When people think of movement disorders, the first condition that usually comes to mind is Parkinson’s disease and its characteristic tremors. However, in addition to Parkinson’s, there are other equally disabling conditions that remain relatively unknown, even though the condition has a great impact on daily life. Dystonia is one of those conditions and is a neurological disorder that may present at any age and is estimated to affect up to 1% of the world population. It is characterized by constant or intermittent contractions of the muscles that cause abnormal postures and twisting movements. These spasms can be very painful and can lead to deformities in the joints. Tremor is also commonly seen in certain types of dystonia.
Dystonia symptoms are often aggravated by stress, fatigue, or negative emotions, and tend to improve with sleep and relaxation. There are also other people who get relieved by just doing simple sensory tricks, e.g., touching the face, holding something in the mouth, or even wrapping a scarf around the neck. There are multiple causes of the condition. The genetic alterations are associated with the inherited forms, which affect the genetics of the dopamine signaling or the basal ganglia functions. Acquired dystonia may develop after trauma, stroke, infection, tumor, medication exposure, or as part of degenerative and metabolic disorders. Idiopathic dystonia, the most common form, has no identifiable cause.
In adults, the focal, or isolated, dystonia is the most prevalent type of dystonia and involves a single part of the body. The most famous one is cervical dystonia or spasmodic torticollis, in which the muscles of the neck and occasionally the shoulder can be involved, and the head starts making involuntary movements, either by nodding or shaking. Additional ones are segmental dystonia, which involves two or more adjacent areas, like the face, jaw, and tongue, in Meige syndrome. Generalized dystonia is a condition that affects the majority of the body, such as the trunk and limbs. Hemidystonia is localized on one side, whereas multifocal dystonia is on two or more entirely separate parts.
Although there is no cure, dystonia may be treated effectively to improve the quality of life. This should be done with the help of an interdisciplinary team, which can consist of neurologists, physiotherapists, occupational and speech therapists, and psychologists with experience in movement disorders. Conventionally, a holistic approach that incorporates both medical care, emotional assurance, and social network can help regain confidence and enhance general well-being. The central place goes to physiotherapy because it enhances mobility, alleviates pain, and assists patients in controlling involuntary movements, in the long run, leading to independence in daily activities.
Research on dystonia continues to progress in areas such as genetics, pharmacological therapies, and brain stimulation techniques. According to the Spanish Society of Neurology, more than 20,000 individuals in Spain live with some form of dystonia, though the actual number is likely higher due to underdiagnosis. The condition is often misdiagnosed as Parkinsonian tremor, essential tremor, tics, myoclonus (sudden, uncontrolled jerking), psychogenic movement disorders, or even spinal malformations like scoliosis.
Dystonia is a severely disabling disorder, with its impact reaching far beyond physical impairment. Its chronic nature often leads patients to experience significant stress, anxiety, and depression. The Spanish Dystonia Association (ALDE) reports that most patients receive a disability rating between 33% and 65%, though in many cases the actual impact is greater. Despite this, many individuals are reluctant to disclose their condition publicly, contributing to its social invisibility. The combination of constant pain, emotional trauma, and social stigma often forces patients into isolation.
References: Natalia Brandín de la Cruz, Lorena Morcillo Martínez, Sandra Calvo. When muscles rebel: a close look at dystonia, a debilitating but widely underdiagnosed movement disorder. The Conversation. Published September 17, 2025. Accessed September 18, 2025. When muscles rebel: a close look at dystonia, a debilitating but widely underdiagnosed movement disorder
