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Shaking Hands To Abnormal Gripping Of Pen While Writing Can Be Signs Of Writer's Cramp: What Is It Exactly?

A trembling hand while writing can mean many things. One of them is writer’s cramp. Know what our expert doctor has to say about it.

Tenzin Chodon
Written by: Tenzin ChodonUpdated at: May 27, 2023 02:30 IST
Shaking Hands To Abnormal Gripping Of Pen While Writing Can Be Signs Of Writer's Cramp: What Is It Exactly?

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In a world where laptops and computers have taken over, writing with a pen or pencil may seem traditional. However, for those who still prefer the latter form of writing, do not ignore the signs of a writer’s cramp, a neurological movement disorder. In conversation with Only My Health, Dr. Natasha Tipnis Shah, Consultant, Neurology & Epilepsy, Jaslok Hospital & Research Centre, Mumbai, explains the condition, its causes, symptoms, and lists treatment options. 

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What Is Writer’s Cramp?

Dr Shah describes writer's cramp as a task-specific focal dystonia characterised by an involuntary muscle contraction that causes repetitive muscle movements, cramps or an abnormal posturing. According to her, dystonia can be generalised, meaning it can affect multiple areas of the body or a particular part of the body. Writer's cramp for instance involves only the hand. It happens only when the individual attempts to write or when they’re attempting to indulge in activities which involve the same group of muscles, for example shaving, applying make-up, using a knife or a fork, using scissors, buttoning or unbuttoning a shirt. 

Understanding Its Causes 

According to Dr Shah, causative factors of writer’s cramp have been under research for years and there still isn’t a complete answer to it. 

“Traditionally, inappropriate posture or holding of the pen and writing for longer hours have been associated with writer's cramp,” said Dr Shah. 

Other known risk factors include a family history of similar issues, genetics (DYT1 mutation), and trauma. According to a study published in the Annals of the New York Academy of Sciences, task-specific dystonia like writer’s cramp accounts for an estimated 70 lakhs to 6.9 crore people, with a higher prevalence in men than women. 

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Symptoms To Watch Out For

Some of the common symptoms of writer’s cramp include: 

  • Excessive or abnormal gripping of the pen or pencil while writing and inability to let go of the pen/pencil
  • Inability to hold the pen/pencil correctly due to the fingers not flexing/extending correctly
  • Feeling like your wrist or fingers are "not listening to you" as you write 
  • Tremor in the affected hand while writing
  • Pain in the affected hand while writing 
  • Hand moving across the page while writing 

Treatment Options

If you’re diagnosed with writer’s cramp, you can get treated for the same. Some of the treatment options include: 

Behaviour modification and physical therapy 

  • Better writing techniques
  • Better posture
  • Reduction of time spent writing
  • Using a special pen made for individuals with dystonia 
  • Relaxation techniques 
  • Auditory grip force feedback

Oral medications

  • Anti-cholinergic drugs eg. trihexphenydyl

In some cases, botulinum toxin injections can be administered into specific muscles. This is often done under the guidance of an electromyography (EMG). 

How To Reduce Risk Of Writer's Cramp

You can also lower your risk of writer’s cramp. Some strategies include:

  • Develop a proper technique and posture of writing 
  • Rest your elbow and wrist when you write for longer durations to help maintain better posture
  • Take breaks while writing for a longer duration


If you experience any difficulties in writing, especially in terms of hand movements, it is best to visit a doctor and get yourself examined. A writer’s cramp may be difficult to diagnose on your own, which is why you need a professional to take a look, only then can you receive proper treatment. 

[Disclaimer: The information in this article is provided by a registered medical practitioner. However, we recommend you consult your healthcare provider for accurate diagnosis and treatment.]