There’s something I wish more young singers understood the risks of: taking ibuprofen or another anti-inflammatory before singing. I am not talking only about the singer who is genuinely unwell and takes something for a headache or an unrelated injury. But there are singers who routinely take ibuprofen or similar painkillers before a performance as a matter of course. Perhaps they feel vocally tired or they know they are going to be singing heavily. Maybe they have pushed or over-sung in rehearsal and don’t want to feel the discomfort during the performance.
I am not a doctor or a health-care professional. And my advice here is gleamed from my years as a performer and teacher, and discussions I have had with a range of health professionals, some through a period of my own vocal stress caused by a long-term affect of Covid-19. If you are experiencing worrying signs in your singing, pain or discomfort, seek the advice of a good teacher and a professional ENT or specialist.
Pain and discomfort are information. They are part of the body’s warning system. If you take a painkiller and then sing through the discomfort, you haven’t solved the problem. You have just removed your awareness of it. That can make it much easier to continue pushing the voice when you should be resting or having a lighter singing load.
There is also a specific concern with drugs such as ibuprofen (from the range of medications known as NSAIDs) as they can affect platelet function and increase the risk of a bleed. For singers, this matters because the vocal folds are subjected to considerable stress when we sing, even on a healthy technique. NSAID use has been identified as one factor associated with vocal fold haemorrhage. This can cause a sudden change in the voice, loss of range or power, and significant dysphonia. For a professional singer, it can mean an immediate interruption to singing and potentially a significant period of recovery.
That doesn’t mean taking ibuprofen once will damage your voice, nor does it mean that NSAIDs are inherently dangerous for singers. There are legitimate medical reasons for taking them, and individual circumstances matter. The problem is using them as part of your vocal technique. If you regularly need painkillers to get through a performance comfortably, I would argue that the more important question is “Why does singing hurt?”
Are you fatigued? Are you over-singing? Are you working beyond your current technical capacity? Are you recovering properly? Is there an underlying vocal problem that needs to be addressed? I also understand the enormous pressure singers face to ‘go on’. I have been working professionally for decades and have faced that predicament myself several times. There are contracts, financial pressures and audiences waiting in the theatre. When singing is your livelihood, cancelling a performance can have very real consequences. Sometimes “just don’t sing” isn’t an option.
But particularly as a young singer, I think we need to ask ourselves a bigger question: Are we making decisions that protect tonight’s performance, or decisions that protect the next thirty years of our careers? Being reliable, consistent, and resilient are important, but so is knowing when something isn’t right and having the clarity and confidence to respond appropriately. Your voice is your instrument, and unlike a broken string on a violin, you cannot simply replace it.
So if you find yourself routinely reaching for ibuprofen before a performance because you are tired, sore or anticipating discomfort, please don’t just accept that as part of being a singer. Listen to what your body is telling you.
And if you experience sudden hoarseness, a loss of stamina, range, power, vocal stability, or any other dramatic change in your voice during or immediately after singing, don’t simply take a painkiller and carry on. Get an assessment from an ENT specialist. The show may have to go on sometimes, but your career has to go on for much longer.
