How To Avoid Hand Pain While Writing?

How To Avoid Hand Pain While Writing
Handwriting for Healthy Hands Be aware of your posture and sitting position when you write. Your body position affects the way you use your arm and hand. Here are some hints to follow when writing:

Avoid leaning heavily on your forearm.Keep your elbow positioned in an open angle (90 degrees or more). Wrist and hand strain increases the more your elbow bends.Keep your fingers relaxed. Your knuckles should not be curled up or turn white when you write.Reduce finger motions. Use your wrist and forearm to move the pen or pencil rather than your fingers.Re-orient your writing paper or use an inclined surface to keep your wrist relaxed, especially for left-handed writing.If writing hurts your thumb, try holding the pen in the web space between your index and middle fingers.Handwrite rather than print. Large, cursive style writing causes less strain than printing small letters.Select large diameter pens and pencils or use rubber grips to reduce gripping force.Place Leaf-It-Finger dots or grips on fingers to increase friction. Tape or tubing can be applied to pens and pencils to increase surface friction.Replace standard ballpoint pens with easy flow ink fountain pens, roller balls, and gel ink pens.Write at a reasonable pace with frequent breaks.

: Handwriting for Healthy Hands


Why does my hand hurt when writing?

Simple Writer’s Cramp – This type of writer’s cramp causes difficulty in performing a specific task. This task is often writing with a pen or pencil. Simple writer’s cramp is most often caused by the wrong placement of the pen in the hand, poor posture when writing and using your hand too much.

Why does my hand hurt when I hold a pencil?

Modifications to Pencil Grip | The Hand Society As a pediatric hand therapist, I see clients who hold their pens and pencils a little bit differently than most. Typically, these clients are using a different grip to compensate for weakness or loose joints. Another example involves holding the pencil tight in the first web space while using all four fingers and thumb to stabilize the pencil. Hand pain from using a non-traditional grasp typically comes from the force of grasp and muscle fatigue. Joints can also be painful due to the position of the joint and the amount of stress on the joint. The goal of hand therapy is to provide alternative methods of pencil grasp to allow decreased force on the joints and muscles while writing. The web space is tight and provides stability and allows the fingertips to move freely. I suggest a pencil grip to decrease force and increase stability. This allows a comfortable grip of the pencil and stability for the fingers. At times, a small splint (orthosis) may assist in providing stability of a joint. An exercise program to strengthen the muscles that cross the joints can be a beneficial addition.

How can I heal my hand from writing?

– There’s no simple, one-size-fits-all approach to treating writer’s cramp. And there’s no cure. You may need to try a variety of therapies, and probably will have to combine a couple of them. A typical treatment plan may include:

Physical and occupational therapy. Learning how to hold your pen differently, using fatter pens or grips, using special-made splints, and changing your paper or arm position can all help writer’s cramp. Botulinum neurotoxin (Botox) injections. Botox injections into selected muscles can help ease writer’s cramp, especially when the wrist or fingers move into unusual postures. Oral medications. Anticholinergic drugs, such as trihexyphenidyl (Artane) and benztropine (Cogentin), help some people. Relaxation and distraction. Relieve stress-induced cramping through relaxation techniques like deep breathing and visualization, or through distractions like writing with both hands at the same time. Sensory re-education. This process of identifying textures and temperatures with your fingers helps retrain brain patterns that cause writer’s cramp. Sensory motor retuning. This rehabilitation therapy uses splints on your unaffected fingers to help retrain the affected fingers. Surgery. Both pallidotomy and pallidal deep-brain stimulation have been effectively used for generalized dystonia, but surgery isn’t usually necessary for task-specific dystonia like writer’s cramp.

How can I strengthen my hand joints?

Slideshow 10 Ways to Exercise Hands and Fingers Medically Reviewed by on October 01, 2022 Hand and finger exercises can help strengthen your hands and fingers, increase your range of motion, and give you pain relief. Stretch only until you feel tightness. You shouldn’t feel pain. Start with this simple stretch:

  • Make a gentle fist, wrapping your thumb across your fingers.
  • Hold for 30 to 60 seconds. Release and spread your fingers wide.
  • Repeat with both hands at least four times.

Try this stretch to help with pain relief and to improve the range of motion in your hands:

  • Place your hand palm-down on a table or other flat surface.
  • Gently straighten your fingers as flat as you can against the surface without forcing your joints.
  • Hold for 30 to 60 seconds and then release.
  • Repeat at least four times with each hand.

This stretch helps improve the range of motion in your fingers.

  • Hold your hand out in front of you, palm facing you.
  • Bend your fingertips down to touch the base of each finger joint. Your hand should look a little like a claw.
  • Hold for 30 to 60 seconds and release. Repeat at least four times on each hand.

This exercise can make it easier to open door knobs and hold things without dropping them.

  • Hold a soft ball in your palm and squeeze it as hard as you can.
  • Hold for a few seconds and release.
  • Repeat 10 to 15 times on each hand. Do this exercise two to three times a week, but rest your hands for 48 hours in between sessions. Don’t do this exercise if your thumb joint is damaged.

This exercise helps strengthen the muscles of your fingers and thumb. It can help you turn keys, open food packages, and use the gas pump more easily.

  • Pinch a soft foam ball or some putty between the tips of your fingers and your thumb.
  • Hold for 30 to 60 seconds.
  • Repeat 10 to 15 times on both hands. Do this exercise two to three times a week, but rest your hands for 48 hours in between sessions. Don’t do this exercise if your thumb joint is damaged.

Use this exercise to help increase the range of motion and flexibility in your fingers.

  • Place your hand flat, palm down, on a table or other surface.
  • Gently lift one finger at a time off of the table and then lower it.
  • You can also lift all your fingers and thumb at once, and then lower.
  • Repeat eight to 12 times on each hand.

Strengthening the muscles of your thumbs can help you grab and lift heavy things like cans and bottles.

  • Put your hand flat on a table. Wrap a rubber band around your hand at the base of your finger joints.
  • Gently move your thumb away from your fingers as far as you can.
  • Hold for 30 to 60 seconds and release.
  • Repeat 10 to 15 times with both hands. You can do this exercise two to three times a week, but rest your hands for 48 hours in between sessions.

This exercise helps increase the range of motion in your thumbs.

  • Start with your hand out in front of you, palm up.
  • Extend your thumb away from your other fingers as far as you can. Then bend your thumb across your palm so it touches the base of your small finger.
  • Hold for 30 to 60 seconds.
  • Repeat at least four times with both thumbs.

This exercise helps increase the range of motion in your thumbs, which helps with activities like picking up your toothbrush, fork and spoon, and pens when you write.

  • Hold your hand out in front of you, with your wrist straight.
  • Gently touch your thumb to each of your four fingertips, one at a time, making the shape of an “O.”
  • Hold each stretch for 30 to 60 seconds. Repeat at least four times on each hand.

Try these two stretches for your thumb joints:

  1. Hold your hand out, palm facing you. Gently bend the tip of your thumb down toward the base of your index finger. Hold for 30 to 60 seconds. Release and repeat four times.
  2. Hold your hand out, palm facing you. Gently stretch your thumb across your palm using just your lower thumb joint. Hold for 30 to 60 seconds. Release and repeat four times.
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If your hands and fingers feel painful and stiff, try warming them up before you exercise. This can make it easier to move and stretch. Use a heating pad or soak them in warm water for about five to 10 minutes. Or, for a deeper warmth, rub some oil on your hands, put on a pair of rubber gloves, and then soak them in warm water for a few minutes.

  • 1) Steve Pomberg/WebMD
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  • 3) Steve Pomberg/WebMD
  • 4) Steve Pomberg/WebMD
  • 5) Steve Pomberg/WebMD
  • 6) Steve Pomberg/WebMD
  • 7) Steve Pomberg/WebMD
  • 8) Steve Pomberg/WebMD
  • 9) Steve Pomberg/WebMD
  • 10) Steve Pomberg/WebMD
  • 11) D-BASE/Photodisc
  • 12) Igor Kisselev/Flickr
  • Catherine Backman, PhD, FCAOT, professor and head of the Occupational Science and Occupational Therapy Department at the University of British Columbia, Vancouver, BC.
  • Kaiser Permanente: “Hand Arthritis: Exercises.”

Lorig, K. The Arthritis Helpbook.6th ed., Da Capo Press, 2006. National Institute on Aging: “Exercise & Physical Activity: Your Everyday Guide from the National Institute on Aging.” Kristin Valdes, OTD, OT, CHT, hand therapist in private practice in Venice, Florida. Valdes, K. Journal of Hand Therapy, May 2012. : Slideshow 10 Ways to Exercise Hands and Fingers

What is the correct way to hold a pen?

How important is economic pen holding? – Let’s start with sitting. You should be relaxed and upright in an adequate trunk posture when starting to write. Tight shoulders or excessive bending of the torso with the head on the table are unfavourable for a good and healthy posture.

  1. The forearm and wrist are on the table.
  2. The non-writing hand is also on the table and can hold the notebook.
  3. The writing should not require too much force; if the child pushes firmly on the desk pad or holds the pen tightly, then the hand becomes tired quickly.
  4. Writing with the entire arm and keeping the wrist stiff will result in pain that spreads to the arm and shoulder-neck region.

In addition, writing speed and writing endurance are reduced, making the lines unclear and reducing the ability to read the handwriting. Here are some examples of difficult ways of holding a pen that will adversely affect the flow of writing and the speed.

Paw grip: The index finger covers the thumb instead of resting on the pen. Cramped grip: The pen lies on the fingers and is guided with the thumb. The thumb is on one side whilst the index and middle finger are on the other side. The thumb grips above the index finger. The index and middle finger grip above the thumb. The whole hand is arched like a fist around the pen. The thumb is usually on the opposite side and holding against it. Fist grip: Pen is held with the whole fist

What is the correct pencil grip?

Lateral Tripod Pencil Grip – The lateral tripod uses the thumb, index and middle fingers to grip the pencil shaft. Although the tips of the index and middle fingers are used, it is the pad of the thumb that is used in this grip. In a lateral grasp (whether tripod or quadripod), the thumb crosses over the shaft of the pencil, and the pad of the thumb often rests against the index finger (instead of the pencil shaft).

What is the correct grip to hold a pencil?

General guidelines for a good pencil grip, as shown in figure 2, include: ◗ the pencil is held in a stable position between the thumb, index and middle fingers ◗ the ring and little fingers are bent and rest comfortably on the table ◗ the index finger and thumb form an open space ◗ the wrist is bent back slightly, and

Which type of hand writing is best?

Most tend to prefer cursive handwriting, where uppercase and lowercase letters flow together on a piece of paper. Writers with particularly good penmanship may even choose a career in hand lettering and typography design.

How can I relax my nerves in my hands?

Wrist Flex and Extend –

Hold your arm straight out in front of you, wrist and hand straight, palm of your hand facing down.Bend your wrist down so your fingers point toward the floor.Use your other hand to increase the stretch, gently pulling the fingers toward your body.Hold for 15-30 seconds.Return to a straight, neutral wrist with palm facing down.Bend your wrist up so your fingertips point toward the ceiling.Use your other hand to gently pull your fingers back toward you.Repeat 10 times.Do this up to three times a day.

Why is my hand paining so much?

Carpal Tunnel Syndrome This is one of the most common nerve disorders of the hand. It causes pain in the: Palm and some fingers of the hand. Wrist.

Which pen is best for writing fast?

The best pens for writing fast – The easiest way to improve your writing speed is to change your pen.,,, or are considered the best tools for writing quickly, for a number of reasons:

Less drag on the paper, which reduces the amount of pressure you need to apply. Better quality ink requires less effort to put pen to paper, meaning decreased strain on your fingers and wrist. Thinner tips allow you to write with less downward pressure, making it easier to form smaller and thinner letters, another tip for fast writing. Good quality rollerball, ballpoint, and fountain pens have a comfortable grip, which promotes good form and a speedier technique.

How do you get 100 in all your exams?

Download Article Download Article Have you got an important test coming up that you really want to ace? Do you generally want to improve your grades and marks? There are a number of tricks and practices which can significantly improve your chances of scoring high on a test. This article will help you in studying, analyzing, and solving exam questions, so read on!

  1. 1 Pay attention in your classes and focus. The best thing you can do to raise your test scores is to pay attention when you’re supposed to be learning the material: in class! Letting your mind wander or not showing up at all are both likely to make you miss out on key information that will later appear on tests.
  2. 2 Take good notes, This is important if you want to have an easier time studying later. Not only will writing the information down as you learn it help you in absorbing the information and paying attention, but you’ll have a reference for when you go to study later. Advertisement
  3. 3 Do your homework, Homework, such as assignments and at-home reading are where you will find the rest of the information that will be on tests, so doing this homework is important. Schedule time and set aside a quiet place just for homework to help beat the procrastination blues.
  4. 4 Use mnemonics and other tricks. Various memory tricks really can be useful for remembering certain things like numbers, categories, and lists. Just make sure that you learn them correctly and don’t mix them up!
    • Mnemonics are phrases which can help you remember the order of certain things. For example, “Katy Perry Came Over For Great Songs” is a great way to remember the biological classifications (Kingdom, Phylum, Class, Order, Family, Genus, Species).
    • Another memory trick is if you have to remember a string of numbers. Instead of trying to remember 2537610925, for example, break it up like a phone number: 253-761-0925. You can break up dates this way too.14 Oct 1066 (the Battle of Hastings) can become a locker combination: 14-10-66.
    • “PEMDAS” is a popular math mnemonic for orders of operations, while “FANBAY” is a well-known English grammar mnemonic for conjunctions.
  5. 5 Do practice tests. Ask your teacher or go online and print a few practice tests. Taking a practice test will help you figure out how much information you actually know vs how much information you think you know. Knowing your weak spots before a test is crucial!
    • You can always make your own mock exams based on your study materials.
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  1. 1 Study frequently. Studying hard for only a few hours the night before the test isn’t going to help ensure perfect scores. If you really want to ace those exams, study old and new material every day, or at least several times a week. This will make test-taking a breeze.
    • Take study breaks, When you study, make sure you take a 5–10-minute break after every 30 minutes of study. This will help keep your brain from getting overloaded and give it more time to absorb the information.
    • On study breaks, try not to fill your brain with more information, even if that information is more about your favourite celebrity’s latest concert rather than Winston Churchill’s foreign policy.
  2. 2 Study according to a learning style that fits the subject. Certain subjects are easier to understand when studied using a style that connects to the nature of the subject. For instance, if you’re studying literature, you’ll need visual reading and writing activities. If you’re studying music, you’ll need auditory resources. For art courses, kinesthetic activities often help.
    • Learning styles, as conventionally understood, are somewhat controversial. Many academic studies suggest that learners develop subjective preferences for studying material, but these styles don’t necessarily mean they learn better through these styles.
    • Nevertheless, the idea of learning styles still persists even in academic circles. If a subjective preference for a certain learning style helps motivate you to study, you can still try it.
  3. 3 Take advantage of sense memory. Your brain is pretty good at associating smells or sounds with ideas or memories. You should take advantage of this! While you’re studying, wear some unusual cologne or perfume (with a smell you don’t usually encounter) and then expose yourself to that smell again right before or during a test.
  4. 4 Listen to music, Your teacher probably won’t let you have headphones during a test, but you should at least listen to music, specifically classical music, right before taking a test. Studies have proven that exposure to certain types of music right before rigorous mental activity can really help, by waking up your brain and increasing your awareness.
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  1. 1 Eat right, The most important thing is to eat, full stop. Being hungry during a test will distract you and make you tired. Don’t eat too soon before a test though, as some foods can make you tired. Instead, make sure you get a meal filled with lean protein before you have to take a test.
    • Eating healthy will generally boost brain performance too, so make sure you’re always eating a healthy diet to help you learn all through school.
  2. 2 Sleep well. If you don’t sleep, you won’t be able to focus when the pressure’s on! Make sure to go to bed early the night before a test, rather than staying up all night to study. Your brain won’t be able to hold on to all that crammed information anyway.
  3. 3 Have all the necessary supplies. Go to your test with all of the calculators, pens, pencils, blank paper, and other supplies you might need. Not having these things could mean you’ll have a much harder time!
  4. 4 Drink lots of water. Getting dehydrated during a test can be distracting and reduce your ability to think clearly. Stay hydrated before your test and bring a bottle of water with you to the test as well.
  5. 5 Don’t do anything different. If you aren’t used to drinking coffee, now is a bad time to start. Try not to do anything different in your basic routine the day of or the night before the test. This can really throw you off.
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  1. 1 Write important things down first. As soon as the test starts, write down all formulas or other important information on some scratch paper before you start going through the questions. This will help keep you from blanking when you need that information later.
  2. 2 Do the problems you know first. Always do the fast, easy problems to which you know the answer first. This will help make sure that you get as much of the test done as possible. If you get stuck, just move on to the next problem that you can answer quickly.
  3. 3 Cross out the wrong answers. Once you’ve answered the questions you know, move on to the ones you’re not sure about. When you’re dealing with multiple choice questions, eliminating answers that you know are impossible or silly will help you better decide between the possible options.
  4. 4 Look for clues in the other questions. Sometimes the answer to a question can be contained within or hinted at in another question on the test. Look at other answers or questions to help jog your memory.
  5. 5 Never leave questions blank. Unless you’re docked for incorrect answers, never just leave a question blank. Especially if it’s multiple choice; you’ll at least have a 25% chance of getting the right answer.
    • As mentioned above, this is where eliminating wrong answers will come in handy.
  6. 6 Pace yourself. This is important! Always keep track of how much time you have and try to use your time wisely. You can always go back to check or improve your answers later!
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Add New Question

  • Question Should I stay up late or wake up early to cram? Ted Coopersmith is an Academic Tutor for Manhattan Elite Prep, a test prep and academic tutoring company based in New York City. In addition to general academic advising, Ted has expertise in preparing for the ACT, SAT, SSAT, and ASVAB tests. He also has over 30 years of financial controller advising and consulting experience. Academic Tutor Expert Answer Intensely studying the night before or the morning of an exam isn’t that helpful. Instead, do a light review of some of the important concepts and mnemonic aids on your study outline.
  • Question How can I pay attention in class better? Try to sit at the front seats. Secondly select a group of friends who do not distract you from concentrating in the class. Take notes and ask questions whenever they come up. Find a way to make the work matter – either by looking up uses you might enjoy, setting a goal (such as by passing a test) or challenging the teacher and student’s viewpoints. If you’re engaged, you’ll pay better attention.
  • Question How can I stop feeling sleepy when I study? Try to stay active when studying. If you are studying a lesson which is boring, read it out loud or even walk around your room while you read. If reading out loud doesn’t work, try teaching it to some stuffed toys as if they were your pupils. Once you can teach someone else you really know it.

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  • Try not to worry about bad marks on previous exams. Instead, take a deep breath whenever you think about it, be optimistic and study well for upcoming exams. Focus on the future instead of the past. As a small thank you, we’d like to offer you a $30 gift card (valid at Use it to try out great new products and services nationwide without paying full price—wine, food delivery, clothing and more. Enjoy!
  • Make notes while studying. Write a synopsis for your subject if you are studying it for the first time. This will help you in the future examinations by allowing you to remember the contents of your subjects. As a small thank you, we’d like to offer you a $30 gift card (valid at Use it to try out great new products and services nationwide without paying full price—wine, food delivery, clothing and more. Enjoy!
  • Make a list of all the things you need to do to study for each subject, and how long you think it will take you. Use this information to make up a study timetable, organizing it so that a harder subject takes more space than an easier subject. Be certain that you have given yourself all the time you think you need, plus a little extra per subject. Also make sure your study plan has enough free space in it so you can shuffle around your plan if something unexpected comes up one day. As a small thank you, we’d like to offer you a $30 gift card (valid at Use it to try out great new products and services nationwide without paying full price—wine, food delivery, clothing and more. Enjoy!

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  • Do not be overconfident. If you are, then your grades will slip. For example, you get 95/100 on your math exam, and if you think you don’t need to study, your second exam you will get 80/100. As a small thank you, we’d like to offer you a $30 gift card (valid at Use it to try out great new products and services nationwide without paying full price—wine, food delivery, clothing and more. Enjoy!
  • Never try to cheat. You are very likely to get caught, which would result in a zero. Be confident, Believe in yourself. If you have the attitude to do well, then you will! As a small thank you, we’d like to offer you a $30 gift card (valid at Use it to try out great new products and services nationwide without paying full price—wine, food delivery, clothing and more. Enjoy!

Advertisement Article Summary X To get higher marks in your exams, take thorough notes in your classes so you can use them to study. Also, try to study for at least 30 minutes every day leading up to your exams so you memorize the material. Avoid cramming for your tests the night before or you could overload your brain and forget everything.

Is writer’s cramp a disability?

Abstract – Writer’s cramp is a task-specific hand dystonia affecting handwriting. Clinical scores such as the Arm Dystonia Disability Scale (ADDS) or Writer’s Cramp Rating Scale (WCRS) as well as kinematic analysis of handwriting movements have been used to assess functional impairment in affected patients.

In 21 patients with writer’s cramp and healthy controls, we analyzed the kinematics of writing and cyclic drawing movements. We rated the severity of dystonia using the ADDS and WCRS and correlated the clinical scores with movement kinematics. Mean stroke frequency was significantly reduced in dystonic patients.

Drawing movements showed more frequently a decrease in stroke frequency than handwriting movements. During circle drawing, mean vertical peak velocity was more variable in patients relative to controls, indicating an impaired ability to reproduce the same kinematic pattern over time.

An increase in vertical writing pressure was only observed during handwriting but not during circle drawing and may reflect a compensatory effort to stabilize the pencil. Kinematic measures and individual ADDS and WCRS scores did not correlate with each other. The lack of correlation is not surprising as ADDS, WCRS, and kinematic analysis probe different aspects of motor impairment.

The ADDS characterizes how dystonia affects a set of fine manual tasks, whereas the WCRS scores the manifestation of dystonia during handwriting. Therefore, the clinical scores and kinematic analysis of handwriting provide complementary insights into motor impairment.

Why can’t I write with my hand?

If you’re having trouble signing on the dotted line, or you’ve noticed a change in your handwriting, it may signal more than just sloppy writing. It could indicate a neurological or muscular problem. “When someone’s handwriting changes and becomes messy, sloppy, illegible or shaky, that might be a sign of an essential tremor, Parkinson’s disease, writer’s cramp or ataxia,” says neurologist Camilla Kilbane, MD,

Along with physical issues, loss of legible handwriting in seniors makes it difficult to perform everyday tasks like writing checks, making shopping lists, filling out forms and sending notes,” she says. The two most common reasons for a change in handwriting are essential tremor and Parkinson’s disease, she says.

An essential tremor is a neurological condition that causes a rhythmic, involuntary, trembling of the hands, head, voice, legs or body. An essential tremor is eight times more common than Parkinson’s disease and affects an estimated 10 million Americans.

Make a deliberate effort to form each letter. This can be hard to do at first, but is very effective in improving size and legibility of handwriting. Use a pen grip (round or triangular-shaped rubber or foam cylinders available at stationery stores or where writing materials are found) or a larger-sized pen to keep your hand more relaxed. Try printing rather than writing in a cursive style. Printing causes you to pause briefly between each letter, keeping writing more legible. Using lined paper may provide a “visual target” to keep all letters big when writing. A ballpoint pen typically works better than felt tip or “rolling writer” styles. Rest your hand if it begins to feel “tight.” Pause briefly when you see your handwriting becoming smaller. Avoid hurrying or trying to write long passages if you’re feeling stressed. Practice helps. Remind yourself to slow down, aim big and pause often.

According to Dr. Kilbane, writer’s cramp, a type of focal dystonia, is another reason a person’s handwriting can deteriorate. Hand dystonia causes excessive muscle contractions in the hand and arm, which affects writing. It’s usually observed in people who perform tasks repeatedly.

This often affects musicians and people who frequently write longhand. “In hand dystonia, involuntary muscle contractions make it hard to write legibly,” Dr. Kilbane says, “The recommended treatment is occupational therapy, Botox injections and a special ‘Y’-shaped, rubber-coated ergonomic designed pen to make writing easier and more fluid.” Ataxia, which is a group of disorders that affects coordination, speech and balance, can also affect the fine motor skills needed for handwriting.

“Ataxia is caused by damage to the part of the brain controlling muscle coordination, called the cerebellum,” she says. “Since writing is a fine-motor skill, when a person has ataxia, their handwriting may suffer.” Dr. Kilbane advises whenever you notice a change in your handwriting and are uncertain of the cause, it’s wise to see a medical professional to determine the reason for this change, so that you can develop a method to deal with it.

  • We work to improve the symptoms involving handwriting issues as we treat the underlying diagnosis,” she says.
  • Camilla Kilbane, MD is a neurologist and directs the fellowship program in movement disorders in the Parkinson’s and Movement Disorders Center at University Hospitals Cleveland Medical Center,

You can request an appointment with Dr. Kilbane or any other doctor online.

Can writer’s cramp be cured?

Abstract – Background: Writer’s cramp is a type of focal dystonia due to dysfunction of the pallido-thalamo-cortical circuit. The symptom is refractory to most conservative treatment, though botulinum toxin injection is generally used for symptomatic relief. As a surgical treatment of dystonia we performed stereotactic nucleus ventrooralis (Vo) thalamotomy for dystonic cramp of the hand. Method: Eight patients (5 men, 3 women, age 26-40 yrs, mean 32.1 yrs) with medically intractable task-specific focal dystonia of the hand underwent Vo thalamotomy. Stereotactic target was chosen at the junction of the anterior and posterior Vo nuclei. Findings: The mean duration of the symptom ranged from 3 to 6 years (mean, 4.0 yrs). All patients had complained of difficulty in writing. Six patients were professional workers, such as comic artist, guitarist, and barber, and, because of the dystonic symptoms at their professional work, they had stopped pursuing their profession. All patients showed immediate postoperative disappearance of dystonic symptoms, and the effect was sustained during the follow up period (3-29 months, mean 13.1 mo) except in one case. One patient showed partial recurrence of the symptom and underwent second thalamotomy 5 months after the initial surgery with satisfactory results. The score of the writer’s cramp rating scale significantly (p < 0.001) decreased after Vo thalamotomy. There was no permanent operative complication. There was no mortality or permanent morbidity. Interpretation: Although a longer follow-up is needed, stereotactic Vo thalamotomy is a useful and safe therapeutic option for writer's cramp.