Involuntary shaking movements, commonly known as tremors, can often lead to feelings of embarrassment or anxiety, prompting many individuals to conceal them due to concerns about social perception. This experience has been openly discussed by public figures such as Canadian-American actor Michael J. Fox and Coronation Street actor Rob Mallard, who have shared their personal journeys with neurological conditions.
However, seeking professional medical assistance is crucial, as tremors may indicate underlying neurological issues, including Parkinson's disease. In anticipation of World Parkinson's Day on April 11th, we consulted Laura Phillips, a senior helpline advisor at Parkinson's UK, for guidance on when to seek help regarding tremors.
What Exactly Is a Tremor and How Does It Affect Daily Life?
Parkinson's UK defines a tremor as an uncontrollable, repetitive shaking movement that typically affects body parts like the hands or arms. According to Phillips, tremors can significantly disrupt a person's ability to perform everyday tasks.
"For instance, simple activities such as fastening a zipper, buttoning a shirt, or tying shoelaces can become quite challenging for someone experiencing a tremor," Phillips explains. "Additionally, many people express worries about how tremors might impair their driving safety, and a Parkinson's diagnosis must be reported to the DVLA immediately."
Is a Tremor Always Indicative of Parkinson's Disease?
"A tremor is one of the most common motor symptoms associated with Parkinson's, but it is not always a sign of the disease," Phillips clarifies. "Some individuals with Parkinson's never experience a tremor at all. It is also important to note that other neurological conditions, such as Multiple Sclerosis (MS), can lead to tremors."
The NHS website highlights that tremors often become more noticeable under specific physiological and emotional stressors, including stress, fatigue, anxiety, anger, caffeine or alcohol consumption, smoking, aging, or extreme temperatures.
"Tiredness, stress, and anxiety can profoundly impact those with Parkinson's symptoms," says Phillips. "People with Parkinson's-related tremors frequently report that their shaking worsens during periods of stress, anxiety, or after a poor night's sleep."
The NHS also notes that certain medications and medical conditions can cause tremors, advising individuals to consult their GP before discontinuing any prescribed drugs.
What Might Suggest That a Tremor Could Be Linked to Parkinson's?
While Parkinson's manifests differently in each person, many affected individuals experience resting tremors. "With Parkinson's, a tremor typically occurs at rest, rather than during voluntary muscle movements or as an intense tremor," Phillips states.
According to Parkinson's UK, a resting tremor often affects the hands and legs, appearing as a "pill-rolling" motion that resembles rolling a pill between the thumb and index finger. However, a resting tremor is rarely the sole symptom, so it is essential to document any accompanying signs.
"Other less obvious symptoms include quieter speech, smaller handwriting (known as micrographia), and a diminished sense of smell," Phillips adds. "Balance issues, pain, stiffness, and fatigue are also common but more subtle indicators of Parkinson's."
When Should Someone Seek Medical Attention for a Tremor?
The NHS recommends visiting a GP if a tremor or shaking hands is worsening over time and interfering with daily activities. "You know yourself better than anyone else, so it is important to seek help if something feels abnormal," Phillips emphasizes. "It may not be Parkinson's—there could be other reasons for your symptoms—but it is always wise to get it checked out."
Keeping a record of symptoms and their frequency can be beneficial. "Maintaining a timeline of symptoms can assist medical professionals in identifying patterns and determining whether they align with common Parkinson's indicators or suggest other potential issues," Phillips advises.
What Questions Might a Doctor Ask?
"Initially, a doctor will inquire about your general health to rule out factors like dehydration or infections that could cause similar symptoms," Phillips explains. "They will likely ask when you first noticed the tremor and when it tends to occur. For example, does it happen while sitting and watching TV, or when reaching for an item? Is it worse or better at different times of day?"
If a GP suspects Parkinson's, they will refer you to a specialist. "The consultant will continue to exclude other possibilities and may order scans such as CT or MRI to check for underlying causes," Phillips says. "Some patients may undergo a DAT scan (Dopamine Transporter Scan) to assess dopamine activity in the brain, as reduced dopamine levels are characteristic of Parkinson's."
