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Latest wrinkle for writer's cramp: Botox

The anti-wrinkle treatment Botox may relieve stubborn cases of writer’s cramp, new research suggests.
/ Source: Reuters

The anti-wrinkle treatment Botox may also smooth out writer's cramp, new research suggests.

Writer’s cramp is a form of dystonia, in which involuntary muscle contractions force a particular part of the body into an abnormal posture or movement. For people with writer’s cramp, the abnormal contractions affect the hand and arm during writing — though in some cases similar tasks, such as using a utensil or shaving, also cause problems.

There are various treatments for the condition — from physical therapy to acupuncture to “writing re-education” — but most people find only limited relief, according to the authors of the new study.

The wrinkle-fighter botulinum toxin A, best known by the brand-name Botox, has been used to treat other forms of dystonia, such as chronic spasms of the eye muscles. The toxin helps by interfering with the chemical messages that trigger muscle contractions.

To see whether the therapy aids writer’s cramp, researchers in the Netherlands randomly assigned 40 patients to be injected in the affected muscles of the wrist and hand with either botulinum toxin or a simple saline solution. The patients were given a second injection one month later, unless they were satisfied with their recovery after the first.

“Writer’s cramp can be very disabling, and patients often feel embarrassment,” said lead study author Dr. Jose Kruisdijk of the University of Amsterdam. “Some of our patients had even lost their jobs because they almost could not write anymore.”

However, after three months, 70 percent of patients treated with botulinum toxin said their condition had improved and that they wanted to continue treatment — versus less than one-third of those given the saline injections — Kruisdijk and colleagues found.

The findings are published in the Journal of Neurology, Neurosurgery and Psychiatry.

Though botulinum toxin helped many of the study patients, the treatment does have downsides. It’s not a permanent fix, so the injections must be repeated over time, and side effects include weakness in the treated muscle.

In the current study, most patients who received the therapy reported some hand weakness, though it was usually mild and temporary, according to the investigators.

“We believe that this evidence is strong enough to treat patients who experience disabling writer’s cramp,” Kruisdijk said. “The more so as there is no other good treatment.”