Overview Of Tremor

A tremor is a rhythmic shaking movement in one or more parts of your body. It is involuntary, meaning that you cannot control it. This shaking happens because of muscle contractions.

A tremor is most often in your hands, but it could also affect your arms, head, vocal cords, trunk, and legs. It may come and go, or it may be constant. This condition can happen on its own or be caused by another disorder. There are several types, including

Essential tremor sometimes called benign essential tremor. This is the most common type. It usually affects your hands, but it can also affect your head, voice, tongue, legs, and trunk.

Parkinsonian tremor, which is a common symptom in people who have Parkinson’s disease. It usually affects one or both hands when they are at rest, but it can affect the chin, lips, face, and legs.

Dystonic tremor, which happens in people who have dystonia. Dystonia is a movement disorder in which you have involuntary muscle contractions. The contractions cause you to have twisting and repetitive movements. It can affect any muscle in the body.

Commonly Associated With

Shaking; Tremor – hand; Hand tremor; Tremor – arms; Kinetic tremor; Intention tremor; Postural tremor; Essential tremor

Causes Of Tremor

Generally, this condition is caused by a problem in the deep parts of the brain that control movements. For most types, the cause is unknown. Some types are inherited and run in families.

There can also be other causes, such as:

  • Neurologic disorders, including multiple sclerosis, Parkinson’s disease, stroke, and traumatic brain injury
  • Certain medicines, such as asthma medicines, amphetamines, caffeine, corticosteroids, and medicines used for certain psychiatric and neurological disorders
  • Alcohol use disorder or alcohol withdrawal
  • Mercury poisoning
  • Hyperthyroidism (overactive thyroid)
  • Liver or kidney failure
  • Anxiety or panic

Symptoms Of Tremor

Symptoms of tremor may include:

  • Rhythmic shaking in the hands, arms, head, legs, or torso
  • Shaky voice
  • Difficulty writing or drawing
  • Problems holding and controlling utensils, such as a spoon

Exams & Tests

To make a diagnosis, your health care provider

  • Will take your medical history
  • Will do a physical exam, which includes checking
  • Whether the shaking happens when the muscles are at rest or in action
  • The location of the tremor
  • How often you have the shaking and how strong it is
  • Will do a neurological exam, including checking for
  • Problems with balance
  • Problems with speech
  • Increased muscle stiffness
  • May do blood or urine tests to look for the cause
  • May do imaging tests to help figure out if the cause is damage in your brain
  • May do tests which check your abilities to do daily tasks such as handwriting and holding a fork or cup
  • May do an electromyogram. This is a test which measures involuntary muscle activity and how your muscles respond to nerve stimulation

Treatment Of Tremor

There is no cure for most forms of this condition, but there are treatments to help manage symptoms. In some cases, the symptoms may be so mild that you do not need treatment.

Finding the right treatment depends on getting the right diagnosis of the cause. The shaking caused by another medical condition may get better or go away when you treat that condition. If your condition is caused by a certain medicine, stopping that medicine usually makes the tremor go away.

Treatments for tremor where the cause includes:

  • Medicines. There are different medicines for the specific types of this condition. Another option is Botox injections, which can treat several different types.
  • Surgery may be used for severe cases that do not get better with medicines. The most common type is deep brain stimulation (DBS).
  • Physical, speech-language, and occupational therapy, which may help to control shaking and deal with the daily challenges caused by the condition
  • If you find that caffeine and other stimulants trigger your shaking, it may be helpful to cut them from your diet.