This page describes some techniques that have been used in some cases for coping with Simple Writer’s Cramp. They have been provided by Rosemary Sassoon.
These techniques are not an alternative to seeking treatment from a qualified neurologist. It is essential that, before trying any course of action to help cope with your dystonia, you discuss it with your neurologist and confirm it is appropriate for your condition and that there is no risk that it will cause aggravation. Please click here for our full disclaimer.
Handwriting is a motor skill - this means that early in life motions that result in writing letters are learned and then 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. With Simple Writer’s Cramp this automation is disrupted for reasons that are not fully understood. As with other forms of dystonia, this disruption can often be worse when the writer is under stress or anxiety – and handwriting often takes place in stressful situations such as examinations or demanding jobs. However, some people find that by relaxing and/or changing the way they write they can cope better with this problem.
Below are some descriptions that have helped in some cases. However, each individual is different and it is important to understand that what helps one person will not necessarily help another.
Some people have found that thinking about how the writer’s cramp originated reduces the level of worry and makes it easier to relax when writing. Ideas how Writer’s Cramp started might include one or more of:
For some, reflecting on how a relatively insignificant, perhaps long-forgotten happening could have escalated into a significant problem has enabled them to approach handwriting with less worry.
There are a number of things that might be a problem with current writing position for example:
These problems can sometimes be seen better if another person photographs or videos the writer. Some people find that identifying and correcting such problems may make it more comfortable and pain-free to write and this may reduce the effect of the dystonia. In some cases, it has also been helpful to try writing on a slanting surface as it can take the pressure off their wrist and help to still any tremor – this can be achieved using a small board or something similar, raised one end on a couple of books.
Most people find that it is not a good idea to switch hands to try and evade the problem. Often, the same problems will affect the other hand in time.
Being unable to write can induce anxiety and it can be difficult to make the body relax. Some people have fond using distraction techniques can help if used cautiously and without overdoing it:
Some have also found it helps to:
Simple writer’s cramp is usually caused by caused by overuse and misuse of certain muscles.
Hughes and McLellan put it this way in 1985: ‘We suggest that writing is prone to induce dystonia because of concurrent requirements. The first is to hold the pen securely in the fingers and to keep it applied evenly to the paper.The second is to permit rapid and very fine modulation of activity in all the co-activating muscles. Muscles that oppose each other (flexors and extensors) must be tensed within a conventional tripod grip, and at the same time, delicately controlled to form the letters’. This conflict of muscles may be made worse by the use of modern pens which often need to be gripped more tightly in order to work properly.
Callewaert, a Belgian neurologist, suggested an alternative penhold which makes use of different muscles which work together rather than opposing. It consists of placing the writing implement between the index and middle fingers. When trying out changing writing method, the writer always starts slowly and does not to overdo it. When writers feel comfortable, perhaps after a few exploratory scribbles, they often find this a considerable relief. However, some people reject it, feeling that it looks odd. But it is not uncommon and, if you watch the world’s leaders signing documents on the television, you will sometimes spot one using this alternative penhold.
These suggestions have been helpful in some cases but do not constitute a permanent solution in the conventional sense. At times of stress, symptoms can often recur even where improvement has occurred. However, in most cases the improvements have returned when things have calmed down.
The Dystonia Society provides the information on this page as general information only. It is not intended to provide instruction and you should not rely on this information to determine diagnosis, prognosis or a course of treatment. It should not be used in place of a professional consultation with a doctor.
The Dystonia Society is not responsible for the consequences of your decisions resulting from the use of this information, including, but not limited to, your choosing to seek or not to seek professional medical care, or from choosing or not choosing specific treatment based on the information. You should not disregard the advice of your physician or other qualified health care provider because of any information you receive from us. If you have any health care questions, please consult the relevant medical practitioner.