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Focal Dystonia of the Hand, and what the Brain has to do with it

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Biology 202
2001 Second Web Report
On Serendip

Focal Dystonia of the Hand, and what the Brain has to do with it

Henrike Blumenfeld

The body is complicated, and often the origins of a condition are all but obvious. Focal dystonia of the hand is one disorder whose underlying cause has been found in the more recent past. Although it can be genetic (1), the form of focal dystonia of the hand I look at here is caused by environmental factors (2).

Focal dystonia of the hand is a condition characterized by a loss in motor control of one or more fingers. A single muscle or group of muscles is involved: muscles in the hand and forearm tense and tighten, with the result of making the hand (or part of it) curl (2). Musicians who have intensively practiced their instruments over a number of years are a group most affected by this condition. The reason is that focal dystonia can be caused by the repetitive movement of the fingers over a significant period of time. The condition was long known as "occupational hand cramp." (3). It can easily be misdiagnosed as simple overuse or stress of the hand (1). Although it may not be obvious at first sight of the symptoms, the level at which the problem is caused is not the hand, but the brain.

Researchers at the University of Konstanz report "overlap or smearing of the homuncular organization of the representation of the digits in the primary somatosensory cortex" (3). Given that functions such as motor control cross over from the right side of the body to be represented in the left hemisphere, they found that the distance between the representations of individual fingers was smaller in the somatosensory cortex side corresponding to the hand that had undergone continued repetitious training (the left hand in case of violin players for example).

What does all this mean in terms of the brain? Looking at the central nervous system as an input-output system, in very simple terms we can observe that a specific input is presented over and over again - in this case the stimulation of the fingers that play the violin - and as a result the organization within the box changes. More specifically, there is a one-to-one correspondence between input and internal representations of this input: all fingers are individually represented on the somatosensory cortex. But somehow, as these regions of representation begin to smear or overlap, the one-to-one correspondence is blurred.

And the result? The problem turns into one of perception and motor control. Subjects with dystonia of the hand consistently are unable to localize light pressure stimuli applied to the tips of the fingers on the correct finger(4). Further, fingers in question cannot be moved individually, and specific movements or movement sequences cannot be controlled any longer (5). We get similar effects in blind people who read Braille with several fingers at once: they develop a single representation of all these fingers on the somatosensory cortex, but are not able to determine which part of the information received in the brain comes from which finger (6). Psychologist Thomas Elbert further points out a parallel of this in all of us: our toes are generally stimulated only simultaneously as we walk, and most of us have trouble telling which of the middle toes has been touched upon application of a light pressure stimulus. Indeed, our toes are not individually represented on the somatosensory cortex as our fingers are (6).

As we can see, through some process, representations in the brain have become reorganized in a way that makes it difficult to distinguish between certain afferent inputs. These inputs enter the peripheral nervous system close to each other, say via two adjacent fingers, and have been presented to the system simultaneously over and over again. The examples are stimulation of the first and the second fingers in quick musical sequences - so quick that stimulation can be seen by the system to happen simultaneously - or continuous use of several fingers in reading Braille (6).

This continuous pairing of two (or more) stimuli, until their representations in the brain merge, is not a new idea. It has been established that if two connected neurons are stimulated at the same time, the connection between them is strengthened (7), and rules of associative learning have been based on this idea. Fittingly, Dr Merzenich of the University of California San Francisco calls focal dystonia of the hand a "learning-based catastrophe" and a "failure of the brain's learning processes" (5). Consequently, he focuses on developing techniques that will help to "re-normalize the learning system", in helping to newly distinguish the areas on the somatosensory cortex that have become blurred. Although this approach is very new, Merzenich claims some good results in training children with linguistic impairments, such as dyslexia, which show similar blurring of representations in the brain (5).

The form of focal dystonia of the hand that is caused by repetitious training of two or more inputs is a clear indicator of the brain's ability to restructure itself. Traditionally, the belief has been that the capacity to restructure is present during childhood, and that the adult brain shows little room for change (6). However, as we can see, the adult brain is still capable of rather far-reaching change, and the old view of a hard-wired adult brain is thus being challenged. Further, we have seen that the central nervous system reacts to the kind of input it receives from the outside world, and the context this input is presented in (what are other impulses presented at the same time?). According to what these inputs are, there seems to be at least some leeway for the brain to adjust, in order to process these inputs in a way that may be more efficient. Indeed, this movement towards efficiency is fulfilled in the combining of various fingers into one larger representation in blind readers of Braille. Those skilled at reading Braille with multiple fingers are quicker than readers of Braille that use only a single finger. However, focal dystonia of the hand also suggests that there may be some rare inputs (such as long-term repetitious practicing of fast musical sequences) that "trick" the central nervous system into making changes that are clearly less beneficial.


WWW Sources

1)The most dangerous medical condition of all: Focal Dystonia, Largely anecdotal site about musicians' experience with Focal Dystonia

2)Research: Recent Findings Lead to New Understanding of Dystonia , More technical but very informative article about Dystonia from theScientist, subscribe for free to access

3)Focal hand Dystonia in musicians, Short and accessible summary of ongoing research activities at the University of Konstanz. Further links on the dystonias available from this site

4)Cortical Representational Plasticity, Brief research summary on brain plasticity, repetitive stimuli and focal dystonia

5)"Catastrophic Breakdowns" in the Brain's Learning Systems, Article on Dr Merzenich(UCSF)'s research into focal dystonia, other neurological disorders, and his theory about seeing them as breakdowns in the brain's learning system

6)Radio National Health Report on Brain Plasticity, Transcript of an interview with Thomas Elbert of the University of Konstanz about focal dystonia in musicians and Braille reading.

7)Enchanted Mind: Brain Plasticity, General site about brain plasticity, the learning process, and how to maximize this process.



Continuing conversation
(to contribute your own observations/thoughts, post a comment below)

01/03/2006, from a Reader on the Web

I was diagnosed with Focal Dystonia in my writing hand in early 1999. I was treated with Botox but they gave me too much of an injection and my arm/hand was paralyized temporarily for approx. 2.5 weeks. My writing became much better for about 1.5 weeks after the injection but the pain before the progress was not worth it for me to go back for more (approx. 300.00 cdn per dose). I suffer more so today and can barely hold a pen anymore and if I do it is only for a few minutes and my arm and hand ache for a few hours following. My question is: Does stress or anxiety or depression exacerbate the dystonia i.e. nervous and excessive shaking of the hand? Is there anything else I can do to help myself?


Additional comments made prior to 2007
I was diagnosed with Focal Dystonia about seven years ago,i also had the botox injections in thirteen muscles in my arm and hand,it was the very painfull. It caused my fingers to be stationary in one position and i had to use my other hand to straighten them. I also went to occupational therepy and they treated it as carpal tunnel.I have been right handed all my life, now i have taught myself to write left handed and do just as well. I have mastered printing but my cursive writing is still alittle bad, but ledgible. My work requires alot of writing and my brain still thinks i am right handed, because i get frustrated sometimes because i put writing off as long as possible, then i get behind and have to rush to get it done. I hope that this never effects my left hand because it would definately change my whole life ... Virginia, 22 March 2006



This condition can be overcome. I have just been watching a TV1 New Zealand programme on the life to date of pianist Michael Houston. During this it was revealed how he was severely affected by Focal Dystonia for about five years. In particular this condition was aggravated through learning, performing and recording the 32 Beethoven piano sonatas in the space of about 3 weeks.


Through the interventions of a sports physiotherapist, an acupuncturist, a doctor dealing with the development of the muscles of the body, and pianist Rae de Lisle, he has overcome this to the extent that he has been able to make a full return to being a concert pianist. He had been advised to quit piano playing because of the condition, but neither he nor his supporters agreed with this suggestion, and the results of their endeavours is a happy one ... Brian Swale, 10 June 2006



Well, maybe my diagnosis of this dystonia thing has come to rest. I am not a musician, just an average 50 year old woman who is right handed and if you can call anything fortunate about my condition is that it has affected my left hand. Left index finger acts the weirdest, but my left hand just acts funky. My journey to this diagnosis hasn't been as weary as some I have juat read about. It's taken about 3 doctor visits - fisrt to a hand surgeon who then sent me to a neurologist who then ordered an MRI, and MRA and then fun of all fun, an EMG. Which at one point, I was tempted to get up off that table and stick the needles in my boyfriend who had dutifully been holding my feet down during my jerks from the electrical shocks. Yes he really loves me. My question now - what now? My dr. prescribed the drug they use in treatment of Parkinson's disease. This whole experience is starting to get on my last nerve. Any advice, words of wisdom, welcome ... Mary Wade, 1 August 2006



I would like to correspond with any others who have been diagnosed with focalized dystonia of the hand. I have been the whole gambut of meds, botox, and so forth. Nothing has helped ... Diane, 8 October 2006



Hi... not really sure if i should say anything at all here... but i was reading where u had been diagnose with focal hand dystonia in 1999. I have it to and i belive that it started in the fall of 2002 and really devloped in 2003 and it started out that i could not printed the digit 7 i can make the horizontal but not the vertical part of the seven.. i have been to the institute of health in bethesda maryland.... my question to you is this ... how and why does it start where does it come from.. and what can we do to get rid of it.... thank you ... Craig, 10 October 2006



I am a physical therapist who has worked with all types of soft tissue injuries and nerve entrapments throughout my entire 47 year career. In 1972 I discovered that by the systematic 10 minute wrapping of involved muscular groups, I could slow the chemistry of the muscles and thereby temporarily decrease their irritability. After a number of wrappings the tissue returns to normal. Muscle is contractile by nature. Its job is to move the bones, and it can only contract. Muscle lengthens only when the opposing muscle group contracts. After overuse or injury, muscles sometimes become confused and begin to contract on a reflex basis in cooperation with the spinal cord. The surrounding tissue becomes filled with fluid and can be hot or warm to the touch. A forearm often feels like a sausage instead of being soft and pliable. Healing can cause hard restricted bundles of muscle fibers to form within the soft tissue. These areas must be released and the tissue pliability restored to regain smooth coordinated muscle function.


When confronted with reflex activity the patient endeavors to perform his normal activities. Because his muscles don't respond easily, larger stronger muscles are often recruited on a voluntary basis. The brain is then involved. These larger muscles overpower the smaller muscles and result in the development of faulty movement patterns. Contracted and distorted muscular patterns often result along with nerve entrapments and strange patterns of functional movement.


These complex neuromuscular problems can be resolved by wrapping the involved sections of the body with moist medium weight terry cloth towels filled with natural ice, and then gently massaging and stretching the involved musculature. Treatment is given with the musculature resting in a plane neutral to gravity. The inherent contractility of the muscles must be respected. Rough treatment of the unhappy muscular tissue can make the condition worse. Reicing of the areas further decreases the irritability of the tissues. During the application of cold, the core temperature of the patient's body is kept warm by the application of large abdominal hotpacks or by placing the patient on full body heat.


Two weeks after the soft tissue returns to normal, reeducation of the faulty voluntary movements can begin. Frequently the most basic of fine movements must be taught first. Use no resistance. It is a bit like reeducating poilo patients after they have forgotten how to move. Relaxed movement must be taught through all ranges of motion. Sometimes the patient has never learned to do relaxed movement, and it is a foreign concept to him. Patience is required on both the part of the teacher and the student.


I love working with these complex cases and get excellent results. I use every type of technique which I have learned in my career as a physical therapist, synchronized swimming coach, ice dancer and performer. The cases are fun and mentally stimulating. I encourage you to start using cold to decrease the irritability of the muscles. Ice works quickly and effectively and is a very effective therapeutic tool ... Elizabeth Morris, 10 January 2007



Focal Dystonia of the hand question related to stress. When I am rushed or stressed, my writing hand (the affected hand) is practically useless. For unexplained reasons my hand will periodically print pretty well but writing is out of the question. The cramping is terrible and yes, I do think stress exacerbates this painful condition ... Barbara Perrin, 21 January 2007



Good contribution. Focal dystonias are typically enhanced by Anxiety/stress, and treatment may be helpful (especially when dystonia and essential tremor are paired). Retraining is worth a serious try,but exercise intolerance is a limiting factor. Botox injections can work (if dose is correct) for up to several months, but may cause rebound worsening. Med alternatives include beta blockers (e.g., propranolol) to reduce tremors and performance anxiety), certain anti-seizure meds, and antiparkinson agents may be tried. The link between dystonia and mitochondria oxidative posphorylation may suggest a role for Coenzyme Q10. Feedback would be of great interest ... SM, 4 February 2007



After having consulted with various specialists regarding the emergence of focal dystonia in my Right Hand litte and ring fingers, and after persuing your information, I was wondering if you have any suggestions regarding the alleviation/'cure' for this problem?


My problem developed spontaneously in approx February/March 2006, as a result of a 12-year period of being a typist, and consists of the said fingers 'curling' or 'bunching' up after no more than perhaps 5 words (after being capable of 130 words-per-minute). There is little pain, and perhaps an occasional aching sensation.


It can also occur with prolonged use of chopsticks, but to a much lesser degree.


It has been suggested to me that a magnetic wrist band may be of some benefit, and after consulting with a neurologist, it appears the neurological pathways are of normal conduction.


Any advice you may be able to offer would be greatly appreciated ... Kris Penny, 28 February 2007



I have been diagnosed with focal hand dystonia since 1999, I had just finished RN school and had been writing more in the last 5 years than in my entire life. I went to a neurologist and have been on beta-blockers and trialed many other medications for parkinsons and even requip without success, I have had 4 botox injections over the years and all did not improve my writing and the last left my index finger numb and still having trouble, the combination of inderal and clonazapam seem to help me write better, but I am looking for more information on treatment to help me write, I posture and hold my hand strangly to write, I perform many tasks as an RN and without shakiness but simple writing makes me shake and is begining to affect my performance. Do you have any suggestions, I also tryed hand therapy but the therapist was not even familiar with my problem and not helpful at all. Also can you suggest anyone in the seattle area that is familiar with this problem because my neurologist is not sure what else he can do for me. Any information would be helpful. I appreciate your time ... Mary Hutchins, 25 April 2007



I have been diagnosed with focal dystonia in my right hand this month. It appears it is made worse by stress, but not really fixed by calmness. My solution is to write with my left hand - the condition does not usually spread from one hand to the other!


Perhaps you could try that. It's hard, but much easier than writing with the affected hand.


There is also a relevant website: dystonia dt org dt UK ... Richard Donkin, 30 April 2007


Serendip Visitor's picture

Focal dystonia

It sounds like myotonia dystrophy. But if it is focal dystonia, it can be easily fixed. You may look at my brief notes about it in this page. My office is not far from LA. I may not be allowed to provide you with my e-mail or phone # right here, but try to find a way to contact me.
Emerson Jou, M.D.

Akkii's picture

HI...!! I am 17 years old

I am 17 years old and I think I am suffering from writers cramp... will exercise help...???
i have a problem with my thumb... my thumb seems curling in after i write 5-10 words please help me ...
Donno if it will spread to my left hand when i start writing with it...

Serendip Visitor's picture

Focal dystonia

Exercises will make it worse. It does not spread to the left side, but your left hand may or may not suffer the same as the right. It can be easily fixed.
Emerson Jou, M.D.

Anonymous's picture

Right hand Dystonia

I was diagnosed with right hand dystonia about 12 years ago. my tremor is more noticeable when I try to write. I taught myself to write left handed, and to speed up the process of writing a check I obtained a Debit card. It is VERY frustrating because I have since started going back to school for nursing and I am very anxious as to the effect my writing ability will have. I purchased a digital recorder to record lectures, so what notes I don't catch during lecture I can fill in at a more lesure pase. I also bought a laptop to help me out with the writing it self.
I do not agree with the Botox treatments. Think about's a toxin a poison) that you're putting into your body that circulates through your blood/your body/your brain(which is part of your nervous system.It numbs the nerves to reduce the tremor. Over time it will atrophy the muscle,and you will have less strength. If it effects the muscle that way what will it do to your brain/memory? These are just some of my thoughts and concerns!

Teri's picture

10 minute muscle wrapping

Hi, my question is for the physical therapist that wrote of the 10 minute wrapping. My head keeps involuntarily turing right. Everyone says its neurological. Can it be cured through this muscle wrapping. I know the muscles such as the scm and trapezius are involved and it is a continuous movement with no pain at all. Thanks

pancsi's picture

It seems you have Spasmodic

It seems you have Spasmodic toticollis, that is best treated with biofeedback to achieve muscle reeducation. Although you could also try wrapping or acupressure on the involved muscles. As body talk goes, there might be something in your life that you don't want to face straight and that is why you turn your head away from it.

Henriette's picture

Touch and Hold Method


Can any one please help me, my husband has got focal hand dystonia for years he has tried everything possible, I was ready about the Touch and Hold Method, can any one explain to me how it is done and if only a doctor can do it or can I do it on him.

I would really appriciate it if anybody can come back to me on this, there isn't much research or anything like that happening here in South Africa

Thank you

Emerson Jou, M.D.'s picture

Focal dystonia

Dear Henriette:

Touch-and-Hold Method applies light touch on the specific injured sites (tender fascia/muscle sites), point by point, for a given duration on each point until tenderness disappears. This can be done by anyone at home. In fact, I always teach and encourage my patients to do as much at home. It sounds simple, but it takes very fine skill, much patience and some experience to do it right to be effective. But first of all, you have to learn how to find those tender points, upon careful examination. Dr. Jou

Pam, OTR's picture

Therapist, Elizabeth Morris, PT

I would like to contact Elizabeth regarding her technique for treating focal dystonia of the UE.

Gentry's picture


Hey All,

your dystonia problems are over. i had dystonia bad in my right index finger...i had a year of botox shots to no my luck, i found a doctor named Emmanuuel Jou, in Tustin Ca. He fixed me using the touch and hold method. Even though your affected areas may not be in pain, there are still internal injuries just under the skin called "fascia." To test yourself, grip your affected finger with your opposite hand. Place your opposite thumb on top of the finger, and press down as hard as you can, all over the affected should feel pain. These "pain" areas affect the finger from moving correctly. Dr Jou, through the touch and hold method, simply finds the painful areas, and applies minimal pressure until they are gone. The finger soon begins to function correctly. I have seen him 4 times. He taught me the procedure, and I now work on myself. I have seen 60% improvement in 2 weeks!!! Believe me, people with finger dystonia would cry if they had 10% improvement. This man is the real deal.

Serendip Visitor's picture

I would love to get

I would love to get information about this doctor, if you anything that can help please write me please

Serendip Visitor's picture

Can I have more information

Can I have more information about this touch and hold method? I am very curious.

Frances R's picture

focal hand dystonia

I was very interested to read that Dr. Emerson Jou helped you to cure your dystonia. As I do not fully understand how to find the tender spot and then touch and hold, can you give me any advice as to this "miracle cure".

Thank you


Dr.Meier Hanspeter's picture

Focal Dystonie

Please explain me the touch and hold method.

Thank you very much

Anonymous's picture

touch and hold method

Hi I read your article and I'm wondering if you can explain the touch and hold
method to me for my neck that involuntarily turns right. Thanks, Teri

Emerson Jou, M.D.'s picture

Focal dystonia of hand (or

Focal dystonia of hand (or any other parts of the body for that matter) is NOT a neurological condition and NOT related to brain. It is merely an external injury (strain) to the fascia tissue under the skin of the entire fingers. Fascia injury is excruciatingly painful that causes pain and difficulty in movements. It can be easily treated and cured. Based on my experience, it takes only 1-2 hours of therapy per finger to cure pain and restore finger function, using light touch i.e. "Touch-and-Hold" method.

Serendip Visitor's picture


Why hasn't anyone heard of this miracle cure? Are our neurologists all crazy? Too good to be true?

Anonymous's picture

focal dystonia of the right hand

i have focal dystonia of the right hand for a very long time stressed and tensed but fortunately its not painful. can you please explain the "touch and hold method" i could not write long and only using my left hand in typing but my i can hold objects. thanks.

Teri's picture

Not Hand Dystonia

Hi Dr. Jou,

Thank you for giving me the opportunity to ask you my question.

I have been diagnosed with dystonia. What is happening is that my head keeps turning right continuously. These are involuntary movements. Your information that you submitted said that any part of the body having a dystonia is not neuological. You are the first to say this. I have felt that something has to be released in my right shoulder, arm or neck. I know the accessory nerve innervates my scm and trapezius muscle and thought it may be that although, again I feel like it isn't neurological.

It has become increasingly more difficult for me to deal with it. It's very frustrating. Can you please let me know your opinion of what you think and how I can cure this. I also read that the touch and hold method is very good. Can you please explain that to me also.

Any information you can give me is very much appreciated.

Thank you,


Emerson Jou, M.D.'s picture

Focal dystonia

Dear Teri:

Sorry for being late in answering, for I have hardly viewed this site. Your condition is called "spasmodic torticollis" which is "focal dystonia" in the neck involving primarily SCM among few other neck muscles (and fascia of course!). Another form of the same nature, for example, is so called "restless legs syndrome". It is not neurological or anything else but mechanical injury. All such injuries can be easily treated and cured, using light touch, i.e. Touch-and-Hold Method. Dr. Jou

paula's picture

touch and hold

i have fhd in left hand would love more info on this method. had stroke 10 years ago tg i got use of my right handat 54 i just want to die i got 3 grandchildren i never got to hug everyone afraid of me dropping them
my life is this computerthis is not livinghas anyone seen dr. jou that can pass this method around please so we can all live again

Serendip Visitor's picture

Focal dystonia

Please refer to my few brief notes in the page about Touch-and-Hold method. If I have a chance, I'll love to explain more, or even fix your problem. Emerson Jou, M.D.

Marvin B. Naylor's picture

Touch and hold method?

Yes, please enlighten us to this method. My Focal Dystonia (of my hand) is not painful in the least, isn't that why it is not considered a physical strain injury? I cannot see how it has anythiung to do with your fascia tissue strain, as you describe it ie, excruciatingly painful. No hand specialist has ever mentioned this to me.

Emerson Jou, M.D.'s picture

The strained fascia tissue

The strained fascia tissue is VERY tender upon touch even with light pressure. Because of such painful tissue, one would have "weakness" upon testing (actually no true weakness but limited strength due to tender tissue),and thus limited movements (again due to tender tissue). Although there may not be pain within the comfortable range, (That is why nobody including physicians ever associate it with pain) but it will be painful when moving beyond the limited range. This tender tissue is caused by mechanical strain to the fascia and sometimes also muscle (not tendon or ligament). Such injury responds to Touch-and-Hold Method and resolves itself with disappearance of pain and thus resoration of strength as well as movements. Improvement and recovery is immediate and obvious. The treatment is truly effective.

jake brown's picture

left hand dystonia

i'm 19 years old and am in physical therapy for my left hand. i have classic dystonia symptoms in my left middle finger without spasms or pain. i've been diagnosed with tenosynovitis and have a trigger finger in my index. guitar is my life and have been soooo devastated by my problem... my worst fear is this problem will take years to fix because these next few years are exremely precious to me and my career.

gentry's picture

touch and hold method


Please please please explain the touch and hold method. Everyone who has written in has been devasted by focal dystonia, including myself. We are all at our wits end with this diagnosis. Please expain the touch and hold method.

Thank you

Anonymous's picture

Focal Dystonia of Right Hand

I have hypoglycemia which is a precursor to diabestes. I noticed uncotrollable movements of my right hand after a really bad hypoglycemic episode. A few months later I had severe carpal tunnel syndrome & required surgery. The doctor told me that the damage to my median nerve was so severe that part of it was dead from being crushed & that I would be left with some residual numbness. It takes both of my hands to hold a pen to even sign my name to anything. I was a cardiac nurse. I am disabled because of this. I also have a metal plate & six pins in my left arm so I cannot lift, pull, or pick up heavy objects. I continually drop things. I take Neurontin, Xanax, & Elavil for my hand. I have very painful spasms if I try to straighten my right hand out. It is curled up. I was offered the chance to try Botox, but I am scared of that. This is just something that I have to live with, I guess. Some people do not even have a right hand or arm, so I am blessed. It could be much worse.

Marvin B. Naylor's picture

Focal Dystonia of the hand

I am a guitarist who plays fingerstyle, ie. with the thumb and 3 fingers of my right hand. I have been diagnosed with Focal Dystonia after seeing a number of so called experts, including one from BAPHAM (performing arts medical board in UK). I cannot use my middle and "ring" finger anymore and have to divert all the work formally done by those fingers onto my forefinger, which is becoming overworked. I am worried that soon this finger will succumb to the ailment, and, if so, my days as a guitarist in the style I have been playing will be over. Does any other musician have this problem and concern? I would be pleased to hear.

Gustavo's picture

Hi, Marvin. It's been a while

Hi, Marvin.

It's been a while since you posted your message, and I hope you already overcame focal dystonia. But, if you still facing the problem, I have two suggestions for you and other people:

1. Guitarist David Leisner overcame focal dystonia. Read how he did it on .

2. Learn about BodyTalk. Some people overcame focal dystonia through this therapy.

Good luck!!

Kevin Walters's picture

fingerstyle guitarist right hand

I have the same problem ie 2nd and 3rd right hand fingers have deteriorated over the last 6/7 years to the point where they barely function anymore and I have to rely on my thumb and index finger--not great for classical guitar technique!!! Specifically,my problem is that after playing a stroke with these fingers they refuse to "return" in order to play a further stroke and so can only be employed occasionally when playing any given piece.I have to say that I have been playing for 40 years and have taught for the last 30,I have no right hand pain but it is incredibly frustrating to be unable to play pieces that I could previously recite with ease!! I am sure that the years will have taken their toll,via the repetition,and I'll have to accept it if there's no remedy,but if anyone has any suggestions I'd be delighted to receive them!

morgan's picture

focal dystonia

i am a 5 string banjo player and have been playing for over 35 yrs recently i noticed my right hand starting to curl whenever i was playing a forward role now i cant play any of the roles i have been going out of my mind trying to find out what is going on and read an artical in a newspaper about focal dystonia and i began to investegate. I have become very depressed about it because my whole life and social life is based around plying banjo my problem is with my thumb and forfinger. If i hit a string with the thumb and then the forfinger the muscles in my finger start to curl the thumb inwards and i cant straighten it back again.i then try to compensate for it and end up using the bigger muscles in my forarm with the result that my whole arm and hand become very tensed up then i cant play at all.It means that i have been cut off from my whole social network and i cant earn any money from playing music anymore it is driving me crazy.

Jeff Lincoln's picture

fingerstyle guitarist with focal dystonia

I am a rythm player who is having issues with the right arm. I play with a pick so I don't have the same finger issues as you. As I play my hand moves quite severly to the ulnar (little finger) side and remains there. The extensor muscles in my forearm contract and my fingers curl backwards. My movements are different than yours but I wonder if the treatment could be the same. I believe my symptoms result from overuse and a lack of warming up and abuse of these fine muscle groups. My problem started in June of 2008 and is progressively getting worse. I experience similar sensations when writing and mixing food in a bowl. The faster I try to play the more pronounced the cramping.

lori liss's picture

help with 15 yr old daughter with dystonia of thumb

I read some of these blogs, and it is somewhat of a relief to hear other people in my daughters situation. No one has been able to help her. It has been a very long year. I read about the physical therapist who does wrapping. Anyone who has any idea about this or any other help please write back. I am very desperate to help my daughter.
thank you in advance
lori l

John's picture

the beginning of a cure

HI I have had Focal Hand dystonia for ~ 5 yrs. I am currently working with a therapist who (thank God) KNOWs what FHD is.. I have over the last couple of months been able to somewhat alter my writing to be able to sign better and have some limited writing sessions. Have also tried Artane( no good) ,but no Botox yet. I would suggest before more drugs, try getting your MD to give you a scrip for PT, It could help. Make no mistake.I still have a long way to go- I am a musician and cannot play guitar without my right wrist curling inward- so handwriting solved first them guitar playing????

Baz's picture

right hand focal dystonia

I was recently diagnosed with focal dystonia and I am curious to know where is your therapist located. Please could you get intouch with me I would apprciate it tremendously.


Anonymous's picture

i am a dentist. I do a lot

i am a dentist. I do a lot of minute works with good pricision. But when try to write anything, i can't control my hand movements. The writing movments varies time to time. It is almost impossible to write when I am stressed or after hard works. but improves with changes of posture,better with my wrist twisted inwards

Anonymous's picture

I am a engineer having hand pain problem for many years

I had noticed long back that writing is a problem for me. I do many other jobs with precision control moment but writing some things makes me nervous. I can write half page with normal flow then hand and fingure mussles start paining and it becomes hard to control movement of hand or fingure. I am having this problem for many years. Now, I noticed that problem is increasing so I started surfing on internet and found I am not alone person facing this. I want to pass few exams to better my life but I am disappinted because I can not write exams due to this problem. I have not taken medicene for this nor I contacted doctors. But, I am planning to visit doctor after reading people experience about this desease in this forom.

Paul Young's picture

studying with FD

I suggest you ask your doctor to write a letter to your college/university asking for you to take all exams by computer. I did my exams for 6 years by computer and I finished top 5 in my class

Good luck

Anonymous's picture

focal dystonia

Hi, I am also a dentist, actually a periodontist, and I have been suffering with this problem for almost a year now. In fact, it has reached the point where I can barely get through perio surgery and I often have to use my left hand to help my right hand function. I have seen two hand specialists and the second one told me that I had focal dystonia. It sounds like the prognosis is pretty bleak.
What has been your experience?

Mary Wade's picture

focal dystonia

i wrote at length re my focal dystonia in my left hand. Requesting coments, help, suggestions. etc. Never heard a thing. Is anyone out there?

Mark's picture

Re: Right Hand Dystonia

After ten years of much frustration, I was just diagnosed with right hand dystonia which has been very painful. It has kept me from writing with a pen or pencil for years.

Looking for a doctor specializing in treatment ie. Botox for this disorder in California.

Any referrals?

Kay's picture

focal dystonia right hand

It is so nice to read that there are others out there experiencing the same feelings of despair and frustration as I do. I was diagnosed by a neurologist a few years ago and all of the medications he prescribed seemed to make no difference for pain. I am feeling so frustrated. My writing is continually getting worse and my hand seems to turn in toward my thumb more and more. I feel like I am crippled. I have tried the left hand several times but it takes so long to even write my name that I become nervous and unhappy. I have gotten to the point that I sign my name with 3 initals only but have so much trouble writing out a check in a store. If I want it to be legible I would have to write very slowly and methodicly and even then there is no guarantee anyone could read the writing. I used to have a beautiful handwriting in high school and college and now I can't even read my own. Please tell me I am not the only one. Thanks for your help and support.

Paul Young's picture

FD in your right hand

Hi, I am writing from australia and like so many of you I suffer from FD in my right hand. It started about 23 years ago when I was a young backpacker and has gradually got worse over the last 23 years ( I was only diagnosed 6 years ago)-yes,I have suffered FD for half my life. The fear of embarassment in public is overwhelming and has caused me to become very creative with explanations if I am witnessed writing. 11 years ago when I went back to University I taught myslef to write left handed and this worked well for 2 years. But the condition seemed to shift to my left hand (or was it some kind of stress reaction). Anyway 9 years ago I went back to being right haded with some minimal success. In 2004, I found a way to minmise the trembling and curling. When I write with my right hand , I place my left hand on my right wrist and this prevents the hand from lifting and curling. The fluency & speed of my writng improved and the legibility of my writing improved considerably. I found this to be a wonderful technique when writing in private but it does draw attention in public. I guess its a trade-off I have learned to live with and when asked I tell people that my hand was crushed or I have had a minor stroke. Unfortunately telling the truth just opens up a conversation when really I want to just get on with the successful life I have. I wish you all well and you have my respect.
Best wishes
Paul Young
Brisbane Australia

Lee's picture

Focal Dystonia

First, let me say that I'm not at all sure that I have this malady. I first heard the term about 30 minutes ago during a visit with the on-site doctor. We have an opportunity during our birth month to do this. He asked about any problems and my hand tremor has gotten worse but only occurrs (or is noticable) when I write. I googled the term and wound up on this site.

I do play guitar occasionally but much less now than when I was younger (I turn 64 this month). The most disturbing problem that I'm having is as you describe. I can barely sign my name and my penmanship has gone from bad to horrible. Unlike you, it never was good.

Anyway, I'm excited that possibly I can at least know a name for the problem if I have it. There is no pain involved for me and I do not have a tremor if I extend my hand (no shakes). Only when I write. Seems to disturb fine motor control.

Let me know if your research has turned up any other good sites to learn more about this. Mine began probably 10-25 years ago and has gotten progressively worse, little by little. I suspect that if I live another 20 years at some point I will be unable to write by hand at all - thank goodness for computer keyboards!

Linda's picture


Your story sounds like mine. I have no pain but my writing is terrible. I can not use a traditional mouse and typing is almost impossible. I am 61 and have had problem for 10 - 15 years and never went to doctor until 2 years ago. It started with my writing , then computer skills. I have had 2 rounds of botox injections...did not work at fact I had no strength and was unable to pick up glass. I am so frusrated. Fortunately I have been in the same job for 40 years and pretty much work at my own pace, otherwise I would not be able to get a job. It is embarrassing for me when people see me trying to write or type. My entire life has been as secretary, admin asst and now manager for major company. As my conditions worsens, more people are aware of my disability. I see no help in sight. I guess it could be worse and I coud b in pain. Any words of wisdom frm anyone?

Lynn's picture

Hand Dystonia

I too have hand dystonia. It started in Dec 2008 and I was finally diagnosed in Aug 2009. I used to be able to type good but now my thumb and first two fingers want to curl up bad. When I reach to use the mouse, I am straining so hard to keep my fingers from cramping up. I used medication that resulted in no change. I've recently had one botox inject (mild) but am unable to tell see a difference. I am due to have another injection in December hoping to see some results. Does anyone know how to fix this or can recommend treatment?