ABSTRACT
Musculoskeletal problems in an of£ce environment have existed as long as writing has been known. The cramping of the writer’s hand was a common complaint and became the subject of clinical interest and controversy in England as early as 1855, when it was termed scrivener’s palsy or, more typically, writer’s cramp. With the growth of commerce in the Victorian era, a large number of scriveners were responsible for copying all the contracts by hand using a quill, whose thin shaft had to be gripped £rmly. The resulting spasms were £rst described in detail by Wilks (1878) and later by others (Sheehy and Marsden, 1982) as resulting from the repetitive forceful contractions of the hand with complications induced by co-contractions of the forearm Ÿexors and extensors. This interaction of various aspects of the motor system as well as the sensory system, technically termed focal dystonia, has only recently been counteracted by the use of peripheral sensory stimulation, high-frequency vibrations, and blocking of selected pathways with lidocaine or botulism (Kaji, 2000). In terms of preventing the problem, increasing the size of a ballpoint pen grip area with a Ÿared design up to a diameter of 13.6 mm signi£cantly reduced EMG of the Ÿexor pollicis brevis and pain scores for various hand regions as compared to a common ballpoint pen during extended writing (Udo et al., 2000).
