Body Tremors: Causes, Diagnosis, And Treatment

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Medical News TodaySubscribeCauses and treatments for body tremors

Medically reviewed by Darragh O'Carroll, MD — Written by Jessica Caporuscio, PharmD — Updated on December 23, 2024

Causes
Categories
Types of tremor
Diagnosis
Treatment
Contacting a doctor
Summary

Body tremors can stem from a neurological condition, such as Parkinson’s disease, medication use, anxiety, and other causes. Treatments for body tremors and shaking will depend on the cause but may include medication, surgery, and lifestyle remedies.

A body tremor is an involuntary muscle contraction with a rhythmic pattern that causes shaking in one or more body parts.

Causes of body tremors

A woman holds her arm after experiencing one of her body tremors. — Piyapong Thongcharoen/Getty Images

In some cases, body tremors are due to a dysfunction in the deep areas of the brain that control movement. This type of dysfunction may occur as a result of the following neurological conditions:

stroke
traumatic brain injury
neurodegenerative diseases, such as Parkinson’s disease and multiple sclerosis (MS)

Certain medications may also cause body tremors. Examples include:

amiodarone
amphetamines
asthma medications
atorvastatin
caffeine
carbamazepine
corticosteroids
cyclosporine
epinephrine
hypoglycemic agents
some psychotic, neurological disorder, and anti-depressant medications

Some other potential causes of body tremor can include:

anxiety
alcohol misuse or withdrawal
mercury poisoning
overactive thyroid or hyperthyroidism
liver or kidney failure

Categories of tremors

Medical experts classify body tremors into two categories – resting tremors and action tremors.

Resting tremors

Resting tremors occur in a body part that is relaxed and completely supported by gravity. For example, a person may experience a resting tremor in their hands when the hands are resting on their lap.

Resting tremors typically decrease during voluntary movements.

Action tremors

Action tremors occur during voluntary muscle movements.

There are five subcategories of action tremor:

Kinetic tremor: Shaking occurs with any type of voluntary movement.
Intention tremor: Shaking occurs with target-directed movements, such as touching the nose. The tremor typically worsens as a person draws closer to the target.
Task-specific tremor: Shaking is only present when performing highly skilled or goal-oriented tasks. For example, a person may experience this tremor when writing, drawing, or speaking.
Postural tremor: Shaking occurs when trying to maintain a position against gravity, such as when holding the arms outstretched.
Isometric tremor: Shaking occurs during a voluntary muscle contraction that does not involve movement. For example, a person may experience this tremor when holding a heavy object in a fixed position.

Types of tremor

Medical experts have further classified the different categories of body tremors into different types.

The following table summarizes the categories and their associated types.

Category of body tremor	Type of body tremor
Resting	•Parkinsonian tremor•dystonic•rubral tremor
Postural	•essential•cerebellar•dystonic•physiologic•drug-induced
Kinetic	•essential•classic cerebellar•dystonic•drug-induced
Task Specific	Primary writing tremor

Parkinsonian tremor

Around 70% of people with Parkinson’s disease experience resting tremors.

The characteristic Parkinsonian tremor (PT) is a relatively slow tremor that begins in the fingers.

Doctors sometimes refer to PT as a “pill-rolling tremor” because the motion resembles rolling pills or other small items between the fingers. In time, the tremor may progress to the forearm.

Other symptoms of Parkinson’s disease include:

slow movements
muscle rigidity
instability when standing or keeping balance

Essential tremor

Essential tremors typically occur on both sides of the body, but symptoms are generally more noticeable on the dominant side.

The characteristic feature of an essential tremor is a tremor in the hands and arms during action and sometimes at rest.

Essential tremors may also occur in other parts of the body, including:

the head
the vocal cords
the legs and feet

Cerebellar tremor

A cerebellar tremor occurs when a person is about to complete a purposeful movement.

For example, a person may experience this type of tremor when bringing a fork to their mouth.

A cerebellar tremor is low in frequency and high in amplitude. Frequency refers to the speed of the tremor, while amplitude is the degree of movement of the body part.

Doctors typically diagnose cerebellar tremors in people with MS and other neurological disorders.

Dystonic tremors

Dystonic tremors involve involuntary twisting or jerking of the limbs. Certain hand and arm positions may cause the tremors to stop.

Dystonic tremors are rare and typically occur in people who are under 50 years of age.

Physiologic tremor

All people have an asymptomatic physiologic tremor, a high-frequency, low-amplitude tremor that occurs at rest and during movement.

Physiologic tremors typically do not affect a person’s day-to-day activities. However, the following factors may exacerbate this type of tremor:

stimulants, such as caffeine and nicotine
anxiety
fatigue
certain medications

Diagnosis of body tremors

When diagnosing body tremors, a healthcare professional may use physical and neurological examinations, as well as diagnostic tests.

Physical and neurological exams

The physical examination involves checking the following:

whether muscle contractions occur at rest or during action
where the tremor occurs on the body
whether the tremor is bilateral (on both sides) or unilateral (on one side only)
tremor frequency and amplitude

When conducting a neurological examination, a healthcare professional will look for the following:

increased muscle stiffness
impaired balance
speech abnormalities

Diagnostic tests

A healthcare professional may also order the following diagnostic tests to determine the cause of body tremors:

Blood and urine tests: These tests may help rule out certain causes of body tremors, such as:
- medication side effects
- drug interactions
- chronic heavy drinking
- thyroid dysfunction
Diagnostic imaging tests: An MRI or CT can help detect any brain damage that may be causing the tremors. A positron emission tomography scan (PET) or a SPECT procedure, where a healthcare professional injects a chemical into the vein, is sometimes appropriate if a doctor believes a person may have Parkinson’s disease.
Electromyogram (EMG): EMG tests record electrical activity in the muscles. A doctor may use it to measure involuntary muscle activity in response to nerve stimulation.

Treatment for body tremors

Specific treatments may help to reduce the frequency and severity of body tremors. What treatment a person receives will depend on the cause, type, and severity of their tremor.

Medications

Medications can help to manage body tremors. The table below shows the different classes of drugs a doctor may prescribe for body tremors, along with examples of each.

Drug Class	Drugs
Beta-blockers	•atenolol•metoprolol•nadolol•propranolol•sotalol
Anti-seizure medications	•primidone•gabapentin•topiramate
Benzodiazepines	•alprazolam•clonazepam
Parkinson’s disease medications	•levodopa•carbidopa

In some cases, doctors have successfully used Botox for certain types of tremors.

Nonsurgical procedures

In some cases, a healthcare professional may recommend a nonsurgical procedure to help manage body tremors.

Focused ultrasound

The thalamus is the part of the brain that controls movement. Damage or disruption to nerve cells in the thalamus can lead to muscle tremors.

Focused ultrasound delivers a fine beam of ultrasound waves to the dysfunctional nerve cells in the thalamus. This destroys the cells, thereby alleviating a person’s tremors.

Radiofrequency ablation

Radiofrequency ablation uses radio waves to generate an electric current. This current heats the dysfunctional nerve and interrupts its ability to send and receive signals.

Surgery

Surgical interventions that may help to manage body tremors include deep brain stimulation (DBS) and thalamotomy.

Deep brain stimulation

DBS is the most common surgical treatment for tremor. The procedure involves surgically implanting electrodes into the thalamus. A surgeon attaches electrodes to a device called a pulse generator, which they implant in a person’s chest.

The pulse generator sends an electrical current to the electrodes in the thalamus. The pulse then enters the thalamus, interrupting the tremor.

Thalamotomy

Thalamotomy is a surgical procedure that permanently destroys the problematic part of the thalamus.

Doctors usually reserve this surgery for a particularly severe tremor that has not responded to other treatments. Where possible, doctors will perform radiofrequency ablation as an alternative to thalamotomy.

Lifestyle changes

Some lifestyle changes may alleviate body tremors or help people to manage their condition. Examples include:

eliminating or reducing tremor-inducing substances, such as caffeine and nicotine
speech therapy to help manage vocal tremors
physical therapy to help improve muscle strength, control, and coordination
occupational therapy to help people carry out their usual day-to-day activities

When to see a doctor

Body tremors can sometimes signal an underlying medical condition. Anyone who experiences body tremors should see a healthcare professional for a diagnosis and appropriate treatment.

A person who suspects that their tremor is a side effect of medication should raise their concerns with a healthcare professional. Where possible, they may adjust the dose or recommend switching to an alternative medication.

A person should not stop taking medication unless advised to do so by a healthcare professional.

Summary

There are many different types of body tremors. The type a person experiences can sometimes indicate the cause.

Sometimes, body tremors are due to an underlying neurological condition, such as stroke, Parkinson’s Disease, or multiple sclerosis. However, they may also be a side effect of medications, anxiety, fatigue, or stimulant use.

A doctor will work to determine the cause and provide appropriate treatments. Correct treatment may reduce the frequency and severity of the tremors.

Multiple Sclerosis
Parkinson's Disease
Anxiety / Stress
Neurology / Neuroscience

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Crawford P, et al. (2018). Tremor: Sorting through the differential diagnosis.https://www.aafp.org/afp/2018/0201/p180.html
Essential tremor. (2024).https://www.fusfoundation.org/diseases-and-conditions/neurological/essential-tremor
Niemann N, et al. (2018). Botulinum toxin for the treatment of hand tremor.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6070882/
Thalamotomy. (2024).https://www.mstrust.org.uk/a-z/thalamotomy
Tremor. (2024).https://www.ninds.nih.gov/health-information/disorders/tremor

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Medically reviewed by Darragh O'Carroll, MD — Written by Jessica Caporuscio, PharmD — Updated on December 23, 2024

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