What Your Handwriting May Say About Your Health

If you're having trouble signing on the dotted line, or you've noticed a change in your handwriting, it may signal more than just sloppy writing. It could indicate a neurological or muscular problem.

“When someone’s handwriting changes and becomes messy, sloppy, illegible or shaky, that might be a sign of an essential tremor, Parkinson’s disease, writer’s cramp or ataxia,” says neurologist Camilla Kilbane, MD.

“Along with physical issues, loss of legible handwriting in seniors makes it difficult to perform everyday tasks like writing checks, making shopping lists, filling out forms and sending notes,” she says.

The two most common reasons for a change in handwriting are essential tremor and Parkinson’s disease, she says. An essential tremor is a neurological condition that causes a rhythmic, involuntary, trembling of the hands, head, voice, legs or body. An essential tremor is eight times more common than Parkinson’s disease and affects an estimated 10 million Americans.

People with Parkinson’s disease also notice a handwriting change as their disease progresses. This change, called micrographia, results in handwriting becoming small and cramped and more difficult to control when writing for long periods of time.

The National Parkinson’s Foundation suggests ways to make handwriting easier for people whose handwriting is compromised due to a medical condition:

• Make a deliberate effort to form each letter. This can be hard to do at first, but is very effective in improving size and legibility of handwriting.
• Use a pen grip (round or triangular-shaped rubber or foam cylinders available at stationery stores or where writing materials are found) or a larger-sized pen to keep your hand more relaxed.
• Try printing rather than writing in a cursive style. Printing causes you to pause briefly between each letter, keeping writing more legible.
• Using lined paper may provide a “visual target” to keep all letters big when writing.
• A ballpoint pen typically works better than felt tip or “rolling writer” styles.
• Rest your hand if it begins to feel “tight.” Pause briefly when you see your handwriting becoming smaller.
• Avoid hurrying or trying to write long passages if you're feeling stressed.
• Practice helps. Remind yourself to slow down, aim big and pause often.

According to Dr. Kilbane, writer’s cramp, a type of focal dystonia, is another reason a person’s handwriting can deteriorate. Hand dystonia causes excessive muscle contractions in the hand and arm, which affects writing. It's usually observed in people who perform tasks repeatedly. This often affects musicians and people who frequently write longhand.

“In hand dystonia, involuntary muscle contractions make it hard to write legibly,” Dr. Kilbanesays. “The recommended treatment is occupational therapy, Botox injections and a special 'Y'-shaped, rubber-coated ergonomic designed pen to make writing easier and more fluid.”

Ataxia, which is a group of disorders that affects coordination, speech and balance, can also affect the fine motor skills needed for handwriting.

“Ataxia is caused by damage to the part of the brain controlling muscle coordination, called the cerebellum,” she says. “Since writing is a fine-motor skill, when a person has ataxia, their handwriting may suffer.”

Dr. Kilbane advises whenever you notice a change in your handwriting and are uncertain of the cause, it’s wise to see a medical professional to determine the reason for this change, so that you can develop a method to deal with it.

“We work to improve the symptoms involving handwriting issues as we treat the underlying diagnosis,” she says.

Camilla Kilbane, MD is a neurologist and directs the fellowship program in movement disorders in the Parkinson’s and Movement Disorders Center at University Hospitals Cleveland Medical Center. You can request an appointment with Dr. Kilbane or any other doctor online.