, 6th floor Philadelphia, PA 19107 215-955-6760

Philadelphia Ear, Nose and Throat Associates
www.phillyent.com 219 N Broad St, 10th Fl Philadelphia PA 19107 215-762-5531

CHOP operates a world-class voice clinic for children. The staff is sensitive to the needs of children who perform at avocational and professional levels.

Children's Hospital of Philadelphia - Voice Clinic
www.chop.edu 215-590-1000 • 34th Street and Civic Center Boulevard Philadelphia, PA 19104

This large group practice treats a broad range of ENT issues, including voice problems of children and adults. 

Ear, Nose and Throat Associates of Chester County
www.entacc.com 610-363-2532 • offices in Exton, Coatesville, West Chester, and Kennet Square

other professionals

A voice doctor may recommend that you work with a speech and language therapist (SLP) as part of your recovery. Like ENTs, SLPs often specialize in various areas of their field. You will want an SLP who specializes in voice. If you are a singer, you may need a singing (or voice) teacher. Look for someone who has experience with injured voices and who teaches the vocal style you wish to sing.

Download this handout as a PDF.

Disclaimer: This blog post does not constitute medical advice, professional diagnosis, opinion, treatment, or services. It simply provides general information for educational purposes only. This information is not a substitute for medical or professional care, and you should not consider it a substitute for a consultation with a physician or other healthcare provider.