Involuntary movements, such as tremors, can cause a great deal of anxiety and embarrassment for those who experience them. These movements often lead individuals to hide them from others, which can be emotionally challenging. Many people are familiar with the impact of such symptoms, including Canadian-American actor Michael J. Fox and Coronation Street’s Rob Mallard, both of whom have spoken openly about their experiences.
Medical professionals emphasize the importance of seeking timely help when dealing with tremors, as they can sometimes indicate underlying neurological conditions, such as Parkinson’s disease. Ahead of World Parkinson’s Day on 11 April, Laura Phillips, a senior helpline advisor at Parkinson’s UK, provided essential advice on when it is important to consult a doctor regarding a tremor.
What is a tremor and how can it affect daily life?
According to Parkinson’s UK, a tremor is an uncontrollable, repetitive shaking movement that affects a part of the body, such as the hand or arm. Having a tremor can significantly interfere with a person’s ability to perform everyday tasks, as explained by Phillips.
“For example, something simple like fastening a zip, buttons, or shoelaces might become quite difficult for someone experiencing a tremor,” says Phillips. “Additionally, many people worry about how their tremor could affect their ability to drive safely. If a Parkinson’s diagnosis is made, it must be reported to the DVLA immediately.”
Is a tremor always a sign of Parkinson’s disease?
While a tremor is one of the most common motor symptoms associated with Parkinson’s, it is not always an indicator of the condition. Some people with Parkinson’s never experience a tremor, and other neurological conditions, such as Multiple Sclerosis (MS), can also cause tremors.
The NHS website notes that tremors often become more noticeable under certain physiological and emotional stressors, such as stress, fatigue, anxiety, anger, caffeine or alcohol consumption, smoking, aging, or extreme temperatures.
“Tiredness, stress, and anxiety can all have a significant impact on people with Parkinson’s symptoms,” says Phillips. “Those with a tremor who have Parkinson’s often report that their tremor worsens during periods of stress or anxiety or after poor sleep.”
The NHS also states that some medications and health conditions can cause tremors. However, it advises consulting a GP before stopping any prescribed medication.
What might suggest a tremor is linked to Parkinson’s disease?
While each person’s experience with Parkinson’s is unique, many individuals with the condition experience resting tremors. A resting tremor occurs when the body is at rest, unlike action tremors, which happen during voluntary muscle movement.
According to Parkinson’s UK, a resting tremor typically affects the hands and legs and may appear as a “pill-rolling” tremor, resembling the motion of rolling a pill between the thumb and index finger.
Although a resting tremor is a common symptom of Parkinson’s, it is rarely the only sign. It is important to note any additional symptoms that may accompany the tremor.
“Other less obvious symptoms include a quieter voice, smaller handwriting (known as micrographia), and a loss of smell,” says Phillips. “Balance issues, pain, stiffness, and fatigue are also common but more subtle symptoms of Parkinson’s.”
When should someone seek medical attention for a tremor?
The NHS recommends seeing a GP if a tremor or shaking hands is worsening over time and affecting daily activities.
“You know yourself better than anyone else, so it’s important to seek help if something feels unusual to you,” says Phillips. “It might not be Parkinson’s, but there could be other reasons for your symptoms. It’s always wise to get it checked out.”
Keeping a record of symptoms and when they occur can be helpful.
“Maintaining a timeline of symptoms can greatly assist medical professionals in identifying patterns and determining whether the symptoms align with a common pattern for Parkinson’s or if another condition might be involved,” says Phillips.
What questions might a doctor ask?
“A doctor will likely start by asking various questions about your general health to rule out possible causes such as dehydration or infections that could mimic similar symptoms,” says Phillips.
“They may also ask about when you first noticed the tremor and when it tends to occur. For instance, does it happen while you’re sitting and watching TV, or when reaching for something in a cupboard? Is it worse or better at different times of the day?”
If a GP suspects Parkinson’s, they will refer the patient to a specialist for further evaluation.
“The consultant will continue to rule out other possibilities and may order specific scans, such as CT or MRI scans, to check for any underlying causes of the symptoms,” says Phillips. “Some patients may also undergo a DAT scan (Dopamine Transporter Scan), which helps assess dopamine activity in the brain, a key factor in Parkinson’s disease.”
