Writer’s Cramp Beyond Writing: Task-Specific Focal Dystonia in a Physiotherapist Affecting Work and Recreation

Abstract

Background & Objectives: Writer’s cramp is a task-specific focal dystonia characterized by involuntary muscle contractions during skilled motor activities, most commonly handwriting. It results from abnormal sensorimotor integration and impaired cortical inhibition. Although symptoms may generalize to other fine motor tasks, involvement of racquet sports such as badminton has rarely been described in the literature. Objective: To describe a case of writer’s cramp in a physiotherapist with symptom extension to occupational and recreational activities, including badminton. Methods: A 38-year-old right-handed male physiotherapist presented with progressive involuntary extension of the right index finger and wrist during writing, later affecting computer mouse use and badminton serving. Neurological examination confirmed task-specific focal dystonia. MRI cervical spine revealed mild multilevel disc bulges without clinical correlation. Contrast-enhanced CT brain was normal. The patient was treated with benzhexol hydrochloride and underwent multidisciplinary rehabilitation including physiotherapy and occupational therapy. Results: Symptoms were task-specific, absent at rest, and not associated with pain, weakness, or sensory loss. Occupational documentation and computer tasks were significantly affected, requiring left-hand compensation. Recreational badminton performance declined due to impaired wrist control. No meaningful improvement was observed following pharmacological and rehabilitative management. Conclusion: This case highlights an uncommon extension of writer’s cramp to badminton, broadening the recognized clinical spectrum of task-specific dystonia. Early recognition and multidisciplinary management may reduce diagnostic delay and optimize functional outcomes.