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  • hand-dystonia
  1. About dystonia
  2. Types of dystonia
  3. Hand dystonia

Hand dystonia

Other names: Focal hand dystonia / Writer’s cramp / Musician’s cramp / Musician’s dystonia

Type: Focal

Focal hand dystonia is a neurological movement disorder characterised by continuous or intermittent muscle contractions which cause abnormal, often painful, repetitive movements in the hand/s or arm/s.

When focal hand dystonia affects writing, causing it to become painful and written work less legible, it is known as Writer’s Cramp.

There are two types:

  • Simple writer’s cramp is more common and occurs when muscle strain causes the writer to press down too hard on the paper and leads to focal hand dystonia symptoms.
  • Dystonic writer’s cramp is rarer. In this case, the involuntary movements and muscle cramps also affect people during non-writing tasks such as using a knife and fork or applying make-up.

Focal hand dystonia in musicians is often called musician’s cramp or musician’s dystonia. Sometimes the effects are quite subtle - but they often prevent playing to a professional standard. It usually affects the body part/area which performs the most complex movement patterns, so the part affected depends more upon the instrument played, rather than hand dominance.

Focal hand dystonia should be diagnosed and treated by a neurologist specialising in movement disorders.

What are the symptoms?

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Symptoms include:

  • muscle spasms
  • fingers curling, clenching, shaking, or sticking in a position
  • gripping writing implements too hard
  • extension of the finger during writing making the writing implement difficult to hold
  • unusual postures of the wrist or elbow
  • reduced precision when playing instruments
  • tremor (more unusual)

Stress and anxiety are known to exacerbate the symptoms.

Published: 1st June, 2020

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Who does it affect?

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  • Focal hand dystonia can affect any profession which requires repeated hand movement but is more common among musicians than any other professional group. It is estimated that they affect approximately 1-2% of all professional musicians.
  • Men are more commonly affected by musician’s dystonia than women with estimates of the ratio ranging from 2:1 to 6:1.
  • Research has identified musicians who have intensively practiced their instruments over several years are most affected by this condition.
  • Usually musician’s dystonia is diagnosed when the person is in their 20s-40s.
  • Dystonic writer’s cramp more commonly affects those with whole body dystonia.

Published: 2nd June, 2020

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What are the causes?

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Dystonia is caused by incorrect signals from the brain to the affected body part but the causes for this are not yet fully understood.

  • Simple writer’s cramp is thought to usually be caused by over-use of the hand, poor writing posture or poor pen hold.
  • Dystonic writer’s cramp is thought to be affected by dystonia in other parts of the body.
  • Musician’s dystonia is thought to be caused by the repetitive hand movements, which result in remapping of the receptive fields in the cortex of the brain.

Published: 3rd June, 2020

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What are the common treatments?

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  • Botulinum toxin injections
  • Oral medication

While there are currently no complementary therapies recommended for dystonia by the NHS, the complementary therapies listed here have sometimes been mentioned by members with focal hand dystonia as being helpful.

  • Sensory re-education
  • Behavioral therapy techniques
  • Complementary therapies such as Alexander technique or Feldenkries therapy

Published: 4th June, 2020

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How will it affect my life?

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You may need to find ways to adapt and might have to learn new ways to complete everyday tasks. However, it is possible to live well with the condition and Dystonia UK is here to support you through all stages including initial onset, diagnosis, finding treatment and beyond.

You may find these coping techniques helpful:

  • Relaxing attitude to handwriting
  • Some musician’s find sensory tricks such as changing the position of keys on a wind instrument, using the opposite hand for bowing on the violin or playing an instrument while wearing a latex glove can be helpful.

Published: 5th June, 2020

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You might also be interested in:

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Published: 6th June, 2020

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