Tremor

Tremor

Topic Overview

Tremor is an involuntary shaking movement that is repeated over and over. Although it may affect any part of the body, tremor most often affects the hands and head. Your voice may also shake. Sometimes the feet or torso may also shake.

Essential tremor, which sometimes runs in families, is one of the most common types of tremor. It is shaking that is most noticeable when you are doing something like lifting a cup or pointing at an object. The shaking does not occur when you are not moving. Medicine can help reduce the shaking. Brain surgery can be helpful in some cases.

Tremors can also be caused by conditions or medicines that affect the nervous system, including Parkinson's disease, liver failure, alcoholism, mercury or arsenic poisoning, lithium, and certain antidepressants. Side effects from other medicines can also cause tremors.

If you notice a tremor, observe it carefully and note what seems to make it better or worse before calling your doctor. There are some differences between essential tremor and tremor caused by Parkinson's disease. If a cause is discovered, the disease will be treated rather than the tremor.

When to Call a Doctor

Call your doctor if:

  • You suddenly develop a tremor or if an existing tremor becomes worse.
  • Tremor interferes with your ability to do daily activities or keeps you from taking part in social events.
  • You suspect that tremor may be a side effect of a medicine.

Treatment Overview

Some tremors can be treated with medicine or surgery.

  • A tremor caused by Parkinson's disease may get better if your Parkinson's disease is treated.
  • Essential tremor is usually treated with medicine, such as:
    • Primidone (for example, Mysoline).
    • Propranolol (for example, Inderal).

Essential tremor that doesn't get better with medicine may be treated with surgery, such as:

Home Treatment

  • Stress reduction can sometimes help to reduce tremors. For more information, see the topic Stress Management.
  • Add a little weight to your hand by wearing a heavy bracelet or watch or holding something in your hand. This may reduce some tremors and restore more control to your hands.
  • Drink beverages from half-filled cups or glasses, and use a straw.
  • Get enough rest and sleep. Fatigue often makes a tremor worse.
  • Reduce your caffeine intake.

References

Other Works Consulted

  • Ropper AH, et al. (2014). Tremor, myoclonus, focal dystonias, and tics. In Adams and Victor's Principles of Neurology, 10th ed., pp. 92–114. York: McGraw-Hill Education.
  • Zesiewicz TA, et al. (2011). Evidence-based guideline update: Treatment of essential tremor. Neurology 77(19): 1752–1755. Available online: http://www.neurology.org/content/77/19/1752.full.html.

Credits

Current as ofJune 3, 2018

Author: Healthwise Staff
Medical Review: Anne C. Poinier, MD - Internal Medicine
E. Gregory Thompson, MD - Internal Medicine
Adam Husney, MD - Family Medicine
Martin J. Gabica, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
G. Frederick Wooten Jr., MD - Neurology

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