When many people think of Parkinson’s Disease, they may think of: older people who are crouched forward and who shuffle walk, or they may think of someone with wild jerky body movements (like Michael J Fox – whose dance-like movements were caused by the medication), or may picture someone who has a tremor. For many with Parkinson’s disease and other conditions, having a tremor is a big deal, but for me (thus far), the tremor is more of an annoyance than anything else. I am more limited by the things that I have written about in my blog posts thus far (like aspects of Parkinson’s disease such as: rigidity, slowness of movement, dexterity issues, sleep issues, bladder issues, etc.). The tremor is socially embarrassing and may be the most noticeable thing to others who don’t know me, if I am sitting down and am having a good day in terms of the other aspects of my condition. I can see that for many PWP, it is probably the most embarrassing aspect of having Parkinson’s disease.
What is a tremor like for a person with PD?
A tremor is an involuntary movement (an oscillating, back and forth, or vibrating movement) which involves anywhere from one body part to several. Most people that I have met who have Parkinson’s disease, have reported their tremors started either with their thumbs, fingers, hands or forearms in general. Not all tremors are caused by Parkinson’s disease, many are caused by other things (for example: medications – such as certain antipsychotics/sleep/anxiety medications, poisoning, other conditions – such as essential tremors or other neurological conditions, withdrawal from alcohol and some benzodiazepines, and certain medical or psychiatric conditions). Tremors may even be inherited (run in families).
I often compare it to the feeling you get when you use a vibrating type of machinery – such as: a lawn mower, weed whacker, jackhammer, or being in a vehicle that has a vibrating motor. Having a tremor can interfere with holding objects and the use of writing or eating utensils.
There are different types of tremors:
* Resting tremor occurs when the hand, arm, leg, neck, of other body part is in a state of relaxation. My hand tremor occurs when my hand is on a chair arm-rest. My hand tremor also occurs sometimes when I am standing with my arm at my side. Between medication periods, my hand tremor also will show itself on other occasions. I also have noticed that I have a jaw tremor, which I only notice if my jaw is resting on the back of my hand. A resting tremor is the most often type of tremor initially observed in those with Parkinson’s disease.
* Action tremor occurs during movement of a limb or body part.
There are also sub-classes of action tremor:
* Postural tremor occurs when the person reaches out (usually going against gravity);
* Kinetic tremor appears during movement of a body part, such as moving your arms, wrist or legs in a direction;
* Intention tremor occurs during a movement designed to touch, point to, or grab an object;
* Task-specific tremor occurs when you are trying to perform detailed, skilled tasks that require sustained effort;
* Isometric tremor occurs when you are contracting a muscle or following a muscle straining task or movement.
Remember, all tremors are not caused by Parkinson’s disease.
For example: a common condition called Essential tremor is often misdiagnosed as Parkinson’s disease!
Essential tremor (sometimes called “benign essential tremor”) is a very common condition. ET typically impacts the hands, but the head and other areas may be impacted as well. Tremors are usually action tremors. There may also be some disturbance with walking that is present.
In contrast, Parkinson’s tremor usually begins with a resting tremor that is initially observed in the hand or may even begin with a “pill-rolling” action of thumb and forefinger. The tremor often starts on one limb or side of the body and then progresses to include the other side of the body. Contrary to popular belief, not everyone with Parkinson’s disease displays a tremor, some people with Parkinson’s disease start out by having rigidity and bradykinesia (slowness of movement).
How do you get rid of a tremor?
There is no cure for having a Parkinson related tremor. My medication can make my tremor diminish or disappear as long as the medication is in my system, but only to a certain degree as I have breakthroughs (called motor fluctuations), when the tremor occurs even though my medication should be at the peak level in my brain. I also notice that my tremor will occur with stress or following muscle strain. Besides anti-parkinson medications, another treatment option for Parkinson’s disease tremor is the surgical procedure of deep brain stimulation or DBS (a brain surgery involving the insertion of electrodes in the brain), something that I am not considering at this point in time.
I have heard that physical therapy and exercise can also improve tremor. I know that exercise is extremely important, but I have not noticed an improvement in my tremor with exercise.
Again, for me (at this point in time), tremor is the least bothersome of all my symptoms. For me, tremor is just an annoyance. If I feel embarrassed about my hand tremor, I sometimes will then sit on my hand or try to hide it below a table. My dexterity limitations occur regardless of whether the tremor is observably present. If you are bothered by tremor, see your neurologist or better yet, a movement disorder specialist (a neurologist with special training in movement disorders such as Parkinson’s disease) in order to see about treatment options or additional treatment options which may help.
Thanks for spending your time with me today! Remember, I am not a doctor – the information above is based on my own experiences and does not substitute nor constitute medical advice. I am just a guy with Parkinson’s disease! As always, I wish you the best on your journey! Keep on!