What is Writer’s cramp and How to treat it?

About Writer’s cramp

Writer’s cramp is a type of focal dystonia that affects hands , fingers and fore arm . It is an idiopathic movement disorder of adult onset that is  characterized by abnormal posturing and movement of the hand and forearm during tasks requiring skilled hand use, such as writing.  Focal dystonia of the hands or Writer’s cramp  is a neurologic movement disorder.  This disorder is characterized by involuntary and excessive muscle contractions which occurs as a result of wrong information send  by  the brain to the muscles These signals can twist hands or fingers into odd postures.

Writer’s cramp is known as a task-specific dystonia. As It happens almost only while performing  a particular activity or task. Like during playing musical instrument that’s why also known as musician’s cramp.  

Types of writer’s cramp

There are mainly two types of writer’s cramp i.e. simple and dystonic.

• Simple writer’s cramp – This type of writer’s cramp  involves difficulty with only writing. It affects person’s ability to write . In this type the abnormal postures and involuntary movements occur after  picking up a pen for writing. 
• Dystonic writer’s cramp – In this type symptoms are noticed in patients not only during writing , but also seen while doing other activities with hands like while typing ,  shaving . 

Symptoms of Writer’s Cramp

Common symptoms that are seen in patient’s of writer’s cramp are

• Wrist flexing
• Gripping of pen or pencil is very hard with fingers
• Difficult to hold pen or pencil
• Abnormal postures of hands or fingers
• Hand’s discomfort and uneasiness
• Stiffness and pain of hand muscles 
• Feeling of vibrations in affected hand
• limited hand activities 
• Stress and mental fatigue 

Causes Of  Writer’s Cramp

• It is presumed to be the consequence of dissipation of voluntary muscular activity.
• Any kind of injury in brain is also can be the reason of writer’s cramp
• Heredity reason  have been reported.
• The failure in functioning of basal nuclei in cerebral cortex and motor cortex results in the writer’s cramp.
• Many other disorders which can lead to writer’s cramp are hypoxia, ischemia, malignancy, and heavy metal poisoning.

Diagnosis of Writer’s Cramp

There is not any specific test for confirming Writer’s cramp. But there are specific parameters that can be helpful in deciding the severity of disease.

• ADDS (Arm Dystonia Disability Scale) and WCRS (Writer’s Cramp Rating Scale) – These are helpful to check writing ability 
• MRI to check systemic abnormality
• EMG to check unusual contractions.

Treatment of Writer’s Cramp

• Physical and occupational therapy. Different techniques and ways to learn how to hold your pen, use of  fatter pens and changing your paper or arm position can all help writer’s cramp.
• Botulinum neurotoxin (Botox) injections. Use of  Botox injections into selected muscles can help in treating  this disorder , especially in condition of unusual postures of wrist and fingers.
• Oral medications. Many kind of oral medications like Anticholinergic drugs can be helpful in this condition.
• Sensory motor retuning. This rehabilitation therapy uses splints on your unaffected fingers to help retrain the affected fingers.
• Surgery. Procedures like pallidotomy and pallidal deep brain stimulation effectively helpful in generalized dystonia.   

Ayurvedic treatment for Writer’s Cramp

• Ayurveda is an ancient and traditional system of medicine that is based on balancing tri doshas i.e. vata, pitta and kapha. When there is any kind of imbalance in these doshas diseases occur. Ayurveda is a science of life that treat the root cause of the disease to prevent its further occurrence. Also importance of diet and life style is given in ayurveda for treating disorders.
• Many kind of herbs have been given in ayurveda that are used from many years in treating various disorders.

Herbs for Writer’s cramp

• Ashwagandha – Withania somnifera

Ashwagandha is widely used herb in ayurveda that is commonly used in treating various disorders . Ashwagandha not only posses therapeutic properties but also acts as an immunity booster. It acts as anti oxidant agent so in helps preventing oxidative damage and  inflammations. Ashwagandha  nourishes the weakened muscles as well as tissues that prevents unwanted contractions and unusual postures of hands or fingers thus acts as good nerve tonic that strengthens the physical . Also  helpful in relieving stress or anxiety so strengthen nervous system.

• Giloy- Tinospora cordifolia

Giloy is designated as ‘ Amrit herb of ayurveda ‘due to its ability to treat many disorders . Giloy contains chemical  constituents like berberine, giloin, choline due to which it acts as anti-inflammatory, anti stress, immunomodulator etc.

• Brahmi – Bacopa monnieri

Bacopa monnieri commonly known as brahmi is  designated as ‘Herb of Grace’ . Brahmi is a very good  CNS stimulator, that is helpful in treating brain disorders. Brahmi contains  active constituents like triterpenoids saponins , alkaloids, sterols which help in overcoming the many disorders like mental diseases related to memory impairment, sleeplessness and protects bone from arthritis and inflammations. Brahmi acts  a brain tonic which relaxes muscle contraction associated which brain cells and soothes the nerve cells and helps in prevention of writer’s cramp.

• Guggulu – Commiphora mukul

Guggulu is considered as one of the best medicine in ayurveda for treating vata disorders. Guggulu is very helpful in treating painful condition also a very good anti inflammatory agent. So it helps in balancing the vitiated doshas of the body.

• Turmeric – Curcuma longa 

Turmeric is one of widely used herbs in ayurveda . Turmeric contains curcumin which helps in  relieving pain, inflammation and stiffness. Antioxidants presents in turmeric  neutralize free radicals thus helping to protect our cells and tissues and relieves pain 

• Ginger – Zingiber officinalis

Ginger contains chemical compounds like gingerols and shogaols that posses  anti-inflammatory properties . These compounds also have antioxidant properties so helpful in  providing strength to nervous system and relieve pain and stiffness.