Tremors

A tremor is a rhythmic shakiness of a body part due to involuntary muscle contractions. This can happen when the body is resting or can happen when the body begins to move.

Essential Tremor vs Resting Tremor

An essential tremor occurs when a person begins an action. For example, when bringing a spoon to the mouth, the hand will begin to shake as the person brings the spoon to their mouth.

Conversely, a person who has a resting tremor would have involuntary movement when they are not trying to move, but when they begin an intentional movement the tremors typically stop. Using the same example of bringing a spoon to the mouth, someone with a resting tremor would be able to coordinate scooping the spoon and bringing it to the mouth, but tremors would begin as they attempt to keep the spoon still to eat from it.

Parkinson's Disease and Resting Tremors

A resting tremor is a symptom of Parkinson’s and often is described as “pill rolling”. This is the movement the fingers look like they’re making. When tremors occur in the hands it often results in spilling things and frustration.

Managing Tremors

Medications are prescribed to manage the symptoms of Parkinson’s, but there are several non-pharmalogical strategies that can help limit tremors including:

• Sleep
• Conserve energy
• Eating foods rich in fiber
• Drinking water
• Regular exercise

The physical symptoms from Parkinson’s can make it difficult to sleep and lack of sleep can increase the symptoms of Parkinson’s. It can become a vicious cycle. Sleep disorders are common in Parkinson’s and being aware of the impact of fatigue on your tremors will assist in making safe decisions on how and when to best complete a task. Strategies to improve sleep include: having a bedtime routine, getting lots of light during the day, avoiding caffeine, and exercise.

Conserving energy involves completing tasks in the most efficient way, pacing yourself, and planning your day so you don’t overdo it.

Constipation is also a common problem that can affect how the body manages tremors. Strategies to improve constipation include eating foods rich in fiber, drinking lots of water, and exercise.

How Tremors Impact Function and What You Can Do About It

When we are toddlers we are constantly problem-solving how to accomplish a task and creating neural pathways that become stronger with each repetition. As adults our brains are wired to accomplish the task without thinking about it. We put our jacket on in the same way everyday. When you experience tremors, suddenly the way you’ve always done something doesn’t work. It’s incredibly frustrating! But there are so many ways to accomplish a task; and learning to modify your movements, your environment, or the activity itself can provide great satisfaction and improved quality of life.

Begin to build the habit of asking yourself some questions:

What can I change about the actual task?
What can I change about the environment?
What can I change in myself (movements, approach, timing) to accomplish the task?

People who experience resting tremors might have difficulty with activities that require fine motor skills, such as handwriting, buttoning buttons, zipping zippers, handling money, etc.

Is there a pen that you can use to help write? Try something thicker, heavier, or a different ink. Does it help to support your arm on a surface or closer to your body? Does it help to sit or stand? Can you use voice recognition software? What accessibility options are available on my smartphone or computer?

Can you wear clothes that don’t have fasteners? Can you pull the fabric over a button instead of pinching the button? Can you use a key ring on a zipper to help pull it up?

What type of wallet will you be able to manage best? Does it help if your bills are organized? Can you use credit cards or virtual payment methods with your smartphone?

To develop self-efficacy reflect on what you want to do, have to do, and need to do. Begin to prioritize and modify.

Bottom Line

Every person is unique in their capabilities, strategies, and what is important to them. When you have a condition that affects the way you are used to doing life, there is a grieving period. Don’t skip that! It’s ok to be sad when you have a loss of function. When you’re ready, begin to make lists, prioritize the things that are important to you, join support groups, and begin to modify your life by looking at the task, environment, and your abilities.

REFERENCES

1. Brunton, S. (2006). A comprehensive approach to parkinson's disease: How to manage fluctuating motor and nonmotor symptoms. Postgraduate Medicine, 119(1), 55-64. Retrieved from https://search.proquest.com/docview/203919124?accountid=143111
2. Lowenstein, N. (2009). A self-management approach to parkinson's disease. OT Practice, 14(9), 14-17. Retrieved from https://search.proquest.com/docview/232422243?accountid=143111

Links for More Information on Tremors:
Essential Tremor:
Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/essential-tremor/symptoms-causes/syc-20350534
US National Library of Medicine: https://ghr.nlm.nih.gov/condition/essential-tremor

Resting Tremor:
National Institute of Neurological Orders and Stroke:
https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Tremor-Fact-Sheet
National Tremor Foundation: https://tremor.org.uk/resting-tremor.html

All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the NEOFECT website is solely at your own risk.