What Is Writer’s Cramp?
Writer’s cramp is a condition that occurs due to sustained cramps in some muscles of hands or fingers. These cramps are a result of involuntary muscle contractions and are task specific. When muscles of only one part of the body are affected, it is termed as focal dystonia and writer’s cramp is one such type.1 It comes under the umbrella of repetitive strain injury.
It could be simply due to overuse; as in case of writers or because of poor postures, where the muscles get overstrained. It is called simple writer’s cramp and complaints generally occur only when writing. The common symptoms observed include, holding pen with different grip and holding it very tight. It can also occur to some pathological changes with more generalized muscle contractions or dystonia.
Causes of Writer’s Cramps
Writer’s cramp is commonly observed in those using the hands for repetitive activities mostly as a part of occupation like writing, playing music instruments with fingers, typing or similar activities.2 Dystonia may also be considered as a neurological disorder in origin, which is triggered by local injury to hand or repeated activities that cause strain.
According to some scientific studies, some of the risk factors possibly related to writer’s cramps include:
- Long hours of writing time or other repetitive activities involving fingers and hands.
- Sudden increase in the time spent on writing
- Sometimes a history of injury may be an associated factor
Symptoms of Writer’s Cramps
People suffering from writer’s cramps generally complain of difficulty in writing, pain in hands and fingers while writing, ultimately leading to possibly awkward grip of pen and illegible handwriting.
- Initially cramps may be felt after prolonged periods of writing.
- The cramps may be associated with pain in fingers, wrists, hands or forearms and difficult co-ordination of hands.
- The hands may even jerk while attempting to write or there may be tremors in an outstretched hand.
These complaints may slowly begin to aggravate and may gradually begin to appear within less time. Writing may continuously exaggerate the symptoms and eventually there is great difficulty or inability to write.
Diagnosis of Writer’s Cramps
The most important part is the patient’s history. Functional assessments that detail the history and exact nature and severity of the symptoms may be helpful for diagnosis of writer’s cramps. For e.g. Arm Dystonia Disability Scale (ADDS) or Writer’s Cramp Rating Scale (WCRS) may be suggested.
On examination, the physician may search for clues of early signs of dystonic postures and movement of hands and arms. They may perform clinical examination to observe posture and complaints while writing, reflexes and other observations specific to dystonia.
Some Investigations That Can Help In Making A Diagnosis Are:
Electromyography (EMG) – To determine the contractions of the muscles.3
Nerve Conduction Studies – To rule out the possibility of a trapped nerve as it can be a cause for similar symptoms.
Magnetic Resonance Imaging (MRI) – To detect any structural abnormality or pathology of a specified area.
Treatment of Writer’s Cramps
As an immediate action, the treatment plan generally suggests, limiting the activities that are causing strain and rest is advised. This allows the muscles to relax and probably heal after the strain has been taken off. Medicines like anti-inflammatory drugs, pain-killers and muscle relaxants are often prescribed depending on the symptoms.
Physiotherapy can also be useful in treatment of writer’s cramp. Transcutaneous Electrical Nerve Stimulation (TENS) may be useful where electrical stimulation to the nerves reduces the muscle spasms and relieves pain. Other treatment modalities in physiotherapy may be advised depending on the symptoms.
Prevention of Writer’s Cramps
Some Basic Tips To Prevent Such Repetitive Strain Injuries Include:
Performing functions within limits, managing the pace of work and spacing the activities whenever possible.
Taking regular breaks between activities to avoid continuous strain on the same muscles will also help.
Maintaining proper posture while sitting for work is essential.
Some Other Measures Useful In Preventing Writer’s Cramp Are:
Lifestyle Modifications To Prevent Writer’s Cramp
Modifying the work structure can help; like reducing the activity when complaints are more and later on restricting it within bearable limits. Simple modifications like using a keyboard instead of a pen in case of writers or using a pen with a comfortable grip and similar other alternative arrangements that can prevent overuse of the muscles already strained.
Exercises To Prevent Writer’s Cramp
As the muscles used for writing or other strain causing repetitive work are affected, resting and relaxing them in between activities is very important. Also, exercises that strengthen the muscles and tissues of the hands can be performed. Exercises should be performed with medical advice and the counts must be gradually increased only if there is no discomfort.
Some Exercises To Prevent Writer’s Cramp Include:
- Clenching the fist tightly and then slowly releasing it with fingers outstretched and giving a gentle stretch. This cycle is repeated.
- Clenching the fist and moving the wrist up and down. Then rotating the wrist in clockwise and anticlockwise direction.
- Bending hand at the elbow and then stretching it outwards giving gentle stretch. This cycle is repeated.
- Holding a stress ball in the palm and pressing with fingers is also a good option for some.
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