Do you experience pain in your hands or when writing? Dystonia is a condition whereby sometimes it becomes painful to write or play an instrument due to cramps in the hand or arm.
The Dystonia Society is the only national charity providing support, advocacy and information for anyone affected by the neurological movement condition known as dystonia.
If the doctor is not able to explain what is causing the cramps, one possible cause is a(otherwise known as Writer’s or Musician’s Cramp). The symptoms vary and may be one or more of the following:
- Twisting or curling up of the hands while writing or playing an instrument.
- Fingers move of their own accord to unusual positions while writing or playing an instrument.
- Writing or playing an instrument becomes painful.
- Symptoms usually disappear when the above activities stop.
commonly appears in people between the ages of 30 and 50. It is one form of dystonia – a condition that causes uncontrollable and often painful muscle contractions believed to be as a result of incorrect messages from the brain to the muscles.
Dystonia is a neurological movement disorder and, if the symptoms listed above are severe or damaging to quality of life, the correct course of action is for a GP to make a referral to a neurologist specialising in movement disorders. There are treatments for hand dystonia that can significantly reduce the symptoms in many cases. Only a specialist neurologist has the knowledge and skill to diagnose and treat dystonia. If the patient and their GP agree that the symptoms might possibly indicate dystonia then the GP should refer the patient to such a specialist.
Dystonia can mimic PD in various and assorted ways and diagnosis can be difficult depending on how the disease manifests its symptoms, which are quite similar to not only PD, but other neurological disorders as well.
Focal dystonias are the most common types of dystonia. Cervical dystonia affects the neck muscles, whereas blepharospasm is known to affect the muscles around the eyes. When the jaw and tongue muscles are affected, it is known as oromandibular dystonia. The voice can be affected, causing a ‘crackling’ sound and known as spasmodic dysphonia.
There are three primary types of dystonia: basal ganglionic, mesolimbic, and dystonia from the cerebellum. All three types are from the brain or brainstem, but presentation can be clinically different with symptoms.
There are also other conditions that can cause similar symptoms, one of which is carpel or cubital tunnel syndrome. The carpal tunnel is a narrow space in the wrist that contains the median nerve. It is surrounded by the bones of the wrist (carpals) and a thick tendon sheath. Friction will cause the tendon sheath to swell and enlarge limiting the space within the carpal tunnel. As a result, the median nerve becomes compressed leading to numbness and tingling within the wrist and hand. Symptoms can be treated conservatively, with night splinting, medications, and cortisone injections. However, carpal tunnel syndrome does not resolve on its own and worsens over time.
Cubital tunnel syndrome is caused by compression of your ulnar nerve at the elbow. The ulnar nerve travels from neck down your arm through a tunnel at your elbow called the “cubital tunnel.” The nerve is especially vulnerable to compression because the cubital tunnel is very narrow and has very little soft tissue to protect it. This compression causes numbness and/or tingling pain in your elbow, hand, wrist, or fingers. This is commonly caused by leaning on your elbow for long periods of time or swelling caused by friction of your ulnar nerve rubbing along structures of the cubital tunnel.
Carpal tunnel and cubital tunnel syndrome are treated at first with conservative treatments like rest, changes in patterns of use, immobilizing the affected area with devices like splints or braces, physical therapy, medication and injections. If the symptoms do not improve after some time, your doctor may suggest a surgical procedure to relieve compression.
As you know I had cubital tunnel release surgery last year and my nerve conduction tests showed I also have carpal tunnel both of which are giving me a lot of pain at the moment. However, on the NHS list of symptoms of Fibromyalgia they do include tingling, numbness, prickling or burning sensations in your hands and feet (pins and needles, also known as paraesthesia)
The best way forward if you are suffering from any of these types of pain is to go and see your GP for him/her to decide your next move to finding out what the problem is.
Living Well with Dystonia is a great book on the subject written by by