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Writer’s Cramp

Handwriting is a motor skill which means that early in life, movements which result in writing are learned and stored in the brain’s motor memory. Once automated, the writer can then forget about how they are writing and concentrate on the content of the written work. Writer’s cramp (scrivener’s palsy or mogigraphia) affects hand and finger muscles causing cramps and a type of focal dystonia (a sustained and involuntary muscles contraction) specific to the task. Writer’s cramp is the most common dystonia of the repetitive movement disorders.

Symptoms

  • Cramping, aching and incoordination of the hand.
  • Loss of precision muscle coordination manifesting in declining writing skills, frequent small injuries to the hands and dropped items.
  • A ‘mirror effect’ often observed in other body parts e.g. use of the right hand may cause pain and cramping in that hand as well as in the other hand and legs that were not being used.
  • Stress, anxiety, lack of sleep, sustained use and cold temperatures can worsen symptoms.
  • Direct symptoms may be accompanied by secondary effects of the continuous muscle and brain activity e.g. disturbed sleep, exhaustion, mood swings, mental stress, difficulty concentrating, blurred vision, digestive problems and short temper.
  • The need to place hands in pockets, under legs while sitting or under pillows while sleeping to keep them still and to reduce pain.
  • A tremor in the affected arm or hand while writing or when the arm is outstretched.

Risk factors

  • Intense writing by hand without adequate breaks
  • Issues with learning to write at school
  • Using unconventional or painful pen holds
  • Bad writing posture
  • Tension and worries when writing (not necessarily about handwriting)
  • An unnatural arm position such as a raised elbow
  • An incorrect paper position leading to uncomfortable twisted wrists and poor posture
  • An injury to hand or arm
  • A too high an expectation of handwriting
  • Holding the pen too tightly or pressing too hard downward on the paper
  • Head trauma.

Management

  • Reducing the amount of writing that is done.
  • Using a keyboard instead of a pen.
  • Using a wider pen or an attachment to make it wider.
  • Many people find the best position to paper to be slightly to their right if right-handed, or the left if left-handed.
  • Treatment aimed at facilitating interdigit separation of digits 1, 2 and 3.
  • Behavioral techniques, such as auditory grip force feedback (using an auditory signal to indicate grip strength).
  • TENS machine.
  • Botulinum toxin (botox) injection.
  • Writing on a slanting surface can take the pressure off your wrist and help to still any tremor (use a small board or something similar, raised one end on a couple of books).
  • Relax before starting writing. Before writing, shrugging the shoulders, shaking the wrists and taking a couple of deep breaths.

Homeopathy and Writer’s Cramp

For readers interested in how complementary medicine could help, there are many homeopathic remedies which can be effective in relieving the spasms, pain and cramps occurring in writer’s cramp such as magnesium phosphoricum, stanum metallicum, conium maculatum or gelsemium.

With thanks to The Dystonia Society at http://dystonia.org.uk

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