When focal hand dystonia affects writing, this is called writer’s cramp. Writing can become painful and written work less legible. There are two types: simple and dystonic.

Simple writer’s cramp is usually caused by over-use of the hand, poor writing posture or poor penhold. The resulting muscle strain can cause the writer to press down too hard on the paper and can lead to spasms and pain.

Symptoms of simple writer’s cramp only appear during writing and include some or all of the following:

  • Gripping the pen too hard.
  • Extension of the finger during writing making the pen difficult to hold.
  • Unusual postures of the wrist or elbow.

These can make writing very difficult. Sometimes tremor is also a symptom although this is unusual. In many cases, symptoms are exacerbated by tension.

In a minority of cases, difficulties in writing are caused by dystonic writer’s cramp which may occur together with a more generalised dystonia that can affect other parts of the body as well. In this case, 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.
There is no cure for writer’s cramp but many individuals benefit from 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.

Some people with writer’s cramp can gain benefit from treatment with drugs either on their own or together with regular injections. There are a variety of tablets that can be helpful, although none are universally successful and side effects can occur.

To read case studies of individuals with writer's cramp that have been featured in Dystoniamatters! click on the links below:

Mary Buck

Elizabeth Ratcliffe



The Dystonia Society provides the information on this page as general information only. It is not intended to provide instruction and you should not rely on this information to determine diagnosis, prognosis or a course of treatment. It should not be used in place of a professional consultation with a doctor.

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