WHAT IS WRITIER'S CRAMP?

Technically, “writer’s cramp” is not an overuse syndrome. Writer’s cramp is a problem of incoordination and loss of control of movement arising in the basal ganglia of the brain. Its cause is unknown. The symptoms are localized, sustained muscle contractions that cause twisting and repetitive movements or abnormal postures when a person performs a specific, fine motor task such as writing. Pain and cramping is uncommon, although discomfort in the forearm wrist and fingers may be present. (Sources: www.dystonia.ie; en.wikipedia.org/wiki/dystonia)

WRITING CAN CONTRIBUTE TO RSIs

Although true writer’s cramp is a rare syndrome, hand pain, muscle fatigue and cramping from repetitive writing is not. Even if writing is not a large part of the job, writing can contribute to the development of repetitive strain injuries. Forceful gripping of the pen and pressing the tip onto the paper, awkward positioning of the pen or the paper, contact stress from holding the pen or leaning on the wrist or forearm are all risk factors of musculoskeletal disorders. In addition to addressing the keyboard and mouse as contributing factors to hand, wrist and forearm pain, writing technique should also be considered.

HISTORY

As early as 1700, Bernardino Ramazzini, considered to be the founder of occupational and industrial medicine, wrote that "the incessant driving of the pen over paper causes intense fatigue of the hand and the whole arm because of the continuous . . . strain on the muscles and tendons." (Source: www.whonamedit.com/doctor.cfm/428.html)

In 1995, almost 300 years after Ramazzini described the occupational hazards associated with writing, the first ergonomic pen was introduced to the mass market. The Dr. Grip pen, with a rubberized and wide-body barrel was designed with the purpose of increasing writing comfort.

Several other wide-body pens followed quickly thereafter including the PhD and the BIC XXL. All of these styles followed the quill, stick-style design.

Recently, the ergonomics of writing have been addressed with alternative pen designs that fit the hand better and reduce the pressure and tension of writing. These pens are breaking away from the standard stick-pen look. Such designs include the EZ Grip, the PenAgain, the RingPen, and the EvoPen.

A Review of Ergonomically Designed Pens

WRITING TECHNIQUE - ERGONOMIC TIPS

The following are some writing tips to reduce your risk of hand and arm pain.

To Reduce Force

• Use the lightest grip possible while writing.
  
• Use ergonomically designed or wide-barrel pens.
  
• Use a rubberized grip or increase traction by wrapping a rubber-band around the pen barrel.
  
• Use a felt-tip pen, gel pen or roller ball so that the tip glides easily over the paper.
  
• Do not plant your wrist or forearm on the desk. Glide over the surface of the desk using your shoulder to initiate the movement of writing.
  

To Avoid Awkward Postures

• Keep the wrists neutral.
  
• Position the elbow so that it is open at more than a right (90 degree) angle.
  
• Keep the shoulders relaxed.
  
• Keep the hand relaxed and avoid forceful bending or hyperextension of the finger joints or thumb when holding the pen.
  
• Position the paper you are writing on about 2 inches above elbow level while sitting with your shoulders relaxed.
  
• Use a sloped desk to reduce the need to bend the neck or round the shoulders forward.
  
• Place the paper in a position that is easily accessible.
  
• Use a microdesk writing platform above the keyboard.
  
• Get in close to the work surface.
  
• Don’t reach around objects placed on the desk while writing.
  
• Don’t hold a pen while typing.
  
• Use a headset if you need to type and speak on the phone at the same time.
  

To Reduce Contact Stress

• Consider one of the new ergonomically designed pens.
  
• Use the lightest hold possible while still maintaining control of the pen.
  
• Don’t lean on the wrist or the forearm, especially on the sharp edge of a desk.
  
• Use a round, not a triangularly-shaped, rubberized grip.
  

To Reduce Repetitive Writing Movement

• Take microbreaks.
  
• Stretch often.
  
• Vary work tasks.
  

For more information on hand and upper extremity injuries, prevention and recovery, visit Hand Health Resources.