• Febris undularis
  • Muscle tremor

Chills are not a disease in themselves, but can be a symptom of many other diseases. This symptom is defined as a sensation of cold, accompanied by involuntary muscle trembling. The muscles contract at a very fast frequency and then relax again without the person affected being able to do anything about it.

Normally, the shivering mainly affects the large muscles, i.e. the thigh and back muscles, and relatively regularly the chewing muscles are also involved in the process. Usually, such an episode lasts several minutes, with the chills getting stronger and weaker at intervals. Since this phenomenon of chills is a great strain on the body, after a chills attack one is often so exhausted that one falls directly into deep sleep.

So it can happen that an attack practically goes straight to sleep. Chills look almost exactly like when someone starts shivering due to severe cold, to protect the body from hypothermia. Heat is generated by the contraction (contracting) of the muscles.

When tension and relaxation alternate as quickly as in the case of chills, this is a very effective method of quickly raising the body temperature again. The normal body core temperature is about 37°C. A healthy person is normally able to maintain this temperature at a relatively constant level due to his metabolic processes and muscle activity.

There are transmitters in the human body which ensure that the “set point” for the body temperature is shifted upwards, so to speak. So the body suddenly “thinks” that it has to raise its temperature to 39 or 40°C, so it tries to produce heat by muscle trembling. At the same time, the metabolism is also changed and the blood circulation is increased in order to reach the new target value.

The cause of chills can be various diseases. In most cases, however, chills occur in the context of feverish infectious diseases (see fever). The most common reason for chills is probably a simple cold or flu.

Diseases that are also frequently accompanied by chills are pneumonia (pneumonia), scarlet fever, blood and fungal poisoning, erysipelas, tetanus, typhoid fever, inflammation of the renal pelvis, inflammation of the epididymis or inflammation of the prostate. However, chills are also a symptom of various tropical diseases, which hardly occur in Germany anymore. So if you develop a chill after a trip to tropical countries, such as South America or Africa, you should urgently see a doctor.

The doctor will then try to rule out diseases such as malaria, anthrax, smallpox, yellow fever or plague. Another disease that is very rare, but which should also be considered if a patient complains of chills and none of the more likely possibilities can be confirmed as the cause, is acute glaucoma (i.e. acutely high intraocular pressure). Exposure to direct sunlight for too long a time can lead to heat stroke or sunstroke.

Although these phenomena usually last only a very short time, they are often accompanied by a chill. Just like adults, children can react to fever with chills. The most common cause is an infection.

However, children are affected by such infections much more frequently than adults and react very quickly with a rise in temperature. As a result, chills are quite common in children. It is not possible to recommend when a child should see a pediatrician because of chills or should be given a fever-reducing medication.

Rather, this decision should be made depending on the level and duration of the fever. If the temperature is slightly elevated, there is no need for antipyretic measures. If the temperature rises above 39°C, antipyretic agents (e.g. paracetamol) can be given in consultation with the paediatrician or antipyretic measures such as calf compresses (except directly in case of chills) and a sufficient fluid intake can be taken.

If the fever lasts longer than one day or if it does not respond to the medication, a pediatrician should be consulted. This also applies if the child develops additional symptoms such as skin rash or diarrhea or if a feverish spasm is observed.In younger children, the assessment of fever is often more difficult. In children under three months of age, a visit to the doctor is advisable from temperatures of 38°C.

Young infants may have infections without fever. Parents should therefore always watch out for changes in skin color, skin rash or drinking habits. First of all, if there is a chill, the doctor will take a detailed medical history.

This means that the patient is asked about his or her symptoms in detail. For example, the doctor will probably want to know how long the chills have been present, whether there are any other symptoms besides the chills, and whether the patient has any other diseases. In addition, he usually also asks whether a trip to a tropical country has taken place recently in order to know whether he also has to consider diseases that are actually unusual in Germany.

Following the interview, a physical examination is then carried out. During this examination, the doctor will see if he can find any obvious centres of inflammation on the body. In addition, he will listen to the lungs and palpate the lymph nodes (in many inflammatory diseases, the lymph nodes are swollen).

After that, the suspicion of a certain cause for the chills has usually been substantiated to such an extent that more specific examinations can follow. Since the most common cause of a chill is bacterial infectious disease, the doctor usually has to draw blood. This blood is then sent to a laboratory for examination, where a blood culture is prepared in which the exact pathogen is determined.

In some cases, it is also more useful to take a smear, for example in the case of inflamed tonsils (tonsils) from scarlet fever, so that a culture can also be prepared. Depending on the doctor’s suspicions, other examinations may also be necessary. For example, bronchoscopy (lung endoscopy), chest x-ray, urine examination, kidney ultrasound, or measurement of intraocular pressure.

The shivering in itself is a symptom, so one cannot really say that it causes other symptoms. However, in addition to the chills, one almost always finds the symptom fever, which is the result of the development of the disease (see above). It can also happen that an affected person suffers from chills, but initially no cause can be found.

Then one should also think of other conditions that can lead to a similar symptomatology. These include hyperthyroidism, mental excitement, which can have a variety of triggers, or withdrawal symptoms that can occur after stopping addictive substances such as alcohol, nicotine or painkillers. The treatment of chills varies depending on the underlying disease.

If the chills are caused by a simple cold or flu and are accompanied by fever, no doctor is usually consulted and the person concerned can treat himself. In most cases, even simple household remedies such as hot baths, warming teas, cold calf compresses or the so-called sweating cure (the fever is supposed to be “sweated out”, the patient is kept warm by being constantly covered with many blankets) provide relief from the symptoms. If a doctor is consulted and he or she has been able to identify a particular pathogen, he or she will decide whether or not it is advisable to treat with antibiotics, depending on which disease is present.

If a disease is expected to heal itself over time without further complications, antibiotics should not be given to prevent increased resistance to the antibiotic used. However, it is usually necessary to administer antibiotics, especially in the case of tropical infectious diseases, as these can often take a severe course. If the chills are the accompanying symptom of an underlying disease, the primary attention must of course be paid to getting the disease under control, which will then secondarily also make the chills disappear.

This applies for example to glaucoma. If the chills are the result of heat stroke or sunstroke, the body must be cooled as quickly as possible. This can be done using cold towels, calf wraps or baths.It may also be necessary to stabilize the circulation to prevent the person from collapsing.

It is also important to ensure an adequate fluid intake, ideally a drink that is particularly rich in minerals to compensate for the loss of fluid and electrolytes caused by increased sweating. Drug treatment should really only be used in very severe cases and is then usually carried out with preparations that have a positive effect on fever and pain, such as acetylsalicylic acid (Aspirin). Furthermore, fever can also be reduced by homeopathy.

Chills in connection with a cold are often only the symptom of rising fever. Basically, therefore, the most important thing is to fight the fever. Some home remedies have a proven effect.

The muscle twitching in the case of chills helps to reach the increased target temperature in the case of fever. This can be supported by supplying the body with heat from outside. The purpose of this is to “sweat out” the fever, so to speak (sweating cure).

Proven methods are, for example, a warm bath and absolute bed rest under possibly several blankets. Warming from the inside can also help. Hot teas, for example from lime blossom or elderberry, or a warm broth are a frequently chosen method.

But drinking a lot has another advantage: it protects the body from dehydration, which often happens with fever. If the chills are the result of heat stroke or sunstroke, cooling measures can help. In any case, further exposure to the sun should be avoided.

It is best not to stay outside or at least in the shade, preferably in a sitting position so that the upper body and head are elevated. Cold, moist towels on the forehead or neck can help, as can calf wraps. In addition, you should also drink a lot!

calf compresses are a very old household remedy that serves to cool the body. Therefore it is often used to lower fever. If the wraps remain on the body for about 10 minutes, heat can be specifically withdrawn.

However, it is important that calf compresses should not be applied if there is a simultaneous chill and fever. Chills should give the body heat. By wrapping the calves, the heat generated would be immediately withdrawn from the body.

Therefore, calf compresses are especially helpful in case of fever when the body is sweating. This means that before putting on the calf compresses you should feel whether your hands and feet are cold despite the increased temperature. If this is not the case, two cloths are wetted with cold water (16-20°C) and wrapped around both calves.

The ankles remain free. Two dry cloths are placed over them to catch excess water. If there is an arterial circulatory disease in the legs, calf wraps should not be used.