Symptoms A-Z

Trouble Speaking Symptoms, Causes & Common Questions

Understand trouble speaking symptoms, including 3 causes & common questions.

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Trouble Speaking Symptoms

Your manner of speech is unique to you and one of the primary ways that others identify you. If speaking becomes difficult, different from what it has always been, or is inhibited entirely, it will likely cause a great change in the way you approach daily life and can be rightfully concerning.

However, most conditions that make speech difficult or impossible can be treated and at least managed, if not cured.

Trouble speaking is also called aphonia or dysphonia.

Common characteristics and other symptoms of trouble speaking

Involuntary tension in the muscles within or surrounding the voice box can lead to your trouble speaking. It is also possible that the vocal cords may be involuntarily forced closed or forced open and remain that way, or all or some of the vocal cords may be paralyzed and impossible to use. This may present as:

Duration of symptoms

Some conditions are lifelong and cannot always be cured, but can be managed.

Who is most often affected?

People who are most likely to experience trouble speaking include:

  • Women under the age of about 50
  • Anyone who is required to spend many hours a day speaking or singing
  • Anyone who habitually strains their voice with yelling or screaming

  • Smokers

Is trouble speaking serious?

The severity of trouble speaking can vary depending on the cause.

  • Not serious: Laryngitis almost always resolves with voice rest and fluids, even if you are unable to speak at all for a few days [1].
  • Moderately serious: If you find it impossible to speak for no clear reason and have no other symptoms, it may due to muscle spasms of the larynx or to anxiety [2]. Both conditions can be treated by your medical provider.
  • Serious: Some types of throat or laryngeal cancer have persistent hoarseness as a symptom. Hoarseness should be investigated if it lasts longer than two weeks.

Trouble Speaking Causes

Many conditions can cause the symptom of trouble speaking. We've listed several different causes here, in approximate order from most to least common [4,5].


This is inflammation of the vocal cords that can be due to [1,2]:

  • Viral infection: This is the most common cause of laryngitis.
  • Fungal infection: This is rare, but can occur.
  • Bacterial infection
  • Allergies, irritants or chemicals
  • Bronchitis
  • Injury
  • Gastroesophageal reflux disease

Involuntary muscle spasms of the larynx

These spasms can be caused by [3]:

  • Neurological disorders: These include multiple sclerosis (MS) or Parkinson's, or, more rarely, Spasmodic dysphonia.
  • Inherited traits
  • Other issues: These include aftereffects of illness or stress, or excess stomach acid being brought up with gastroesophageal reflux disease (GERD), also referred to as heartburn.

Neck injury

Injuries to the nerves or muscles of the neck may include:

  • Physical injury: This may be due toa car accident, a fall, sports injury, or assault.
  • Surgical injury: This may be due to the removal of the thyroid gland, removal of a tumor in or near the larynx, or a tracheotomy.


Severe social anxiety can cause a person to feel as though they cannot breathe and their throat is closing up. This can alter the voice and make it difficult to speak at all.

Rare and unusual causes

Rare and unusual causes may include:

  • Vocal cord paralysis: This may result from surgical injury, viral infections, or some forms of cancer.
  • Laryngeal cancer: Tumors in an around the voice box may make speech difficult or impossible.
  • Psychological disorder: The physical structure of the voice box is normal, but there is a psychological block (greater than simple social anxiety) against speaking at all.

We've listed some specific conditions that can cause trouble speaking, along with how to identify each of them.

3 Possible Trouble Speaking Conditions

The list below shows results from the use of our quiz by Buoy users who experienced trouble speaking. This list does not constitute medical advice and may not accurately represent what you have.

Stroke or tia (transient ischemic attack)

Transient ischemic attack, or TIA, is sometimes called a "mini stroke" or a "warning stroke." Any stroke means that blood flow somewhere in the brain has been blocked by a clot.

Risk factors include smoking, obesity, and cardiovascular disease, though anyone can experience a TIA.

Symptoms are "transient," meaning they come and go within minutes because the clot dissolves or moves on its own. Stroke symptoms include weakness, numbness, and paralysis on one side of the face and/or body; slurred speech; abnormal vision; and sudden, severe headache.

A TIA does not cause permanent damage because it is over quickly. However, the patient must get treatment because a TIA is a warning that a more damaging stroke is likely to occur. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through patient history; physical examination; CT scan or MRI; and electrocardiogram.

Treatment includes anticoagulant medication to prevent further clots. Surgery to clear some of the arteries may also be recommended.

Rarity: Common

Top Symptoms: dizziness, leg numbness, arm numbness, new headache, stiff neck

Symptoms that never occur with stroke or tia (transient ischemic attack): bilateral weakness

Urgency: Emergency medical service

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Carotid artery dissection

A carotid artery dissection is a tear in a layer of the wall of a blood vessel called a carotid artery, one of two such arteries found in the neck. Blood vessel walls normally have three layers, and a tear in any of these can allow blood to flow into the result...

Brain tumor or mass

In medical terms, "mass" and "tumor" mean the same thing: the unexplained, out-of-place growth of tissue anywhere in the body, including the brain.

The cause of any sort of brain tumor is unknown. Some originate in the brain, while others spread from cancers growing in other parts of the body.

Symptoms may include increasing headaches; nausea and vomiting; blurred or double vision; loss of sensation in an arm or leg; loss of balance; confusion; speech difficulties; or seizures.

If symptoms persist, it is important to see a medical provider so that any treatment can begin as soon as possible.

Diagnosis is made through neurological examination, CT scan, and/or MRI.

If the mass or tumor is found to be benign, that means it is not cancer and not harmful. It may or may not be treated.

If it is malignant, that means it is cancer and must be treated. This will involve some combination of surgery, radiation therapy, and chemotherapy, followed by specialized therapy to help with recovery.

Rarity: Rare

Top Symptoms: fatigue, headache, nausea, loss of appetite, irritability

Symptoms that always occur with brain tumor or mass: focal neurological symptoms

Urgency: In-person visit

Trouble Speaking Treatments and Relief

If your symptoms are not severe, treatment can begin at home. However, if symptoms persist and you do not find relief, you should consult your physician.

At-home treatments

Treatment can begin at home with the following methods.

  • Conserve your voice: To protect your voice from overuse, practice 10 minutes of silence for every 90 minutes of speaking or singing.
  • Avoid whispering: This can strain the voice more than just normal speech.
  • Stay hydrated: Drink plenty of water and keep the air around you moist, using a humidifier if necessary.
  • Do not use decongestants: These are very drying to the tissues of the throat.

Medical treatments

You should consult your physician for the following.

  • Discussion of medical treatment: This may be needed for inability to speak at all above a whisper, especially if there is pain when attempting to speak.
  • Discussion of surgery: This may be needed if other medical treatment alone cannot resolve the problem.
  • Referral for voice therapy: This can often resolve, or at least help, a speech problem.
  • Referral for counseling: This can help with the social issues of anxiety, or of having limited speech or no speech at all.

Seek immediate treatment in the emergency room or call 911 for the following

Along with the inability to speak, these symptoms below constitute an emergency.

FAQs About Trouble Speaking

Here are some frequently asked questions about trouble speaking.

Can constant screaming, as in singing loud rock and roll music or coaching a sports team, cause permanent voice loss?

The voice may not be lost entirely, but you can do permanent damage to it with the strain of constantly shouting, screaming, and singing very loudly, especially if you smoke [6]. You can create irregular nodules on the vocal cords and even cause vocal cord hemorrhage [3]. The damage can usually be helped with voice rest, voice therapy, and, sometimes, surgery.

Can anxiety or stress cause a complete loss of voice?

It can, though it will be caused by a mental reaction rather than a physical one. Most often, severe social anxiety causes muscle spasms in the throat. In rare cases, a psychological block can cause the person to feel compelled to keep silent, no matter how much they might want to speak.

What is the best treatment for a severe case of laryngitis?

The most important thing is to rest the voice, especially if you cannot speak at all. Trying to forcibly produce speech with laryngitis can cause severe and permanent damage to the vocal cords. Instead, keep silent, communicate with notes, and drink plenty of water. See a medical provider if laryngitis has not improved after a few days [1,2].

What is the difference between voice therapy and speech therapy?

"Voice" is the basic sound produced by the voice box and vocal cords. "Speech" is the refinement of the voice into words or song by the lips, tongue, and throat. A voice therapist works with voice problems created by the vocal apparatus, while a speech therapist works with speech problems and the parts of the body that create them.

Can Botox help with a loss of voice?

In some cases, yes. At the site of injection, Botox blocks the signals that the nerves send to the muscles [7]. This leaves the muscles in a state of relaxation for days or weeks. If the loss of voice has been caused by muscle spasms in the voice box or the surrounding muscles, the relaxation can allow speech to return.

Questions Your Doctor May Ask About Trouble Speaking

To diagnose this condition, your doctor would likely ask the following questions:

  • How would you describe your speech difficulty?
  • Are you having any difficulty walking?
  • Did you just suffer from a high impact injury (e.g., a fall, collision, accident or sports trauma)?
  • Have you noticed a change in your hearing?

The above questions are also covered by our A.I. Health Assistant.

If you've answered yes to one or more of these questions

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Trouble Speaking Symptom Checker Statistics

People who have experienced trouble speaking have also experienced:

  • 5% Headache
  • 4% Fatigue
  • 3% Dizziness

People who have experienced trouble speaking were most often matched with:

  • 36% Stroke Or Tia (Transient Ischemic Attack)
  • 36% Carotid Artery Dissection
  • 26% Brain Tumor Or Mass

People who have experienced trouble speaking had symptoms persist for:

  • 38% Over a month
  • 27% Less than a day
  • 21% Less than a week

Source: Aggregated and anonymized results from visits to the Buoy AI health assistant (check it out by clicking on “Take Quiz”).

Trouble Speaking Symptom Checker

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  1. Vorvick LJ. Laryngitis. U.S. National Library of Medicine: MedlinePlus. Updated October 1, 2018. MedlinePlus Link
  2. Chronic Laryngitis. Harvard Medical School: Harvard Health Publishing. Published May 2015. Harvard Health Publishing Link
  3. National Institute on Deafness and Other Communication Disorders (NIDCD). Updated March 6, 2017. NIDCD Link
  4. Voice Disorders. American Speech-Language-Hearing Association. ASHA Link
  5. Shelat AM. Dysarthria. U.S. National Library of Medicine: MedlinePlus. Updated October 1, 2018. MedlinePlus Link
  6. Vocal Cord Disorders. Harvard Medical School: Harvard Health Publishing. Published January 2015. Harvard Health Publishing Link
  7. Adler CH, Bansberg SF, Hentz JG, et al. Botulinum Toxin Type A for Treating Voice Tremor. Arch Neurol. 2004;61(9):1416-1420. JAMA Network Link

Disclaimer: The article does not replace an evaluation by a physician. Information on this page is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes.