Tremor
What is a tremor?
A tremor is a neurological condition that includes shaking or trembling movements in one or more parts of your body. It most often affects the hands. But it can also affect the arms, legs, head, vocal cords, and torso (trunk). A tremor is involuntary, meaning that you cannot control it. It happens because of muscle contractions.
A tremor may come and go, or it may be constant. It can happen on its own or be caused by another disorder. It is not life threatening, but it may cause challenges. It can make it hard to do daily life tasks such as writing, typing, eating, and dressing. In some cases, a tremor can even lead to disabilities.
What are the types of tremor?There are several types of tremor, including:
- Essential tremor, sometimes called benign essential tremor or familial tremor. This is the most common type. It usually affects both your hands and arms while you are moving them. It can also affect your head, voice, or legs.
- 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.
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, chemotherapy, corticosteroids, and medicines used for certain psychiatric and neurological disorders
- Alcohol use disorder (AUD) or alcohol withdrawal
- Poisoning from certain toxic substances, including pesticides and heavy metals such as mercury and lead
- Hyperthyroidism (overactive thyroid)
- Liver or kidney failure
- Anxiety or panic
- Too much caffeine
Anyone can get tremor, but it is most common in middle-aged and older adults. For certain types of tremor, 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
Your health care provider may use many tools to make a diagnosis:
- A medical history, which includes asking about your symptoms
- 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
- A neurological exam, including checking for:
- Problems with balance
- Problems with speech
- Increased muscle stiffness
- Blood or urine tests to look for the cause
- Imaging tests to help figure out if the cause is damage to your brain
- Tests that check your abilities to do daily tasks such as handwriting and holding a fork or cup
- An electromyogram, a test that measures involuntary muscle activity and how your muscles respond to nerve stimulation
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 can include:
- Medicines. There are different medicines for the specific types of tremor. Another option is Botox injections, which can treat several different types of tremor.
- Surgery may be used for severe cases that do not get better with medicines. The most common type is deep brain stimulation (DBS). DBS uses electrodes that are implanted in the brain. The electrodes send electrical pulses to the parts of the brain that are causing the tremor.
- 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
Felter's Materia Medica on Tremor
The fungus Amanita muscaria, Persoon; (Agaricus muscarius, Linné.) (Nat. Ord. Fungi.) An extremely poisonous fungus found in the pine forests of... / ...l backward. Webster thought it useful in typhoid conditions and spinal irritation when there is tremor, restlessness, and desire to get out of bed. These indications are of homeopathic origin an...1
The rhizome of Dryopteris Filix-mas and of Dryopteris marginalis, Asa Gray (Nat. Ord. Filices). World-wide ferns of the Northern Hemispheres.... / ...causes nausea, vomiting, purging, severe abdominal pain, headache, dizziness, muscular prostration, tremors, cramps, dyspnea, cold perspiration, cyanosis, collapse, and death. In some cases amblyopia ...1
The dried flowering tops of the female plant of Cannabis sativa, Linné, or the variety indica, Lamarck (Nat. Ord. Cannabinaceae). Asia, East... / ...abeyance, and partial anesthesia prevails. While the ultimate effects of the drug in some result in tremor, great weakness, loss of appetite and convulsions, no deaths have been known to occur in man ... / ...of the urino-genital tract and relieves pain. For the first condition it is invaluable in more or less painful conditions in which opium see1
...bility, neuralgia and delirium, all from atony; restlessness and muscular twitching, typhomania and tremors in low forms of fever; wakefulness from mental unrest; menstrual irregularities, with despon......eves the nervous unrest attending gleet, and the sexual erethism of debility. In the typhomania and tremors of low fevers it is a safe and often effectual drug, but like all others in these conditions...1
The dried bark of the stems and roots of Punica Granatum, Linné (Nat. Ord. Punicaceae). India, southwestern Asia, and the Mediterranean... / ...rge amount of tannin it contains, such action is frequently followed by diarrhea. Other effects are tremors, muscular weakness, and cramps in the extremities, dizziness, mental confusion, drowsiness, ... / ...Epsom salt, fluidextract of jalap, or castor oil may be used as the cathartic. If the tannate is employed it may be administered in capsule.1
The dry, ripe seeds of Strychnos Nux vomica, Linné (Nat. Ord. Loganiacae). According to the U. S. P. it should contain at least 2.5 per cent of... / ...at first marked uneasiness and restlessness, with more or less of a sense of impending suffocation. Tremors of the whole body are observed. Suddenly there is violent starting of the muscles, and the e... / ...and the heart from cramp asphyxia. The body stiffens after death and this rigidity has been known to persist for months. The smallest doses 1
The dried, ripe seed of Physostigma venenosum, Balfour (Nat. Ord. Leguminosae). A climbing perennial, native of Calabar, in the Gulf of Guinea, on... / ... the eye so treated. Poisonous doses increase the foregoing symptoms, with the addition of muscular tremors or fibrillary twitchings (confined only to portions of the muscle), the reflexes are abolish... / ...drug has not therefore had a fair trial. It is one of the suggested antidotes for strychnine poisoning, the alkaloid being preferred. For all of1
... illness, or from mental or physical exhaustion, or teething; nervousness with muscular excitation; tremors; subsultus tendinum; hysteria, with inability to control muscular action; functional heart d......antage during acute and chronic illness to maintain nervous balance, control muscular twitching and tremors, and is sometimes effectual in subsultus tendinum during grave prostrating fevers. Too much,...1