A tremor is an involuntary, rhythmic muscle contraction causing shaking movements in one or more body parts. This neurological condition most commonly affects the hands, but it can also manifest in the arms, legs, head, vocal cords, or torso. Tremors can occur constantly or intermittently, and while not life-threatening, they can significantly impact daily activities like writing, eating, or dressing. Understanding their causes is important for management, as tremors are common, particularly among older adults.
Understanding Tremors
Tremors are categorized based on when they occur. Resting tremors happen when muscles are relaxed and supported, meaning the affected body part is not actively being used. A notable example is the “pill-rolling” tremor seen in Parkinson’s disease, where the thumb and forefinger move rhythmically as if rolling a small object.
Conversely, action tremors manifest during voluntary movement. Postural tremors occur when a person maintains a position against gravity, such as holding the arms outstretched.
Kinetic tremors are associated with any voluntary movement, like moving the wrists up and down. An intention tremor becomes more pronounced as a person approaches a target during a purposeful movement, such as reaching for a cup. Task-specific tremors appear only during particular goal-oriented activities, like writing or speaking.
Key Neurological Conditions
Certain neurological conditions are linked to tremors in older adults. Essential Tremor (ET) is a prevalent movement disorder, characterized by rhythmic shaking that primarily affects the hands and arms during action. This tremor is typically bilateral and can also involve the head, voice, or legs. The exact cause of essential tremor is unknown, but it is believed to involve abnormal brain activity.
Parkinson’s Disease (PD) is another neurological cause of tremors, characterized by a resting tremor. This tremor often begins asymmetrically and is commonly described with a “pill-rolling” motion of the fingers. Unlike essential tremor, the shaking in Parkinson’s disease tends to decrease or disappear with intentional movement. Other symptoms accompanying Parkinson’s tremor can include muscle stiffness, slowness of movement, and balance difficulties.
Other Contributing Factors
Beyond neurological diseases, other factors can cause or worsen tremors in older individuals. Medications are a common culprit, as some drugs can induce tremors as a side effect. Examples include certain asthma medications, antidepressants, and mood stabilizers. These medication-induced tremors often resolve once the offending drug is discontinued or its dosage is adjusted.
An enhanced physiological tremor is a more pronounced version of the normal, barely perceptible tremor. This type of tremor is not indicative of a neurological disease but can be exacerbated by various systemic factors. Stress, fatigue, anxiety, and excessive caffeine intake are common triggers that can make this tremor more noticeable.
Thyroid dysfunction, particularly hyperthyroidism, can also lead to tremors. The excess thyroid hormones can overstimulate the nervous system, resulting in rhythmic shaking. Additionally, alcohol withdrawal can trigger tremors, as the nervous system reacts to the absence of its depressant effects.
When to Consult a Doctor
Seeking medical attention for tremors is advisable, especially if they are new, worsening, or interfere with daily activities. While some tremors may be benign, others can signal an underlying medical condition requiring diagnosis and management. A healthcare professional can evaluate the tremor’s characteristics, consider other symptoms, and determine the most appropriate course of action. It is important to consult a doctor if tremors are accompanied by other symptoms, such as muscle stiffness, balance problems, or changes in speech.