What is Writer’s Cramp?
Writer’s cramp Writer’s cramp, also called mogigraphia and scrivener’s palsy, is a disorder caused by cramps or spasms of certain muscles of the hand and/or forearm, and presents itself while performing fine motor tasks, such as writing
or playing an instrument. Writer’s cramp is a task-specific focal dystonia of the hand. ‘Focal’ refers to the symptoms being limited to one location (the hand in this case), and ‘task-specific’ means that symptoms first occur only when the individual engages in a particular activity. Writer’s cramp first affects individuals by interfering with their ability to write, especially for prolonged periods of time.
In simple,sudden painful contraction with pain of certain muscles of hand and or fingers is termed as writer’s cramp. It is a problem that involves nervous system too as after researches it has found that who have reduced level of gray matter in brain are more prone to have with this condition. Writer’s cramp involves musculoskeletal system because symptoms are seen with stiffness of hand muscles with pain and discomfort. Patient experiences uncontrolled, tiresome contractions of hand muscles that alter the normal movements and position of hand.
What are the causes of Writer’s Cramp?
Although the cause of writer’s cramp is not well known, it was historically believed to be the result of excessive fine motor activity, possibly complicated by a tense or otherwise inappropriate writing technique.
Musician’s cramp (a similar focal dystonia which affects some 1% of instrumentalists) has historically been grouped together by research clinicians with writer’s cramp because of this and their common task-specificity. No matter exactly how it arises, researchers generally agree that these types of focal dystonia are the result of a basal ganglia and/or sensorimotor cortex malfunction in the brain.
Early symptoms may include loss of precision muscle coordination (sometimes first manifested in declining penmanship, frequent small injuries to the hands, dropped items and a noticeable increase in dropped or chipped dishes), cramping pain with sustained use and trembling. Significant muscle pain and cramping may result from very minor exertions like holding a book and turning pages. It may become difficult to find a comfortable position for arms and legs with even the minor exertions associated with holding arms crossed causing significant pain similar to restless leg syndrome.
Affected persons may notice trembling in the diaphragm while breathing, or the need to place hands in pockets, under legs while sitting or under pillows while sleeping to keep them still and to reduce pain. Trembling in the jaw may be felt and heard while lying down, and the constant movement to avoid pain may result in the grinding and wearing down of teeth. The voice may crack frequently or become harsh, triggering frequent throat clearing. Swallowing can become difficult and accompanied by painful cramping. Patients may also present with varying degree of disability and symptoms, such as experiencing more difficulty writing down-stroke as compared to writing upstroke.
Direct symptoms may be accompanied by secondary effects of the continuous muscle and brain activity, including disturbed sleep patterns, exhaustion, mood swings, mental stress, difficulty in concentrating, blurred vision, digestive problems and short temper. People with dystonia may also become depressed and find great difficulty adapting their activities and livelihood to a progressing disability. Side effects from treatment and medications can also present challenges in normal activities.
In some cases, symptoms may progress and then plateau for years, or stop progressing entirely. The progression may be delayed by treatment or adaptive lifestyle changes, while forced continued use may make symptoms progress more rapidly. In others, the symptoms may progress to total disability, making some of the more risky forms of treatment worth considering in the future.
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Who can get Writer’sCramp?
Both men and women are equally affected and can be seen most commonly in people after 30 or 35 years of age. It can be primary or complication of some diseases (secondary).
What are the symptoms of Writer’s Cramp?
Symptoms of Writer’s Cramp
1. Altered hand writing
2. Improper writing mode
3.Not able to hold the pen
4.Not able to grip objects
5.Not able to perform tasks like playing instrument
6.Hand’s discomfort and uneasiness
7.Stiffness and pain of hand muscles
8.feeling of vibrations in affected hand
9.Stress and mental fatigue
Symptoms vary in patient to patient and can be very severe in some which can be there for years.
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What is the treatment for Writer’s Cramp?
Although dystonias may be induced by chemical exposure/ingestion, brain injury, or hereditary/genetic predisposition, the task-specific focal dystonias such as writer’s cramp are a unique challenge to diagnose and treat.
Behavioral retraining attempts may include writing devices, switching hands, physical therapy, biofeedback, constraint induced motion therapy and others.
Some writing instruments allow variations of pressure application for use. None of these are effective in all cases, however. A few medications described hereunder are useful in controlling dystonia of fingers-hand and arm muscles:
1.AZARAQI: 1 capsule three times a day with warm water followed with milk for 30 to 50 days
2.Painostat: 1 capsule three times a day with warm water followed with milk for 30 to 50 days
3.Ashwagandha choorna:1teaspoonful along with AZARAQI or Painostat capsule three times a day with warm water followed with milk for 30 to 50 days
4.Dynogesic liniment: Application for external massage on painful areas to be used as per requirement
AZARAQI,Painostat,Ashwagandha choorna and Dynogesic liniment are conceived and formulated by expert team of GAMS,B.Pharm (Ay)and MSc (Med.Botany) and BAMS personnels