With review and feedback from CEENTA Voice &amp; Swallowing Specialist Terri Gerlach, PhD, CCC-SLP (SouthPark)If you spent the night screaming at a rock concert or sporting event, you probably woke up the next morning with a sore, hoarse voice. Why does screaming cause this pain?How does your voice work?When we speak or sing, our vocal cords vibrate against each other because air from the lungs passes through them when closed, creating a sound or acoustic signal that moves through the throat, mouth and nose. Speech sounds are then formed by our articulators such as the tongue, teeth, nose, and palate. The rate at which the vocal folds vibrate varies depending upon the pitch produced. Normal female speakers generally have a rate of vibration of around 180-220 times per second (hertz). Normal male speakers generally have a pitch range of approximately 120-140 Hz. The loudness of the voice depends on how forceful the vocal folds vibrate against each other. Normal speaking and singing, which includes sufficient airflow from the lungs, do not cause harmful collision force. However, very loud voice use, yelling, or speaking for long periods of time in a noisy environment can result in injury to the vocal folds.Why does my voice hurt after screaming?Normal loudness levels for speaking are around 70 dB. Yelling can result in over 100 dB. When you scream, the collision of the vocal folds as they vibrate against each other is much more forceful and damaging than normal speaking due to increased compression of the vocal folds against each other and reduced airflow as they vibrate. The pain indicates that it was so forceful that the tissue was damaged during this impact. This is considered an acute injury that can cause pain. Sometimes the pain also indicates that an area within the tissue has begun to bleed, CEENTA Voice &amp; Swallowing Specialist Terri Gerlach, PhD, CCC-SLP, said. It’s also possible for polyps or cysts to develop on the vocal folds, which may require surgery.How do I make my voice better?If you feel you have caused some damage to your vocal folds, you should rest your voice as much as possible for a few days. Do not use your voice if it hurts to talk. Drinking as much water as possible will help the tissue to heal as well. Avoiding whispering is important, as this can cause strain. When you do speak, just let whatever comes out come out. Try not to clear your throat or cough. Instead, take several sips of water to prevent the cough. Coughing and throat clearing also cause the vocal folds to experience high impact force/collision force and can further damage the tissue, Dr. Gerlach said.What if my voice doesn’t improve?If you are still experiencing hoarseness that does not improve in 1-2 weeks, you should schedule an appointment with an ear, nose, and throat physician at CEENTA. However, if the pain continues over several days, try to make this appointment as soon as possible. Very often, the ENT doctor will refer you to a voice specialist for a full evaluation, and together the ENT doctor and voice specialist will determine a plan of care. If voice therapy is recommended, you will be provided with exercises and voice-use protocols designed to address your specific diagnosis and problem.We all know how easy it can be to get swept up in the excitement of an event, but if you can avoid screaming, you’ll feel just as good the next day as you do then.This blog is for informational purposes only. For specific medical questions, please consult your doctor. New patients can make appointments online with our ENT doctors in North and South Carolina. Current patients can also make appointments through myCEENTAchart with physicians they have already seen.