Is your hand hurting while doing physical work? You may have writer’s cramp

Article authored by – Dr. Shubha Subramanian, Neurology
Fortis Hospital, Vadapalani

We have heard about writer’s block, where the author is unable to generate new content or when he experiences a creative slowdown mentally. While this condition is normal with any author or creator, there is a medical condition called writer’s cramp that has been on the rise. Dr. Shubha Subramanian, NeurologyFortis Hospital Vadapalani, shares more insights on what writer’s cramp is and how should one be able to deal with this specific condition.

According to latest Research, 7 to 69 per million people in the general population are seen to be affected by this disorder. It is a specific type of dystonia causing involuntary movements that affect fingers, hand and forearm. The brain sends incorrect information to the muscles causing involuntary, excessive muscle contractions. This condition often leads to neurologic movement disorder causing the hand to twist in odd postures. This disorder takes place when a person is made to write for long hours especially among students during examination time and when a person begins to write after a long-time gap.

Symptoms
It begins with pain in the initial stage and slowly aggravates to the shoulders. Fingers begin to pain and at one point can also start to get numb, on a person who is exposed to writing for a long period of time. Slowly he/she is seen to lose the grip of pen or pencil. The muscles stop to cooperate as the cues given by brain are abnormal thereby affecting the motor skills, movement, and sensory functioning. Other common symptoms include:
• Cannot hold the pen or pencil for long period
• Wrists flexing
• Fingers extending during writing, making it difficult to hold the pen
• Wrists and elbow moving in unusual positions
• Hands and fingers not responding to the commands
• Fingers gripping the pen/pencil hard

Types
In simple writer’s cramp condition, the hand will respond normally during other activities but will get uncontrollable only during trigger moments. In dystonia involving the hand, any activity gets difficult to complete. Any basic activity involving hands may get difficult to proceed with.

Causes
Although research is ongoing for writer’s cramp, focal dystonia is a problem with how the brain gives orders to the muscles. Simple writer’s cramp is associated with overuse of the pen, poor writing or holding the pen posture. Dystonia affects even non-writing tasks like holding the simple things gets difficult or affect typing for long.It is possible that writer’s cramp can be inherited so it can be associated with genetics.

Treatment options
Simple exercises using soft balls can be done on regular intervals for school children who are about to take up examination. Even adults can practice from time-to-time. Other medications include oral medications – use of drugs, botox injections and the last stage may be even surgery. Relaxation and distraction exercises if practiced periodically may reduce the stiffness in the muscles and the brain signals to the muscles are improved over a period of time.
Although there is no direct cure for writer’s cramp, treatment can lead to symptomatic improvement. A fair amount of physical, mental and drug therapy helps to retain the ability to write. With the examination time around, it is also important for parents and teachers to understand that the kids can go through writer’s cramp condition and need to help them overcome this without imposing fear.

Tips for healthy writing
You can prevent or protect from pain while writing by correcting the writing and sitting position. The irregular position or posture will affect the way you use your arm and hand. Some of the tips are.
– The more your elbow bends the more your wrist and hand strains. So, keep you elbow positioned in 90 degrees or more.
– Avoid stressing high on your forearm
– Reduce your finger motions and keep it relaxed. Be aware that your knuckles should not turn white when you write
– Instead of moving your finger frequently, use the wrist and forearm to adjust the pen or pencil position
– Adjust or turn the writing paper if your wrist pains. You can also use inclined surface to keep your wrist relaxed, especially for lefthand writing
– If your thumb hurts while writing, try holding the pen between your index and middle fingers
– Choose large diameter pens or pencils with rubber grips to reduce gripping force. Tubing can be applied to pens or pencils to increase surface friction
– Standard ballpoint pens shall be replaced with easy flow ink fountain or gel pens
– Above all, write at a reasonable pace with frequent breaks