Twain was one of the most popular country artists in the world when she fell ill following the public breakdown of her marriage to her songwriting partner Robert John Lange, who allegedly had an affair with her best friend.
In 2011, she said the medical condition dysphonia led to her vocal struggles, but now she’s revealed Lyme disease was the cause of all her problems.
Lyme disease can be incredibly painful with symptoms including, rashes, joint pain and weakness in limbs.
She said voice-strengthening exercises and intense vocal warm-ups help her recover.
“I learned a lot about myself, and my voice, both because I’d been having a lot of problems with my voice prior, and because this was a real plunge into the unknown,” she told The Los Angeles Times.
Twain was married to Lange for 17 years before his alleged affair with her best friend Marie-Anne Thiebaud.
In 2011, she told Oprah Winfrey she was devastated when she found out, although neither have ever admitted to the infidelity.
She said she wrote to Thiebaud and begged her to leave her husband alone, asking: “Why are you torturing me? Let it go, please. Find love somewhere else from someone else.”
Months later she turned to Thiebaud’s ex-husband for support as the only other person who could understand what she was going through.
The pair eventually fell in love and are now happily married.
Now, Twain has written a new album, her first without her ex by her side. It’s due out this September.
This article originally appeared on Starts At 60.