Home » Symptoms » Shakes and Tremors

Shakes and Tremors

Shakes and tremors are involuntary movements, shaking, or trembling of the hands, head, voice, and other body parts. It is one of the most common movement disorders, affecting about one million people in the UK.

Make Appointment

What do these mean?

The symptoms may include:

Shaking hands
An unsteady voice
Unsteady movements from the head, hands, or legs

People of any age can experience a shake or tremor, and they can be a sign of various medical conditions. These can include Parkinson’s disease, essential tremors, multiple sclerosis, anxiety, or stress.

These conditions can greatly impact your quality of life and emotional well-being, making it difficult to perform daily tasks like writing, eating, or dressing. A tremor may start gradually and worsen over time, but the severity and frequency of the tremors can vary from person to person.

Causes
The exact cause is not fully understood, but it is believed to be related to abnormal communication between certain areas of the brain that control movement. You may experience tremors if you have:
- Neurological disorders, such as Parkinson’s disease, essential tremor, multiple sclerosis, cerebellar dysfunction and dystonia
- Side effects from some medications, for example, antidepressants, antipsychotics, and asthma drugs
- Severe alcohol withdrawal (delirium tremens)
- An overactive thyroid gland
- Stress and anxiety (temporary tremors and shakes)
- Hypoglycaemia (low blood sugar) in people with diabetes
- Excessive consumption of nicotine, caffeine and other stimulants
- Traumatic injuries, such as head injuries
- Genetic factors
As you age, you may also experience tremors due to the natural ageing processes in the body.
Diagnosis

There are several tests that neurologists may use to investigate tremors. The specific tests we suggest will depend on the suspected cause of your tremors and your individual circumstances.

Common tests include:

Neurological examination: This involves a physical examination of the nervous system functions, including testing for tone, muscle strength, reflexes, and coordination.

Blood tests: To diagnose any underlying medical conditions, such as thyroid conditions or liver disease.

Imaging tests: Scans such as CT, MRI and DAT scans can help identify structural abnormalities in the brain.

Electromyogram (EMG): This test measures the electrical activity of muscles and nerves to identify any condition affecting your muscles, nerves, or motor neurons.

Tremor analysis: To measure the frequency, amplitude, and other characteristics of the tremors using specialised equipment.

As tremors can vary, we may also ask you to record your tremor on video. A video recording allows us to get a better understanding of its type and severity. In some cases, we may prescribe medication as a therapeutic trial to see if it reduces your tremors, which can help with diagnosis.
Treatment
The treatment options for shakes and tremors depend on the underlying cause. If it is caused by a known trigger, such as stress, medications, or alcohol, avoiding or reducing these are likely to help. Getting enough sleep can also be beneficial. We often don’t need to treat a minor tremor, but a severe one requires a thorough evaluation before treatment.

Treatment options include:
- Medications
- Therapeutic practices
- Non-surgical or surgical procedures
- Botox^® for tremors in the head and face
It is vital to seek medical attention if you or someone you know is experiencing shakes or tremors. Your doctor can help determine the underlying cause and provide the most suitable treatment. Early diagnosis and intervention can improve outcomes and enhance your quality of life.
Medications

We may prescribe medications to reduce the frequency or severity of tremors, such as beta-blockers, anticonvulsants, and sedatives. In some cases, we may also recommend medications used to treat Parkinson’s disease.

If your tremors are caused by medication side effects, your doctor may be able to adjust your dosage or switch you to a different medication.
Therapy

Physical therapy or exercise can help you improve muscle control and coordination. You might benefit from occupational therapy, which can teach people with tremors how to perform daily tasks more easily and safely. For example, we may recommend assistive devices, such as canes or walkers, to improve balance and mobility.

Some people may find relief from tremors through alternative therapies like acupuncture, massage, or yoga. Practising relaxation techniques, such as deep breathing or meditation, can reduce stress and anxiety, which can contribute to internal tremors. How well these therapies work depends on the individual, and you may want to try a few before you decide what works for you.
Non-surgical and surgical procedures

Focused ultrasound therapy is a non-surgical procedure that uses ultrasound beams to target the brain cells causing tremors. We may recommend this if you have a moderate to severe tremor that has not responded to medication.

Severe cases may require surgery to alleviate pressure on nerves or the brain. Deep brain stimulation (DBS) is a surgical procedure that involves implanting a device in the brain that sends electrical impulses to specific areas to reduce tremors and other symptoms.

A focused ultrasound thalamotomy is another surgical procedure that involves treating a small area of the brain responsible for tremors called the thalamus. Another name for this procedure is transcranial magnetic resonance-guided focused ultrasound thalamotomy.
Current research and future perspectives

Current research on tremors has focused on understanding their causes and developing effective treatments to manage them. Some recent studies have explored the role of dopamine — a brain chemical that makes you feel good — in tremors and the potential use of deep brain stimulation.

Other research has focused on non-invasive techniques, such as transcranial magnetic stimulation and ultrasound brain focused therapy (MRgFUS), to modulate brain activity and reduce tremors.

Additionally, advancements in wearable technology means people can wear devices that monitor and track their tremors, providing valuable data for research and treatment.

In the future, further research may involve exploring new medications or therapies, as well as developing targeted interventions based on individual characteristics.

FAQs

What makes essential tremor worse?

Your tremor may worsen with caffeine, stress, or lack of sleep. You might find that your tremors lessen if you rest. Certain medications can also trigger tremors; talk to your doctor if you believe a medicine increases your tremor.

Is essential tremor life-threatening?

Essential tremor (ET) can be disabling for some people. However, it is not usually life-threatening and does not typically progress to more serious neurological disorders. Different medications can help with mild and moderate ET, and various brain procedures can help control the more severe tremors.

Do tremors mean Parkinson’s?

While tremors can be a sign of Parkinson’s disease, there are many other possible causes, some of which are temporary. We discuss these causes higher on our page.

Contact Us

Ten Harley Street Limited
10 Harley Street
London W1G 9PF
United Kingdom

Opening Hours:
Monday to Friday 9am to 5pm

Call: 07954 847 479