Understanding Focal Task-Specific Dystonia (FTSD)

There are different types of FTSD. They affect different parts of the body. Some examples are:

Writer’s cramp. This is a kind of dystonia that causes problems with writing. You may have muscle spasms or pain in your hand, wrist, or forearm. This makes it hard to hold and use a pen or pencil.

Musician's dystonia. This type of dystonia can make it hard to play a musical instrument. You may have muscle cramps or spasms in your hands. You may have loss of fine motor control in your fingers, hands, or wrists. This may cause problems playing an instrument such as piano, guitar, or violin. You may feel clumsy when you play. Your hands may get tired quickly. You may not be able to play as fast. Or you may have muscle cramps or spams in your lips, tongue, or jaw. This may make it hard to play an instrument with your mouth, such as a flute or horn. You may also have problems with speech and eating if the symptoms get worse.

Other types. Dystonia can affect people who do any kind of physical task over and over again. It may affect parts of the body, such as the legs or face, in repetitive use. People affected by this include:

• Golfers

• Tennis players

• Dart players

• Billiards players

• Tailors and seamstresses

• Hair stylists

• People who type or use a computer mouse

In some people, focal dystonia may also affect daily tasks, such as buttoning clothes, brushing hair, shaving, and using a knife and fork.

Researchers don’t know what causes FTSD. Some gene changes may put some people at more risk. FTSD can run in some families. But most people with dystonia have no family history of it. Environmental factors may set off the problem. FTSD is more common in men. It doesn't seem to be related to anxiety. But it may be because of problems in parts of the brain that control movement. Research is still ongoing.

Dystonia causes muscle movements you can’t control. Symptoms of FTSD occur during specific tasks. They can include:

• Muscle contractions

• Muscle spasms

• Pain

• Tremors

• A joint stuck in a bent or straight position

You may have:

• Tight feeling in the muscles

• Trouble moving the area normally

• Symptoms that get worse over time

• Loss of ability to do the task well

Dystonia can be hard to diagnose. It doesn’t show up on tests. Instead, you may have tests to look for other problems that can cause symptoms like FTSD. These include tests to check for nerve problems, seizures, medicine side effects, and other conditions.

Treatment may help with some symptoms. These include:

• Botulinum toxin. Injecting muscles with this toxin may help relax muscles and reduce pain. These shots are given every 3 to 6 months. But this can also cause muscle weakness.

• Retraining the muscles. This needs a multistep approach. This includes splinting, immobilization, and exercises.

• Occupational therapy. This can help you manage daily activities and improve movements.

• Medicines. Some medicines may help treat stiff muscles, pain, and movement. But no medicines are proven to help everyone.

There is ongoing research about how to treat FTSD. Talk with your healthcare team or go to clinicaltrials.gov if you want to be part of a clinical trial or other research.

FTSD is hard to treat, and often does not go away. It may get worse over time. For hand symptoms, the problem may start to show up in both hands. Musician’s cramp may lead to a loss of ability to play the instrument permanently. In some cases, a musician may be able to play a different instrument without dystonia. FTSD may lead to anxiety or depression.

FTSD can be a stressful, frustrating condition to manage. At times, it may seem overwhelming. Talk with your healthcare team about ways to get support. They can refer you to counseling.

Call your healthcare provider if any of the following occur:

• Anxiety or depression gets worse

• Symptoms that don’t get better, or get worse

• New symptoms