Tremors: Causes, Types, and Treatment

Tremors are involuntary, rhythmic muscle movements that cause shaking in one or more parts of the body. They can affect the hands, arms, head, legs, voice, or torso and may be temporary or chronic.

Types of Tremors

1. Essential Tremor (ET) (Most Common)

🔹 Genetic (runs in families)

🔹 Affects hands, head, or voice

🔹 Worsens with movement (e.g., holding objects, writing)

🔹 Improves with alcohol in some cases

2. Parkinsonian Tremor

🔹 Seen in Parkinson’s disease

🔹 Occurs at rest (resting tremor)

🔹 Starts in one hand, spreads slowly

🔹 “Pill-rolling” motion of fingers

3. Cerebellar Tremor

🔹 Caused by brain damage or disease (stroke, MS, alcohol damage)

🔹 Occurs at the end of a movement (e.g., reaching for an object)

🔹 Uncoordinated, jerky movements

4. Physiologic Tremor (Normal, mild shakiness)

🔹 Temporary and subtle

🔹 Triggered by stress, caffeine, anxiety, fatigue, or medications

🔹 Often resolves on its own

5. Dystonic Tremor

🔹 Seen in people with dystonia (muscle contractions)

🔹 Irregular movements that improve with rest

🔹 Affects neck, face, hands, or arms

6. Orthostatic Tremor (Rare)

🔹 Rapid shaking in the legs when standing

🔹 Stops when sitting or walking

Causes of Tremors

Neurological disorders (Parkinson’s, multiple sclerosis, stroke)

Genetic (hereditary essential tremor)

Overactive thyroid (hyperthyroidism)

Anxiety, stress, or fatigue

Excess caffeine or alcohol withdrawal

Low blood sugar (hypoglycemia)

Medications (antidepressants, asthma drugs, steroids)

Brain injuries or tumors

Diagnosis of Tremors

🔹 Neurological exam – Tests coordination, strength, reflexes.

🔹 Blood tests – To check thyroid, blood sugar, and toxin exposure.

🔹 MRI/CT scan – To rule out brain disorders.

🔹 Dopamine tests – If Parkinson’s is suspected.

Treatment for Tremors

1. Medications

Beta-blockers – Propranolol (for essential tremor).

Anti-seizure drugs – Primidone, gabapentin.

Parkinson’s medications – Levodopa, dopamine agonists.

Anti-anxiety meds – Clonazepam, diazepam (if stress-related).

2. Lifestyle Changes

Reduce caffeine & alcohol intake

Practice relaxation techniques (yoga, meditation)
Improve sleep quality

Use weighted utensils for eating/writing

3. Physical Therapy & Adaptive Tools

 Strength training & coordination exercises.

 Weighted pens & adaptive devices to assist daily tasks.

4. Surgical Options (For Severe Cases)

🧠 Deep Brain Stimulation (DBS) – A brain implant that reduces tremors.

🩺 Focused Ultrasound Therapy – Uses sound waves to target tremor-causing areas.

When to See a Doctor?

🔹 If tremors worsen over time or interfere with daily life.

🔹 If tremors occur at rest (may indicate Parkinson’s).

🔹 If accompanied by balance issues, weakness, or speech changes.