What is a 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. Tremor can happen on its own or be caused by another disorder.
What are the types of tremor?
There are several types of tremor, 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 is 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.
What causes tremor?
Generally, tremor 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
Who is at risk for tremor?
Anyone can get tremor, but it is most common in middle-aged and older adults. For certain types, having a family history raises your risk of getting it.
What are the 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
How is tremor diagnosed?
To make a diagnosis, your health care provider
Will take your medical history
Will do a physical exam, which includes checking
Whether the tremor happens when the muscles are at rest or in action
The location of the tremor
How often you have the tremor 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
What are the treatments for tremor?
There is no cure for most forms of tremor, 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. Tremor caused by another medical condition may get better or go away when you treat that condition. If your tremor is caused by a certain medicine, stopping that medicine usually makes the tremor go away.
Treatments for tremor where the cause is not found include
Medicines. There are different medicines for the specific types of tremor. 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 tremor and deal with the daily challenges caused by the tremor
If you find that caffeine and other stimulants trigger your tremors, it may be helpful to cut them from your diet.
NIH: National Institute of Neurological Disorders and Stroke
