Muscle Tension Dysphagia: The Silent Partner of Muscle Tension Dysphonia

 When food and drinks feel stuck, there’s options!

Last month, I watched the Webinar "An Evening with Dr. Lott: All About Muscle Tension Dysphagia." As a clinician, I am always looking to learn about new topics and improve my treatment skills. I didn't know what to expect as I joined this webinar but as I listened, it all clicked!

Muscle tension dysphagia (MTDg) is the feeling of a lump in your throat, also known as “globus sensation." Muscle tension dysphagia can often be elusive to diagnose requiring years of doctor visits and testing with no “real answer.” At Insight Speech and Swallowing Therapy, we specialize in treating both muscle tension dysphonia (MTD) and MTDg.

What is Muscle Tension Dysphagia and its relationship with Muscle Tension Dysphonia?

MTDg is considered a idiopathic functional dysphagia without malignancy. This means testing often reveals a "functional swallow" despite feelings of tightness when eating or drinking. Because testing might not visually reveal an "impairment," patients may not be offered treatment by their otolaryngologist (ENT) or gastroenterologist (GI).

Patients experiencing MTDg may have initially received a diagnosis of Muscle Tension Dysphonia (MTD). Both conditions impact the same portion of the anatomy- the larynx or throat. Laryngeal function is a continuum including voice (phonation), swallowing, breathing, and sensation. The laryngeal space consists of the same muscles all completing different tasks and the thought it an abnormality in the system can affect sensory and motor functions.

Laryngeal Irritation and lead to hypersensitivity and a hyper-responsive muscle tension. Across all the laryngeal functions, this presents in different ways.

• Voice: Muscle Tension Dysphonia

• Swallowing: Muscle Tension Dysphagia

• Breathing: Chronic cough, Paradoxical vocal fold movement (PVFM)

• Sensation: Globus pharyngeas (feeling of something "stuck" in your throat)

  
  

  So what does this all mean? For clients experiencing muscle tension dysphagia, there is a close relationship with muscle tension dysphonia and chronic cough.

Getting Diagnosed

What we see in our clients is a often a long road of eliminating other diagnoses before they find us for treatment.

Symptoms of muscle tension dysphagia include pain or discomfort when swallowing (odynophyagia), early satiety, vomiting, abdominal pain, pneumonia, peri or post prandial coughing, and unexplained or unintentional weight loss.

A swallowing test (video fluoroscopic swallow study (VFSS)) is completed with normal findings and an otolaryngology (ENT) visit with endoscopy is completed to visualize laryngeal muscle tension. Someone experiencing MTDg may also experience laryngopharyngeal reflux (LPR) or silent reflux symptoms including chronic cough, Paradoxical Vocal Fold Movement (PVFM), and globus sensation.

To learn more about how speech therapy helps in the treatment of chronic cough, read our recent blog post: How Does Speech Therapy Help Chronic Cough?

Treatment

The goal with any treatment of MTD or MTDg is to unloading laryngeal muscle tension. Treatment for both conditions overlap and we typically see rapid improvement in symptoms

Treatments options include circumlaryngeal massages, counseling, semi- occluded vocal tract exercises, low Diaphragmatic relaxation breathing, and resonant voice therapy.

When to Work with a Speech Therapist

If you have pain when swallowing, feel full sooner, unexplained weight loss, or coughing during or after your meals, these could all be signs you are experiencing muscle tension dysphagia. Additionally, those experiencing chronic cough symptoms benefit from treatment

At Insight Speech and Swallowing Therapy, our clinicians can help identify, and train exercises and strategies that work for you to improve your ability to enjoy the foods you love most! 

Let's get you back to eating the foods you love and enjoying meals!

We offer muscle tension dysphagia evaluations for teens and adults. During your assessment, your clinician will assess the functional impacts on your daily life and create a customized therapy plan.

Call us at (856) 200-8392 or request an appointment to get started today!

Insight Speech and Swallowing Therapy – Helping you return to eating the foods you love. Serving Cherry Hill, NJ, and nearby South Jersey communities with compassionate, expert speech-language care.