Tremors. Is it Parkinson’s Disease?

Have you ever experienced a tremor? No, not the earthquake tremor, but the unintentional, somewhat rhythmic muscle movement involving one or more parts of your body. Tremors are somewhat common, and can be caused by many different things, including stress, tiredness, caffeine, hypoglycemia, excitement or alcohol.

Although experiencing a tremor is not life threatening, it can be embarrassing and make it harder to perform tasks. But what if your tremor returns again and again? Could it be Parkinson’s disease, which is often associated with tremors?

“There are many causes of tremor,” says Arthur Dick, M.D., an expert neurologist and president of the Lakewood Hospital medical staff. “Although a tremor is one of the most common signs of Parkinson’s disease, not everyone with a tremor has Parkinson's disease.”

A tremor caused by conditions other than Parkinson's disease get better when your arm or hand is not moving and gets worse when you try to move it. The most common cause of non-Parkinson's tremor is essential tremor, a treatable condition that is often wrongly diagnosed as Parkinson's disease.

“Essential tremors can affect almost any part of your body, but the trembling occurs most often in your hands — especially when you try to do simple tasks, such as drinking from a glass, tying shoelaces, writing or shaving,” says Dr. Dick. These tremors also may affect your head, voice, arms or legs.

“For most people who develop Parkinson’s disease, the disease begins with a trembling or shaking in one of the hands,” says Dr. Dick. “It is usually one of the first symptoms of Parkinson’s that family members notice.”

As the disease progresses, the tremor may spread to both sides of the body, although in some cases the tremor remains on just one side.

“The tremor happens when the muscles of the hands are relaxed and resting, which is why it is called a resting tremor,” he says. “It usually looks like you are rolling a cigarette or a pill between your thumb and index finger.”

In addition to tremor of the hands, arms, legs and face, Parkinson’s is also indicated by rigidity or stiffness of the limbs and trunk, bradykinesia or slowness of movement, and postural instability or impaired balance and coordination. Each person with Parkinson's will experience these symptoms differently.

“When a person has Parkinson’s disease, their dopamine-producing cells begin to die and the amount of dopamine produced in the brain decreases,” says Dr. Dick. “As a result, messages from the brain telling the body and when to move are delivered more slowly, leaving a person incapable of initiating and controlling movement in a normal way.”

At least one million people in the United States and more than four million worldwide live with Parkinson’s disease.

“A person with Parkinson's disease may slowly become more dependent, fearful, indecisive, and passive,” says Dr. Dick. “They may talk less often, withdraw from family and friends, and remain inactive unless encouraged to move about.” Depression, which is common in people with Parkinson’s, often improves with proper treatment.

There is a wide range of treatment options for Parkinson's that includes oral medications, botulinum toxin injections, and deep brain stimulation surgery. A regular daily exercise program is also vital for maintaining muscle tone, strength, and flexibility.

“Parkinson’s can be very difficult to diagnose because the symptoms may be quite variable in their presentation,” says Dr. Dick.
If you are experiencing a tremor or believe you may have Parkinson’s disease, promptly contact your primary care physician, who may want to refer you to a neurologist such as Dr. Arthur Dick.

To schedule an appointment with Dr. Dick or with any of our other expert physicians on staff at Lakewood Hospital, please call our physician referral service at 1.866.733.6363.