The Symptoms of Writer's Cramp

At first, fatigue and sense of insecurity in arm and hand; patient grasps his pen too firmly; fingers seem clumsy; pen jerked up and down by twitching of the muscles of the hand and arm.

Under the head of writer's cramp may be included a number of allied diseases affecting other muscles than those of the hand; thus we have cobbler's cramp, milker's cramp, and blacksmith's cramp, as well as writer's cramp.

The Cause of Writer's Cramp

The principal cause which has been assigned to this affec tion, is the long-continued use of a single set of muscles in a particular way, as in writing, milking, and other occupations. The most recent explanation of the nature of the disease is, that it is chiefly due to an increase of the power of automatic movement in the affected parts. It is well known that when certain movements are many times repeated, they may after a time, become automatic, that is, are performed without the direct action of the will. It has been suggested that writer's cramp is an exhibition of this faculty in an exaggerated degree, due to a long continued use of one set of muscles in the same way. It is said that copyists are much more likely to be affected with the disease than editors, authors, and others who compose as they write. This explanation does not seem to us very satisfactory, however, since walking, an act which becomes almost completely automatic, is not affected by any disturbance of this sort. The observation mentioned with reference to the class of persons affected, may be readily explained by the fact that with the copyist the motions of the hand are more uniform and continuous. Authors write as they think, sometimes fast, sometimes slowly, and often with frequent pauses, which affords opportunity for the muscles to rest. It has been noticed that this affection has arisen since the introduction of steel pens, and hence it is attributed in some degree to their use. It is also thought that the disease is encouraged by anything which restricts the motions of the muscles of the arm, as a tight coat-sleeve, an elastic, or any other means of constriction.

The Treatment of Writer's Cramp

In many cases, absolute rest of the affected muscles is necessary. This frequently necessitates a change of occupation. Every possible attention should be given to improvement of the general health. The application of galvanism to the affected muscles is an effective remedy in many cases. Hot sponging, alternate hot and cold applications, and massage, are also of use. Some patients obtain the needed relief of the affected part by learning to write with the other hand; but, unfortunately, in many cases, this also becomes affected. Some relief from the disagreeable jerking may be obtained by the use of quill or stub pens.

Still more benefit may be derived by the use of a simple apparatus shown in Fig. 322, which consists in a rounded part, to be held in the hand, to which is attached an adjustable pen-holder and pen. By means of a screw, the pen-holder may be placed at any angle necessary. The fore and middle fingers are supported by rests at the sides of the instrument, while the thumb lightly grasps the rounded portion in the palm. This enables a person to write without putting the hand in the usual position, in which the pen is grasped by the thumb and forefinger. Fastening a sponge to the pen-holder at the point at which it is held, sometimes answers the same purpose. Some persons find relief to a considerable degree by grasping the pen between the first and second fingers, instead of between the thumb and forefinger.

Fig. 328. Apparatus for Relief of Writer's Cramp.

Fig. 328. Apparatus for Relief of Writer's Cramp.