306. MS Voice Changes Are Real: What's Happening and What You Can Do

Does MS make your voice sound shaky, hoarse, or quieter than it used to? You're not imagining it… and you're not alone.

In this solo episode, I'm answering a listener's question about voice changes with multiple sclerosis (MS). It's not one of the most common MS symptoms, which is exactly why it can feel so isolating. But it's real, and there are things you can do about it.

Here's what we cover 🔑:

1️⃣ Signs MS may be affecting your voice
→ A shaky voice (aka vocal tremor)
→ A hoarse, breathy, weak, or quiet voice (aka dysphonia)
→ Slow or slurred speech, or talking that takes more effort (aka dysarthria)
→ Running out of breath mid-sentence or trouble projecting
→ Pitch and volume that are hard to control

2️⃣ Why MS can change your voice
Your voice is movement. It just uses much smaller muscles than your legs do. MS lesions can affect the nerves that control your breathing, your vocal cords, and your speech coordination. That includes the vagus nerve and one of its branches, the recurrent laryngeal nerve, which controls the small muscles of your voice box. And just like with walking, fatigue, weakness, and stress can make voice symptoms worse on some days.

3️⃣ The voice and swallowing connection
If your voice changes during or after eating, or you cough, choke, or gasp for air when you swallow, mention it to your provider. Vocal cord weakness can keep your airway from closing fully during a swallow, so addressing it early helps keep eating safe.

4️⃣ Physical therapy-based strategies to support your voice
→ Diaphragmatic (belly) breathing, which creates the steady, controlled airflow your vocal cords need
→ Releasing tension in your neck and jaw
→ Seated rows to strengthen the muscles between your shoulder blades, plus a doorway chest stretch. Sitting taller opens your chest so your voice can project with less strain.
→ Energy conservation, like short check-ins and breaks through the day, since your voice often fades as your energy drops

5️⃣ Who can help
A speech-language pathologist (SLP) is the go-to specialist for voice and swallowing. Bring this up with your neurologist, physical therapist, or primary care provider, and ask for a referral, not just a note in your chart.

This episode is for you if:
✅ Your voice sounds shaky, hoarse, or weaker than it used to
✅ People keep asking "What did you say?"
✅ You run out of breath while talking
✅ Your voice fades as the day goes on
✅ You've noticed coughing or choking when you eat or drink

Your voice is made of muscles too… and those muscles deserve attention. You're not alone in this 🧡

Do you have an uncommon symptom you want covered? Email Us! 

Resources mentioned in this episode: 

The MSing Link Podcast, Episode 178, Improve Your Movement Through Functional Exercise - Apple | Spotify

The MSing Link Podcast, Episode 110, Speech & Language Pathology for MS w/ Pamela Miller, SLP - Apple | Spotify

Additional Resources: https://www.doctorgretchenhawley.com/insider

Reach out to Me: [email protected] 

Website: www.MSingLink.com

Social: 

★ Facebook: https://www.facebook.com/groups/mswellness

★ Instagram: https://www.instagram.com/doctor.gretchen

★ YouTube: https://www.youtube.com/c/doctorgretchenhawley?sub_confirmation=1

→ The Progress Method for MS: https://www.doctorgretchenhawley.com/the-progress-method-for-ms

→ Total Core Program: https://www.doctorgretchenhawley.com/TotalCoreProgram

→ The MSing Link: https://www.doctorgretchenhawley.com/TheMSingLink