Dystonia

Dystonia is a neurological movement disorder that causes muscles in the body to contract or spasm involuntarily. The involuntary muscle contractions may cause twisting, repetitive movements and abnormal postures. These muscle contractions often interfere with daily activities.

Dystonia can come affect specific body parts, giving it different names. For example, dystonia can happen in the neck (cervical dystonia), in the jaw (oromandibular dystonia), in the eyelid (blepharospasm) and in the hand (writer’s cramp).

There are other types of dystonia that are related to medication or conditions like Parkinson’s disease, which may be more general in distribution or fluctuate over the day. Undergoing dystonia treatments, such as cervical dystonia treatment therapy, can help cure the condition.

Common challenges:

Muscle spasms
Dragging of the leg
Involuntary pulling of the neck to one side
Cramping of the hand or foot
Speech difficulties
Locked jaw
Sensory changes
Emotional difficulties
Pain
Altered sleep quality

The role of the neurological physiotherapist in dystonia:

Neurological physiotherapists are physiotherapists with additional training and expertise in treating conditions affecting the brain, spinal cord, inner ear and nerves. While the full mechanism of dystonia is still not well understood, we are able to work with your neurologist to assist you in accessing the most evidence-based and effective treatment options. This will involve an objective assessment of your movements and understanding when and where your dystonia occurs. We also know what treatments not to provide which may make the dystonia worse.

In focal dystonia, botulinum toxin (Botox) injection from a neurologist may be a possible treatment option whereby the involved overactive muscles are temporarily weakened. This will allow us to work with you to improve the use of the affected body part and teach your brain how to ‘rewire’ and function more normally. We may also consider sensory retraining techniques and other strategies to help you regain the sense of midline and movement control, and suggest other adjunctive activities that can help in the longer term.

In generalised dystonia, a neurologist opinion may be worthwhile and he or she may prescribe medication or discuss alternative treatment options such as deep brain stimulation or the use of medication pumps. Being recognised in our field, we can provide professional advice to assist you in liaising with a neurologist as understandably this can be a difficult decision to make. Our hand dystonia therapist or cervical dystonia physio practitioner can always provide genuine information for your rapid recovery.

What our skilled therapists can offer:

A thorough assessment of different parts of your body that may be affected by your dystonia
Critical analysis of your movement preferences and postural control
Hands-on treatment to guide your body in moving differently or with a different emphasis
The use of adjuncts such as music, rhythm or a cognitive strategy
Evidence-based treatments for any pain associated with your dystonia
A referral to a suitable neurologist who specialises in movement disorders
Liaise with your child's network (e.g. kindergarten, school, other therapists) as appropriate

Frequently Asked Questions

How can I tell if I have dystonia?

Dystonia manifests as involuntary muscle contractions that cause repetitive movements or abnormal postures. Common symptoms include twisting movements, tremors, and painful muscle spasms. If you notice these symptoms, a neurologist can conduct diagnostic tests to confirm dystonia. Dystonia can be focal (e.g. writer’s dystonia, cervical dystonia) or generalised in the body.

Does dystonia develop suddenly, and are there early warning signs?

While dystonia often develops gradually, it can also appear abruptly. Early warning signs include cramping, a feeling of tightness in the muscles, or a dragging leg. These symptoms can intensify, leading to more noticeable involuntary movements.

Is dystonia considered a life-threatening condition?

Dystonia itself is not life-threatening but can severely affect a person’s quality of life. In rare cases, it can impact vital functions like breathing or swallowing if the muscles involved are severely affected, necessitating immediate medical attention.

Can stress or anxiety trigger dystonia symptoms?

Yes, stress and anxiety can exacerbate dystonia symptoms in some individuals. Emotional distress may lead to increased muscle tension and involuntary movements, worsening the severity of dystonic episodes.

Is dystonia commonly misdiagnosed?

Yes, dystonia is often misdiagnosed initially due to its varied presentation and overlap with other movement disorders. Patients may be initially diagnosed with conditions like Parkinson’s disease, essential tremor, or functional movement disorders before receiving an accurate diagnosis of dystonia.

What lifestyle adjustments can help manage dystonia symptoms?

Managing dystonia often involves lifestyle modifications to reduce triggers and improve overall well-being. Strategies such as stress reduction techniques, maintaining a balanced diet, regular exercise, adequate sleep, and avoiding alcohol or caffeine may help alleviate symptoms.

Are there support groups for individuals with dystonia?

Yes, there are numerous support groups and online communities dedicated to individuals living with dystonia and their caregivers. These groups provide valuable resources, information, and emotional support, helping individuals navigate their journey with the condition.

Can dystonia affect a person's ability to work or perform daily activities?

Yes, depending on the severity and location of muscle contractions, dystonia can significantly impact a person’s ability to work, perform daily tasks, and engage in activities they enjoy. Occupational therapy and assistive devices may be recommended to help individuals adapt and manage their functional limitations.

What role does a movement disorder specialist play in treating dystonia?

A movement disorder specialist is a neurologist with additional training in disorders that impair movement, such as dystonia. These specialists are crucial in diagnosing dystonia accurately, crafting personalised treatment plans, and managing the disorder through medications, Botox, therapy, or surgical interventions.

Can dystonia go into remission?

Yes, dystonia can go into remission, although the course can be unpredictable. Factors influencing remission may include the type of dystonia, the effectiveness of treatments, and individual differences. Some patients may experience significant reductions in symptoms or complete cessation for varying periods.