Most people don’t know what dystonia is, because it’s a less common and less well-known movement disorder than others, such as Parkinson’s.

However, what is particularly striking is that the vast majority of musicians I’ve spoken to are completely unaware of what musician’s focal dystonia is, despite the fact that it’s a neurological condition that affects many professionals in the field and can be highly disabling when playing their instruments.

Unfortunately, many musicians come to know what dystonia is once they are faced with it.

Others can spend months suffering from the symptoms without even knowing what it is, which is even more frustrating and distressing.

This lack of awareness about dystonia more than three decades ago, when it happened to me, was understandable. However, today, despite the amount of information we have, the same thing continues to happen.

For this reason, I have decided to explain in a simple way what muscular dystonia is, and in particular, musician’s focal dystonia.

Dystonia is a movement disorder, which is actually an issue with the central nervous system.

It is characterized by sustained or intermittent involuntary muscle contractions that can affect one or more parts of the body, causing abnormal movements and postures.

Types of Muscular Dystonia

There are several types of muscular dystonia, classified according to the affected body region:

• Generalized dystonia: Affects many parts of the body.

• Segmental dystonia: Involves two or more contiguous regions of the body.

• Focal dystonia: Affects only one part of the body.

Types of Focal Dystonia

Cervical dystonia (spasmodic torticollis): Affects the neck muscles.

Blepharospasm: Affects the eyelids, forcing them to close.

Vocal cord dystonia: Affects the muscles that regulate the opening and closing of the vocal cords.

Occupational dystonia or task-specific focal dystonia: Involuntary contraction of certain muscle groups that interferes with an individual’s ability to perform their profession.

The latter is particularly relevant to musicians, as it interferes with the playing of our instruments.

Within this group of occupational dystonias, the most common are:

Focal hand dystonia: Characterized by involuntary contractions occurring in some of the fingers, lack of coordination between some of them, slowness in certain movements, tremors, and spasms in a particular finger, the wrist, or the forearm.

Oromandibular dystonia: This condition affects wind instrument players. It is also known as embouchure dystonia. It causes spasms in the jaw, lips, and tongue muscles, affecting the correct mouth shape while playing the instrument.

This type of occupational dystonia, also known as task-specific focal dystonia, as its name suggests, affects only a specific task. In the case of musicians, it interferes with the performance of one instrument without necessarily affecting the performance of another, although over time, symptoms often appear to a greater or lesser extent in other daily tasks or when playing other instruments, leading to progressive focal dystonia.

Symptoms of Focal Hand Dystonia

This is a description of some of the sensations experienced with focal hand dystonia:

• Involuntary contraction of one or more fingers

• Spasms in the fingers, wrist, or forearm

• Feeling of weakness in a finger

• Lack of independence between some fingers

• Lack of coordination of the fingers

• Slowness

Dystonic Movements and Compensatory Movements

Musician’s focal dystonia is a movement disorder consisting of dystonic movements and compensatory movements.

One of the challenges we face when suffering from this condition is learning to differentiate one movement from another, as this is one of the keys to beginning to work efficiently on our recovery.

In some cases, the dystonic finger contracts toward the palm of the hand, and in others, the finger experiences a spasm and stiffness when extended.

These dystonic movements are accompanied by compensatory movements that other fingers perform involuntarily to compensate for the dystonic movements.

Compensatory movements can occur in one or more fingers, both in extension and contraction.

Although dystonia is a painless condition, these compensatory movements, in an effort to control dystonic movements, can cause pain due to muscle overload.

It is vitally important to fully understand this disorder and its behavior in order to effectively treat dystonia.