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What is a tremor?

A tremor is a movement you cannot control that occurs in a rhythm. Tremors most commonly occur in the hands. Other common places include the head or face, trunk, or legs. Your voice can also have a tremor and sound shaky when you speak. A tremor may be caused by a nerve problem, too much thyroid hormone, or by certain medicines, caffeine, or alcohol. Tremors may be temporary or permanent. The tremor may go away and return, or worsen with stress. Tremors can happen at any age, but they are more common in later years.

What are the types of tremors?

A tremor may happen when you are at rest. For example, your hands may move even though you are resting them in your lap. Tremors may also happen when you move. You may have a tremor when you hold your arms out, or when you move your wrists. A tremor may happen when you try to reach for something, or when you write or speak. You may also have a tremor when you contract a muscle, even if you do not move the body part. You may have tremors in your legs when you stand. Anxiety or a strong emotion can also cause tremors.

What increases my risk for tremors?

  • Older age
  • Certain medicines, such as steroids, antipsychotics, or amphetamines
  • A family history of tremors
  • A condition such as Parkinson disease, multiple sclerosis, a thyroid problem, or liver failure
  • A brain injury, stroke, or disease that affects your brainstem
  • Alcohol abuse, or withdrawal from alcohol

How is the cause of a tremor diagnosed?

Your healthcare provider will ask about your tremors and when they began. Tell him if you have tremors on one or both sides of your body. Tell him if anything triggers a tremor or makes it stop. He may also ask if anyone in your family has a history of tremors.

  • Blood or urine tests may be used to check for medicines, illegal drugs, or alcohol.
  • A neurologic exam may be used to check for nerve damage. Your healthcare provider may ask you to use an eating utensil or write words on paper. He may ask you to touch your finger to your nose. These tests can help your healthcare provider see tremors that happen during these activities.
  • CT or MRI pictures may be used to check for a brain problem or injury. You may be given IV contrast liquid to help your brain show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.
  • An electromyogram may be used to check for muscle or nerve problems. A machine measures the activity in your muscles when the muscles are stimulated. A needle with a device called an electrode attached to the end will be inserted into your muscle through your skin. An electric current is sent through the needle and into the muscle. Your healthcare provider may measure muscle activity when you are at rest and when you move the muscle.

How are tremors treated?

You may not need treatment if your tremor is mild. You may need treatment for a condition that can cause tremors, such as a thyroid disorder. Your healthcare provider may stop or change a medicine that may be causing tremors. Do not stop or change any medicine unless your doctor tells you to.

  • Medicines may be used to help control some kinds of tremors.
  • Deep brain stimulation is used to control some types of tumors. Electric currents are delivered into parts of the brain that control movement. The currents disrupt the tremor.
  • Thalamotomy is surgery that may be used to control some types of tremors if other treatments do not work. During surgery, parts of the thalamus are destroyed. The thalamus is a small area of the brain. It is located deep inside the brain and helps control movement.

What can I do to manage my symptoms?

  • Do not have caffeine or other chemicals that affect your nerves. Limit or do not have caffeine. Caffeine can make tremors worse. Talk to your healthcare provider about herbal medicines, teas, and supplements. They may also increase tremors. Do not use illegal drugs.
  • Go to physical and occupational therapy as directed. A physical therapist can teach you exercises to help reduce the tremor and improve muscle control. You may be shown how to hold the body part during a tremor to help control the movement. The therapist can also help you build strength and balance. An occupational therapist can show you how to use adaptive devices to help you move more easily.
  • Use objects that will help you control movements. You may have more hand control if you add a watch or bracelet to your wrist. It may be easier for you to drink from a straw, or to fill your cup only half full. Cups with lids, such as travel mugs, can also help you drink with more control. Heavy eating utensils can help you eat more easily. A button fastener can help you button clothing if tremors in your hands make this difficult.
  • Set a regular sleep schedule. Lack of sleep can make tremors worse. Try to go to bed at the same time each night and wake up at the same time each morning.

When should I contact my healthcare provider?

  • You have a new or worsening tremor.
  • You have tremors that make it difficult to do your regular activities.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.