Muscle spasms may be due to focal dystonia

I first heard about focal dystonia while reading the biography of music composer Robert Schumann. He was an interesting character, not because he suffered from this neurological disorder, but because there are many stories about his wife’s relationship with the composer Johannes Brahms, and I was itching for a good love story.

That not found, I focused on how Schumann was affected by a debilitating task-specific loss of voluntary control of the middle finger of his right hand. So painful, in fact, that he wrote a piano concerto that didn’t require using that finger. Eventually, he stopped performing but continued to write music.

Cleveland Clinic tells us: “Focal dystonia causes involuntary muscle movements or contractions in one part of your body. You may have focal dystonia in your neck, eyes, jaw or vocal cords. Focal dystonia can also affect your wrists, hands or fingers.”

The description “task-specific” is self-explanatory. Examples include embouchure dystonia, which includes muscle spasms or cramps in your lips, jaw or tongue. It often affects musicians who play brass or woodwind instruments. Musicians’ dystonia might happen to those who play the piano, guitar or violin. And writer’s cramp is when you have uncontrollable muscle spasms in your hand or wrist.

“Task-specific focal dystonia often affects people who have jobs or hobbies that require a lot of fine motor skills, like tennis players,” Cleveland says. Although the symptoms may be similar to carpal tunnel, focal dystonia occurs due to problems with communication between your brain and nerves, not overuse or damage to the nerves.

You may have heard a golfer blame bad putting on the “yips.” That’s when focal dystonia affects athletes who play sports involving lots of hand or wrist movement, like baseball and, of course, golf.

“Although dystonia is one of the most common types of movement disorders, focal dystonia is relatively rare. It affects about three in every 10,000 people in the U.S. It typically happens to adults ages 40 to 60, and women develop the condition three times as often as men.

Focal dystonia is idiopathic. Sometimes the symptoms are connected to changes in habits, such as an athlete or musician changing their technique after an injury, learning a new sport or instrument or practicing, performing or competing more than usual.

“Researchers haven’t proven a genetic link in focal dystonia. But about one in 10 people who develop focal dystonia have a family history of it,” Cleveland says

Symptoms vary depending on what body parts are affected. The first sign may be a slight decrease in muscle coordination. Over time it can cause more severe muscle symptoms such as cramps, muscle pain, twitches and abnormal posture of the affected body part.

People with focal dystonia might develop secondary symptoms not related to the muscles themselves. These symptoms may include blurred vision, depression, difficulty sleeping, fatigue, mood swings, short temper and trouble focusing.

“Focal dystonia symptoms may worsen for a period, stabilize and then recur. But, in some people, focal dystonia may stop progressing altogether,” Cleveland says.

Diagnosis involves ruling out other conditions that could be causing the symptoms. Blood tests, CT scans and MRIs are some of the diagnostics your health care provider may use. You may have an electromyogram to test how your muscles process electrical signals.

Since there isn’t a cure for focal dystonia, treatment focuses on relieving symptoms and trying to stop them from worsening. Besides medications, Botox injections and, rarely, surgery, you may be encouraged to make some lifestyle changes.

“Changing a task’s physical sensations can help your brain process movements with less interruption. For example, a violinist may have fewer spasms if they wear a glove while performing. A writer’s symptoms may improve if they change the grip of the pen. You can also practice stretches or exercises to manage discomfort,” Cleveland explains.

Without knowing what causes focal dystonia, there is little advice on how to prevent it. Experts say it might help to avoid excessive movements, manage stress and reduce fatigue with healthy sleep habits and a nutritious diet.

Schumann developed a plethora of maladies and spent his last years in a lunatic asylum. Just another clue why I tell you to seek treatment from your primary care provider regularly.

Kathy Hubbard is a member of the Bonner General Health Foundation Advisory Council. She can be reached at kathyleehubbard@yahoo.com.