Hand / arm dystonia
The following information is taken from our factsheet, Writer's cramp.
Download the Writer's cramp factsheet (PDF format)
Writer's cramp
Some people find that writing becomes difficult due to tremor, involuntary movement or cramps in their hand or arm muscles. This is called writer's cramp. In these cases, writing can become a painful activity and written work can become far less legible.
In many cases, writer's cramp is caused by over-use of the hand or use of inefficient writing strategies such as poor writing posture or penhold. These can cause the muscles to consistently strain, so causing a person to press very hard on the paper when writing, which can then lead to spasms and pain.
In these cases, the wrist and fingers are often held in unusual postures, making gripping the pen and writing very difficult. Sometimes the tremor that comes on when writing is the major problem rather than abnormal posture. In many cases, symptoms are exacerbated by tension.
There is no cure for writer's cramp but many individuals can gain significant benefit from spending time with a specialist who will help them understand how the problems arose and may suggest techniques to help them 'retrain' their muscles and 'unwind' the problems with hand posture and pressure, one by one.
Often there is a need to relax not only hands but attitudes to handwriting, too. In these cases, relief is literally in one's own hands.
Dystonic writer's cramp
In a minority of cases, difficulties in writing are due to a form of dystonia that affects the hand and arm muscles. In cases of dystonic writer's cramp, the involuntary movements and muscle cramps can also be apparent when undertaking other non-writing tasks such as using a knife and fork or applying makeup, etc.
Treatment
Some people with writer's cramp can gain benefit from treatment with drugs either on their own or together with botulinum toxin injections. There are a variety of tablets that can be helpful, although none are universally successful and side effects can occur.