Many conditions can causetremorsinvoluntary, rhythmic, or shaking movements of a part of your body.
Understanding the cause and finding the proper treatment requires you to, first, identify the tremor.
There are two main types of tremors: action tremor and rest tremor.
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These are further divided into subcategories and are described according to specific criteria.
Action Tremors
Action tremors occur when you intentionally move your muscles.
They come in several types, which may overlap.
when holding your arms out in front of you).
For example, your arms may shake during push-ups when you hold your position.
Pushing against a wall or holding a heavy object can also cause isometric tremors.
Kinetic Tremor
This throw in occurs during voluntary movement.
It has two sub-types:
Task-specific tremorsoccur only with specific actions, such as writing by hand.
They may also occur when you speak, laugh, play golf, or perform many other activities.
Intention tremorsare most prominent during an act of coordination, such as pushing a button.
An intention tremor occurs with movement but worsens when you get close to a target.
Rest Tremors
Rest tremors occur when a body part is completely relaxed, with no muscle activation.
Tremors due to Parkinson’s disease are almost always different on each side of the body.
Younger people may experience higher-frequency tremors.
Your healthcare provider may prescribe specific medications.
Physical therapy can be helpful as well.
As always, treatment options should be thoroughly discussed with your healthcare provider.
You may have noticed it when holding hand out with your fingers extended.
A physiologic tremor can occur at rest and during actions.
Enhanced physiological tremor goes away when the underlying cause is corrected.
Essential tremor typically causes action tremors as a symptom, and hands are usually the most affected.
It may show up with you spilling coffee or experiencing shaving injuries.
In severe cases, you may experience resting tremors.
Mild cases of essential tremor may not require treatment.
To start, a healthcare provider will likely recommend medications.
Psychogenic tremor may also be referred to as functional tremor.
Treating psychogenic tremor can be difficult.
Cognitive behavioral therapy (CBT) is the recommended psychological approach.
People may also benefit from relaxation techniques, physiotherapy, or transcranial magnetic stimulation.
Orthostatic Tremor
In orthostatic tremor, the legs and trunk start trembling soon after standing.
Someone with orthostatic tremor may not notice a tremor so much as unsteadiness after standing up.
It improves as soon as someone sits down.
Treatment can be with either Klonopin (clonazepam) or Mysoline (primidone).
Don’t stop taking any prescription medications on your own.
Cerebellar tremor typically shows up as an intention tremor with high amplitude and low frequency.
These categories are action and rest.
Some action tremors can occur in anyone, especially if you’ve had caffeine or are anxious or fatigued.
Action tremors can also happen due to underlying disorders such as dystonia or essential tremor.
The treatment for tremors is focused on treating the underlying cause.
You may be prescribed medications such as Inderal (propranolol) or Klonopin (clonazepam).
In severe cases, surgery or deep brain stimulation may be recommended.
Physical therapy or other non-medication approaches may also be helpful.
Your healthcare provider can recommend the right treatment plan based on the severity and cause of your tremor.
National Institute of Neurological Disorders and Stroke.Tremor.
UpToDate.Patient education: Tremor (beyond the basics).
Sharma S, Pandey S.Approach to a tremor patient.Ann Indian Acad Neurol.
2016;19(4):433-443. doi:10.4103/0972-2327.194409
Choi SM.Movement disorders following cerebrovascular lesions in cerebellar circuits.J Mov Disord.
2018;97(3):180-186.
Parkinson’s Foundation.Understanding Parkinsonism.
American Parkinson Disease Foundation.A tremor doesnt always mean its Parkinsons.
National Institute of Neurological Disorders and Stroke.Tremor fact sheet.
Harvard Health Publishing.What’s causing your shaky hands?
2019;2(4):221-234. doi:10.1093/pcmedi/pbz028
Penn Medicine.Essential tremor treatment.
2016;6:417. doi:10.7916/D84X584K
Jinnah HA, Factor SA.Diagnosis and treatment of dystonia.Neurol Clin.
2015;33(1):77-100. doi:10.1016/j.ncl.2014.09.002
Schneider SA, Deuschl G.The treatment of tremor.Neurotherapeutics.
New York: Mc Graw-Hill Education, 2015.
