Writer's Cramp - Causes, Symptoms, Treatment, and More

8/7/2019 Writer’s Cramp: Causes, Symptoms, Treatment, and More
What Causes Writer’s Cramp and How Is

It Treated?
Medically reviewed by Timothy J. Legg, PhD, CRNP on November 21, 2017 —
Written by Beth Axtell
Types Symptoms Causes and risk factors Diagnosis Treatment

Complications Outlook
What is writer’s cramp?

Writer's cramp is a specific type of focal dystonia that affects your fingers,
hand, or forearm. Focal dystonia of the hands is a neurologic movement
disorder. The brain sends incorrect information to the muscles, causing
involuntary, excessive muscle contractions. These signals can make your
hands twist into odd postures.
Writer’s cramp is known as a task-specific dystonia. It happens almost

only when you perform a particular activity. Other highly skilled
movements can incite focal hand dystonia — things like playing a musical
instrument, typing  , or sewing.
Other terms used to describe writer's cramp or similar problems include:
musician’s cramp
focal hand dystonia

arm dystonia
finger dystonia
task-specific dystonia
occupational cramp or dystonia

the “yips”
Anyone can get a task-specific dystonia like writer's cramp. Estimates

range from 7 to 69 per million people  in the general population.
Symptoms usually appear between the ages of 30 and 50. Task-specific

dystonias — particularly musician’s cramp — are more common in men. 
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https://www.healthline.com/health/writers-cramp#outlook 1/11
Are there different types?

There are two basic types of writer's cramp: simple and dystonic.
Simple writer's cramp involves difficulty with only writing. The abnormal
postures and involuntary movements begin soon after you pick up a pen.
It only affects your ability to write.
Dystonic writer's cramp moves beyond the one task. Symptoms will
show up not only during writing, but also when doing other activities with
your hands — like shaving or applying makeup.
What symptoms can it cause?

Sometimes holding a pen or pencil too tightly can cause the muscles in
your fingers or forearms to spasm after you’ve been writing for a long
time in one sitting. This would be a painful overuse problem. But writer's
cramp is more likely to cause trouble with coordination.
Common symptoms of writer’s cramp include:
fingers gripping the pen or pencil very hard

wrists flexing
fingers extending during writing, making it difficult to hold the pen
wrists and elbows moving into unusual positions

hands or fingers failing to respond to commands
Your hand usually won’t ache or cramp. But you may feel mild discomfort
in your fingers, wrist, or forearm.
In simple writer’s cramp, the hand will respond normally during other

activities and only become uncontrollable during the trigger activity. In
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dystonic writer’s cramp, other hand-focused activities may also prompt

symptoms.
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What causes this condition and who’s at risk?

Focal dystonia is a problem with how your brain talks to the muscles in
your hand and arm. Experts think that repetitive hand movements result in
remapping of certain parts of the brain.
Simple writer’s cramp is associated with overuse, poor writing posture, or

holding the pen or pencil improperly. However, symptoms begin after
holding the writing tool for just a few moments, not after hours.
Although stress doesn’t cause hand dystonia, it can aggravate symptoms.

Stressors — like test-taking — can make your writer’s cramp worse. But
worrying about and focusing on the cramping can also make it worse.
Dystonic writer’s cramp is less common than simple writer’s cramp and
may occur as part of generalized dystonia that affects several parts of the
body. In this case, the involuntary movements can occur when you’re
doing other non-writing tasks, such as using a knife and fork.
It’s possible for writer's cramp to be inherited, usually with early onset
generalized dystonia, which is associated with the DYT1 gene.
How is this condition diagnosed?

If you think you may have focal dystonia, start by visiting your doctor.
They may refer you to a neurologist. Your doctor will ask you a series of
questions and perform a physical and neurologic exam.
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They’ll be looking for the following:
specific triggers of dystonia

which muscles are involved
characteristics of the spasms and postures
which body parts are affected
which activities are affected
whether any muscles are affected while at rest
Although not routinely recommended for diagnosis, nerve conduction and

electromyography studies may help your doctor rule out other possible
causes of your symptoms. Brain imaging usually isn’t necessary.
Overuse syndromes are usually painful, but writer’s cramp primarily

causes coordination and control issues. If your condition is painful, your
doctor may check for:
arthritis
tendon problems
muscle cramps
carpal tunnel syndrome
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What treatment options are available?

There’s no simple, one-size-fits-all approach to treating writer’s cramp. 
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And there’s no cure. You may need to try a variety of therapies, and
probably will have to combine a couple of them.
A typical treatment plan may include:
Physical and occupational therapy. Learning how to hold your pen

differently, using fatter pens or grips, using special-made splints, and
changing your paper or arm position can all help writer’s cramp.
Botulinum neurotoxin (Botox) injections. Botox injections into

selected muscles can help ease writer's cramp, especially when the
wrist or fingers move into unusual postures.
Oral medications. Anticholinergic drugs, such as trihexyphenidyl

(Artane) and benztropine (Cogentin), help some people.
Relaxation and distraction. Relieve stress-induced cramping

through relaxation techniques like deep breathing and visualization,
or through distractions like writing with both hands at the same time.
Sensory re-education. This process of identifying textures and

temperatures with your fingers helps retrain brain patterns that
cause writer’s cramp.
Sensory motor retuning. This rehabilitation therapy uses splints on

your unaffected fingers to help retrain the affected fingers.
Surgery. Both pallidotomy and pallidal deep-brain stimulation have

been effectively used for generalized dystonia, but surgery isn’t
usually necessary for task-specific dystonia like writer’s cramp.
Are complications possible?

For some people, the cramping and unusual movements in the hands
may also include muscles around the elbow and shoulder. You may
develop a tremor or shaking that accompanies the cramping. You may
develop a second dystonia, like of the eyelids or vocal chords. Symptoms
can also begin to affect the other hand.
About half  of people with simple writer’s cramp will end up progressing
to having dystonic writer’s cramp. Other hand-related activities like eating
or brushing your teeth may also be affected.
About two-thirds  of those with writer’s cramp have ongoing problems

with their writing. Handwriting may eventually become illegible.
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What’s the outlook?

Although there’s no cure for writer’s cramp, treatments can lessen
symptoms and perhaps prevent simple writer’s cramp from affecting other
activities or your other hand. A combination of physical, mental, and drug
therapy can help you retain your ability to write — so you can keep
handwriting letters to your friends and family.
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8/7/2019 Writer’s Cramp: Causes, Symptoms, Treatment, and More

What Causes Writer’s Cramp and How Is

Types Symptoms Causes and risk factors Diagnosis Treatment

What is writer’s cramp?

Writer’s cramp is known as a task-specific dystonia. It happens almost

Other terms used to describe writer's cramp or similar problems include:

focal hand dystonia

occupational cramp or dystonia

Anyone can get a task-specific dystonia like writer's cramp. Estimates

Symptoms usually appear between the ages of 30 and 50. Task-specific

Are there different types?

What symptoms can it cause?

Common symptoms of writer’s cramp include:

fingers gripping the pen or pencil very hard

wrists and elbows moving into unusual positions

dystonic writer’s cramp, other hand-focused activities may also prompt

What causes this condition and who’s at risk?

Simple writer’s cramp is associated with overuse, poor writing posture, or

Although stress doesn’t cause hand dystonia, it can aggravate symptoms.

How is this condition diagnosed?

They’ll be looking for the following:

specific triggers of dystonia

whether any muscles are affected while at rest

Although not routinely recommended for diagnosis, nerve conduction and

Overuse syndromes are usually painful, but writer’s cramp primarily

LIMITED APOLLO 11 WATCHES

What treatment options are available?

A typical treatment plan may include:

Physical and occupational therapy. Learning how to hold your pen

Botulinum neurotoxin (Botox) injections. Botox injections into

Oral medications. Anticholinergic drugs, such as trihexyphenidyl

Relaxation and distraction. Relieve stress-induced cramping

Sensory re-education. This process of identifying textures and

Sensory motor retuning. This rehabilitation therapy uses splints on

Surgery. Both pallidotomy and pallidal deep-brain stimulation have

Are complications possible?

About two-thirds  of those with writer’s cramp have ongoing problems

What’s the outlook?

READ THIS NEXT

Why Is My Hand Cramping?

Medically reviewed by Gregory Minnis, DPT

Hand cramps can be extremely uncomfortable. When your hand cramps

9 Home Remedies for Carpal Tunnel Relief

Having carpal tunnel syndrome doesn't have to be a pain. Check out

What Does Wrist Arthritis Feel Like?

Pain in the wrist can be a sign of arthritis, carpal tunnel, or tendonitis.

9 Remedies for a Pinched Nerve

What Causes Forearm Pain and How Is It

How Collagen Can Boost Your Body’s Skin,

How to Fall Asleep in 10, 60, or 120 Seconds

Do You Live with Anxiety? Here Are 11 Ways to

I Don’t Like Meditating. Here’s Why I Do It

The Difference Between VLDL and LDL

Cholesterol is a fatty substance that's needed to build cells. Low-density

Get our wellness

Fitness and nutrition tips, health news, and

Your privacy is important to us

About Us Health Topics

Health News Contact Us

Advertise With Us Advertising Policy

Privacy Policy Terms Of Use

Find An Online Doctor

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