Have you ever woken up with arm, leg, or hand tremors? Have you ever experienced tremors in other parts of your body? Have you ever experienced them not only after waking up but also during your daily routines?
Tremors are muscle twitches that many of us have experienced at some point in our lives. Some of them can be quite harmless and mild and can just come and go, while others can be quite painful and severe, not to mention that they can last for a long time. And the worst of it all? They aren’t curable.
However, there are treatment methods. That’s why we’re devoting this article to body tremors—to help you learn more about them, about the types of body tremors, and get an idea as to what causes them. We’ll talk about the diagnostic options, the warning signs, and we’ll also give you a rundown of the different treatment options available. Our goal is to equip the individuals who have to live with these tremors with the knowledge they need to make their lives easier.
What Is a Tremor?
Tremors are reflexive, rhythmic muscle contractions that lead to shaking movements in one or more body parts.
This is a widespread movement disorder that usually affects the hands, but it can also occur in the head, torso, legs, and arms.
Tremors can be constant or spasmodic; the latter refers to tremors that occur at separate times, with pauses. They can happen sporadically or occur as a reaction to some other disorder.
Tremors occur mostly in middle-aged and older individuals, but younger people can be affected too. Gender is not a risk factor, meaning that both women and men are equally affected.
Although tremors can make daily activities difficult or—in some cases—impossible at their worst, you can relax because they aren’t life-threatening.
Causes of Tremor
Basically, tremors result from problems in the brain’s deeper parts which control the movements of your body. Since tremors are connected to parts of the brain, the cause of some forms of tremors is still unknown.
Tremors can happen on their own, or they can be a symptom related to numerous medical conditions of the nervous system, such as:
- Stroke;
- Traumatic injury of the brain;
- Epilepsy;
- Neurodegenerative diseases, which have an impact on some brain parts, such as Parkinson’s disease or multiple sclerosis (MS).
There are other causes like:
- Alcohol abuse or withdrawal;
- Lack of sleep;
- Mercury poison;
- Overactive thyroid gland, also known as hyperthyroidism;
- Severe kidney or liver medical conditions;
- Anxiety disorder;
- Low blood sugar, also known as hypoglycemia;
- Side effects from medications, such as asthma medications.
Tremor Classification
Medical experts have divided tremors into two main categories based on movement:
- Resting tremors;
- Action tremors.
Resting Tremors
Resting tremors happen when your muscles loosen up, for example, when your hands are resting on the table. Usually, these tremors affect only the fingers and the hands. During voluntary motions, resting tremors are reduced.
Action Tremors
On the other hand (pun not intended), action tremors happen during voluntary muscle motions. These tremors are divided into five subcategories:
- Kinetic tremors.
This tremor is apparent when an individual performs activities like drinking from a cup, buttoning a coat, or even writing. Kinetic tremors affect everyday tasks and are thus considered more severe. - Intention tremors.
This category of tremors occurs during targeted movements like touching one’s eye. The tremor gets worse as the individual comes closer to the target. - Postural tremors.
Postural tremors occur when an individual is trying to hold a position opposite to gravity, like keeping your hands above your head. - Task-specific tremors.
This category of tremors occurs only when you try to perform an activity that requires skill such as drawing, speaking, or writing. - Isometric tremors.
Isometric tremors happen when there are voluntary muscle contractions that don’t require any motion, such as holding a heavy cup in a particular position. - Internal tremors.
Internal tremors are characterized by general shakiness, usually associated with a vibrating sensation inside the body.
Types of Tremors
The other classification of tremors is by their cause. There are over 20 types of tremors, and the following are the most common ones:
- Essential tremor;
- Parkinsonian tremor;
- Cerebellar tremor;
- Dystonic tremor;
- Physiologic tremor;
- Psychogenic tremor.
Essential Tremor
Essential tremors occur as a result of problems in the nervous system. However, individuals that have this type of tremor rarely experience other symptoms of dysfunction of the nervous system. What causes these tremors is unknown, but they are often related to family genetics.
Essential tremors often start during early adulthood, but they can occur at any age as well. As the individual grows old, essential tremors become more and more noticeable, and due to this, essential tremors are often known as senile tremors. Although they often impact the hands and arms, they’re also known to impact the head. In that case, individuals usually look like they’re nodding their head as if they are saying “yes” or shaking it as if they are saying “no.”
Even though essential tremors can remain mild, they can be quite embarrassing and irritating. Essential tremors negatively influence a person’s ability to write and even make using appliances quite difficult. In some individuals, these tremors worsen as time passes. The common symptoms of essential tremors can resemble the symptoms of Parkinson’s disease. However, an individual can rarely have essential tremors and Parkinson’s disease.
Parkinsonian Tremor
Over 70% of individuals that experience Parkinson’s disease have resting tremors, which are, in this case, also known as Parkinsonian tremors. The main Parkinsonian tremors (PT) tend to progress slowly and usually start with the fingers.
Parkinsonian tremors can occur in only one limb or on one body side, but PT can spread to the entire body as this medical condition progresses. Usually, strong emotions and stress can provoke this tremor to become worse. Over 25% of individuals that suffer from Parkinson’s disease have some type of action tremor as well.
Cerebellar Tremor
Cerebellar tremors occur when an individual tries to execute a targeted movement, such as bringing a spoon to the mouth. These tremors have high amplitude and low frequency, where the frequency refers to the tremor’s speed, while the amplitude refers to the level of movement.
Healthcare professionals usually diagnose cerebellar tremors in individuals that have multiple sclerosis or another medical condition of the nervous system.
Dystonic Tremor
Dystonia is a movement disorder where an individual’s muscle twitches involuntarily and, at the same time, causes twisting or repetitive movements. This movement disorder can have an impact on two or more adjacent parts of the body, known as segmental dystonia, on only one body part, known as focal dystonia. It can also affect the entire body, known as general dystonia.
The muscle twitches can range from mild to severe. Dystonic tremors can be painful and can cause difficulty in doing daily activities.
Physiologic Tremor
Physiologic tremors are known as normal tremors due to the fact that all of us have them to an extent. For example, you can often experience slight tremors when you hold your hands outstretched. In some cases, physiologic tremors can become very noticeable and may cause worry for some individuals. Physiologic tremors can get worse if an individual:
- Suffers from stress and anxiety;
- Consumes a large amount of caffeine;
- Takes particular medications, such as corticosteroids and asthma medications;
- Has a medical history of particular disorders like hyperthyroidism.
Psychogenic Tremor
Psychogenic tremors, also known as functional tremors, can be manifested as any type of tremor. Their symptoms can be very different. However, they usually appear abruptly and can impact the whole body. Psychogenic tremors increase when the individual is under stress and decrease or even disappear when the stress is gone. Some persons that have psychogenic tremors also suffer from psychiatric medical conditions, like post-traumatic stress disorder (PTSD) or depression.
Warning Signs of Tremor
Here are some common symptoms that might necessitate looking for medical advice from a neurologist:
- Body tremors that started suddenly and unexpectedly;
- If you feel body tremors, but you’re younger than 50, and there’s no one else in your family that has essential tremors;
- If you feel any neurological symptoms, like weakness in your muscles, you walk differently, you have difficulty speaking, or your mental status has changed;
- If you feel anxiety and your heart is beating really fast.
How Is a Tremor Diagnosed?
In order to diagnose body tremors, a healthcare professional can use neurological and physical examinations as well as other diagnostic tests.
Neurological and Physical Examinations
Physical examinations are usually the first step and are conducted to determine:
- Whether the muscle twitches appear during an action or during rest;
- The tremor’s location;
- Whether the tremors affect the entire body or just on one side;
- The amplitude and the frequency of the tremor.
Afterward, the doctor may conduct a neurological examination and search for the following things:
- Abnormalities while speaking;
- Impaired balance;
- Increased stiffness in the potentially affected muscle.
Other Diagnostic Tests
In order to determine the reasons for body tremors, healthcare professionals can order these diagnostic tests:
- Urine and blood tests.
With these tests, a particular cause of body tremor can be excluded, like side effects from medications, the interaction of drugs, alcoholism, and dysfunction of the thyroid gland. - Diagnostic imaging of the brain.
Doctors can conduct diagnostic brain imaging with MRI (Magnetic Resonance Imaging) or CT (Computed Tomography). This diagnostic can be used if the individual has other neurological symptoms that indicate a brain disorder, like multiple sclerosis or Parkinson’s disease, tumor, or a stroke, or if the tremors have become worse. - Electromyography.
This involves muscle stimulation and recording electrical activity, which is rarely conducted.
Treatment Options for Tremor
The treatment for tremors is different for each individual, depending on the type, severity, and causes of the tremor that they experience. Certain treatments can be useful in reducing the frequency and the pain level of the body tremor. Below are some of the options.
Medications
Medications can be helpful for managing body tremors. Beta-blockers, also used as blood pressure and heart rate medications, are some of the various medications that impact tremors, like propranolol. Other medications used for tremors are anti-seizure and epilepsy medications, like primidone, benzodiazepines (antidepressants) such as clonazepam, and Parkinson’s disease medications like levodopa.
In some very specific cases, the Botulinum toxin, a.k.a. Botox, can be used to treat body tremors.
Procedure Without the Use of Surgery
Sometimes the best way for treating tremors are the non-surgical procedure, such as:
- Focused ultrasound.
The main role in the movement of the human body is played by the part of the brain called the thalamus. The outcome of damaging or disturbing the nerves of the thalamus will be body tremors. In this case, the focused ultrasound sends a ray of ultrasound waves directly to the damaged or disturbed nerves, causing tremor alleviation. - Ablation by using a radiofrequency.
By using radio waves, we create an electric current that interferes with the damaged nerves’ ability to receive and send signals and alleviates the tremors.
Changing Your Lifestyle
This is maybe the most non-invasive treatment for body tremors, and it can help individuals manage their tremors. Here are some examples:
- eliminate nicotine and caffeine;
- speech therapy as a treatment for tremors in your vocal cords;
- physical therapist.
Concluding Thoughts
As you can see, there are many different types of body tremors, and they all have one thing in common: they aren’t curable by themselves and are usually associated with medical conditions of the nervous system. However, there are various treatment options that an individual who experiences tremors can use to get some relief. It might not be much, but that’s what the options are for now. In the future, we could see some more permanent solutions as medicine keeps advancing by the day.
Article Sources
- Deuschl, G., Raethjen, J., Lindemann, M., & Krack, P. (2001, May 15). The pathophysiology of tremor. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine, 24(6):716-735. https://onlinelibrary.wiley.com/doi/abs/10.1002/mus.1063
- Puschmann, A., & Wszolek, Z. K. (2011). Diagnosis and treatment of common forms of tremor. In Seminars in neurology © Thieme Medical Publishers., 31(1):65-77. https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0031-1271312
- Haubenberger, D., & Hallett, M. (2018, May 10). Essential tremor. New England Journal of Medicine, 378(19):1802-1810. https://www.nejm.org/doi/full/10.1056/NEJMcp1707928
- Rohl, B., Collins, K., Morgan, S.,et al., (2016, December 15). Daytime sleepiness and nighttime sleep quality across the full spectrum of cognitive presentations in essential tremor. Journal of the neurological sciences, 371:24-31. https://www.sciencedirect.com/science/article/abs/pii/S0022510X16306372
- Crawford III, P. F., & Zimmerman, E. E. (2011). Differentiation and diagnosis of tremor. American family physician, 83(6):697-702. https://www.aafp.org/pubs/afp/issues/2011/0315/p697.html