Writer’s Cramp: An Overview
Writer’s cramp (WC) is a task-specific dystonia, a neurological disorder that causes involuntary muscle contractions and abnormal limb postures or movements (American Psychiatric Association, 2013). It is also referred to as focal hand dystonia or occupational cramp. It is characterized by pain and a sense of fatigue in the hand and forearm during writing activities. Commonly affected muscles include the thumb, index, and middle fingers. The condition is usually unilateral, but can affect both hands simultaneously (Leboyer, et al., 2017).
The exact cause of WC is unknown, but it is thought to be related to an imbalance in the neurotransmitters dopamine and acetylcholine (Leboyer, et al., 2017). Some studies suggest that WC is related to psychological and emotional stress, and that it is worsened by a decrease in dopamine (Evers, et al., 2015). Other factors associated with WC include poor ergonomics, overuse of the hand, and repetitive tasks (Evers, et al., 2015).
WC is usually diagnosed through a physical examination and medical history. Common diagnostic tests used to diagnose WC include electromyography (EMG), which measures electrical activity in the affected muscles; magnetic resonance imaging (MRI), which can help detect any structural abnormalities in the brain; and nerve conduction studies (NCS), which measure nerve activity (Leboyer, et al., 2017).
WC is typically treated with physical therapy, occupational therapy, and medications. Physical therapy includes exercises to stretch and strengthen the affected muscles. Occupational therapy focuses on improving writing technique and ergonomics. Medications used to treat WC include botulinum toxin and anticholinergics (Leboyer, et al., 2017).
In conclusion, WC is a neurological disorder characterized by pain and fatigue in the hand and forearm during writing activities. It is thought to be related to an imbalance in the neurotransmitters dopamine and acetylcholine, and is worsened by psychological and emotional stress. It is typically diagnosed through physical examination and medical history, and is treated with physical therapy, occupational therapy, and medications.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Evers, L.E., Zijlstra, W.J., Zilvold, G. & van Dijk, J.G. (2015). Writer’s cramp: The role of psychological and emotional stress in the development and exacerbation of the disorder. Neuroscience & Biobehavioral Reviews, 52, 187-196.
Leboyer, M., Guehl, D., Sauleau, P., & Corvol, J.C. (2017). Writer’s cramp: A review of clinical features, diagnosis, and treatment. Neuropsychiatry, 7(3), 253-261.