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.

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.

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

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