Tremor

Approximately 70% of people with Parkinson's experience tremor. A tremor is an involuntary, rhythmic shaking or quivering movement which can occur in the hand, arm, foot, leg, and chin with the most common being in a person's hands.

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Imbalances in neurotransmitters cause tremors. As dopamine cells disappear because of Parkinson's, a neurotransmitter called acetylcholine becomes overexpressed, and this excess results in involuntary shaking movements. Tremor is typically seen on one side of the body, often starting in a hand in the early stages of Parkinson's. As Parkinson's progresses, tremor may impact both sides of the body or affect more regions. The patterns, forms, and progression of tremors vary for everyone.

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Tremors can be aggravating, especially when it comes to managing activities of daily living that involve fine motor skills. Writing, brushing teeth, shaving, and eating may all be impacted by tremor, requiring activities to take longer to accomplish. While it can be bothersome, and even embarrassing for some, it is not life-threatening or incapacitating. 

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Types of Tremor

There are many different types of tremor. They include:

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• Pill-Rolling Tremor: One of the first symptoms of Parkinson's generally occurs in the fingers. Finger twitching is a movement that looks like a person is rolling a pill between their thumb and fingers.

• Resting Tremor: The most common tremor in PD is the resting tremor, which occurs when a person is at rest or under emotional / physical stress. Resting tremors will often subside while the impacted body part is moving. Resting tremor in the legs occurs when a person is lying down or sleeping. If the person starts moving, the tremor disappears.

• Action Tremor: Opposite to the resting tremor, an action tremor is the shaking motion that occurs when a limb or body part is being moved. While less common in people with Parkinson's, more than 25% of people with PD experience them.

• Internal Tremor: Internal tremors are not typically visible by other human beings, but people with PD may report a shaking sensation inside their chest, abdomen, or limbs. It can be difficult to explain this tremor to others and be a distraction or interruption to activities. They are both difficult to identify and describe, but generally respond to medications in similar ways as other tremors.

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Managing Tremor

Medications are the most common form of treatment used to minimize tremor. It is important that medications for tremor be taken consistently and on time to avoid any "off" times. Keeping a constant level of the prescribed medications can help manage tremor return. Ensuring your medications work optimally is critical to treating tremor. This includes taking your medication each day at the same time, establishing routines, keeping hydrated, and optimizing absorption by eating meals 30 minutes before or after medication is taken.  Other ways to reduce tremor, include:

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• Exercise

• Reduce Multi-Tasking

• Reduce Stress

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Products and Technologies to Aid with Tremor

There are many tools, gadgets, and equipment that are designed to help people who experience tremor. This could include stretchy elastic shoelaces, or a long-handled shoehorn to help you put on socks and shoes, to an adaptive mouse for computer work, weighted silverware to help decrease tremor while eating, or velcro buttons.

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What works for some, may not work for all. A good place to see recommendations is by participating in social media groups where those living with Parkinson's and care partners share tips and advice on what products have helped.

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Although some adaptive products are covered by insurance, many are not. However, a written prescription from your physician for any changes in your home, from grab bars in the bathroom, to a ramp inside or outside your home, can help with potential tax deductions.