Muscle tremors, known as tremors in technical language, can have various causes. For example, people tremble from cold, nervousness or exertion, such as during sports. The involuntary tremor can occur in the legs, hands, arms, voice or throughout the body, for example. However, the causes of muscle tremors are not always harmless. The tremor can also indicate serious diseases, such as Parkinson’s disease or a thyroid disorder. We present possible causes and explain how to treat muscle tremors.
Tremors as a natural reaction
Tremors are usually not a bad thing. In fact, our muscles always tremble a little unnoticed. In the process, opposing muscle groups are repeatedly contracted in turn. This so-called physiological tremor only becomes visible when it is intensified. For example, when it is cold, the body tries to generate kinetic energy by increasing the rhythmic movement of various muscle groups in order to heat up. But stress, anxiety, exhaustion or excitement can also intensify normal muscle tremors – as can too much alcohol, nicotine or caffeine. Unlike muscle tremors, the muscle twitching that occurs at night during sleep or just before falling asleep is not a rhythmic movement and therefore not a form of tremor.
Muscle tremor during exercise
Muscle tremors often occur when exercising or stretching individual muscles and are normal to a small degree. However, anyone who experiences severe tremors while exercising or stretching should interpret this as a sign from the body that the muscles in question are overworked and pause exercises. If the muscles tremble during exercise, this may also indicate a deficiency of magnesium, calcium or potassium. This is because the body also loses minerals when it sweats. It is therefore particularly important for athletes to get enough of these minerals from their diet. Cheese, bananas and legumes, for example, are suitable for this purpose.
Tremor: get the causes clarified
If a tremor cannot be attributed to a normal physical reaction or if the muscle tremor lasts for a longer period of time, a doctor should be consulted. Making a diagnosis often requires a complex examination by a family doctor or neurologist. In the course of a diagnosis, the function of muscles, nerves and brain is tested in particular. Laboratory values and, for example, magnetic resonance imaging (MRI) can also provide information about an existing disease. In most cases, differential diagnostics are used to search for or rule out possible causes. The following questions are also important for this purpose:
- How long has tremor been present?
- What are the pre-existing conditions?
- Does the affected person suffer from other movement disorders or other abnormalities?
- Which parts of the body are affected?
- When, how fast and how strong does the tremor occur?
Forms of muscle tremor
Different types of tremor are distinguished, depending on the situation, frequency and strength in which the tremor occurs. The so-called rest tremor starts when the corresponding body region is not moved. This contrasts with action tremor, which occurs during voluntary muscle movements. Here, the following distinction is often made:
- The movement tremor occurs with consciously controlled, non-goal directed movements, for example, when moving the hands.
- Intention tremor begins when a target is aimed at (for example, extending a finger toward the tip of the nose) and intensifies as the hand gets closer to the target.
- Holding tremor occurs when a load is applied by gravity, for example, when a glass is held with an outstretched arm.
- Isometric tremor occurs during muscle contractions without movement, for example, when clenching a fist.
In addition, there are many other types of tremor, which occur, for example, task-specific when writing, standing or speaking, or describe the exact expression of the resting tremor (for example, head tremor).
Tremor: Frequency and severity
The frequency of a tremor can be measured accurately and allows conclusions to be drawn about its cause. Depending on the speed of the muscle tremor, a distinction is made between low-frequency tremor (2 to 4 hertz, i.e. oscillations per second), medium-frequency tremor (4 to 7 hertz) and high-frequency tremor (more than 7 hertz).Depending on how expansive the tremor is (“amplitude”), a tremor is classified as fine-beat (barely expansive), medium-beat, or coarse-beat (very expansive).
Diseases as causes of muscle tremors
The form of the tremor may provide an indication of its cause. However, a definite diagnosis is always possible only after further investigations. For example, a moderate-frequency resting tremor may indicate Parkinson’s disease: Often the hands or only one hand are affected. However, quite different forms of tremor can also be triggered by Parkinson’s disease. In addition, rest tremor is also one of the side effects of some medications.
Common causes of tremor
In addition to the causes already mentioned, muscle tremors can have many other triggers. For example, tremor can also result from psychological reasons such as anxiety disorders or as a result of traumatic events. Other common causes of tremors include:
- Multiple sclerosis
- Wilson’s disease
- Diabetes mellitus
- Hyperthyroidism
- Epilepsy
- Stroke or TIA
- Medication or withdrawal from medication
- Alcohol and drug abuse and associated withdrawal symptoms.
- Poisonings
- Diseases of the liver or kidney
- Deficiency of vitamin B12
If a tremor occurs in isolation, that is, without being a symptom of a disease, it is called an essential tremor. This occurs mainly in older people and is considered hereditary. Incidentally, in pregnant women, muscle tremors shortly before birth is completely normal: with this, the body tries to release tension in the muscles before the onset of labor.
Treatment of muscle tremors
The treatment of a tremor depends primarily on its cause. For example, if Wilson’s disease is diagnosed as the trigger of the muscle tremor, treatment is primarily directed at this underlying condition. In the course of this, the tremor usually subsides. The following treatment options are available when the muscles tremble:
- Certain forms of tremor can be treated with medication, for example, anticonvulsants or beta-blockers.
- In individual cases, surgery, such as the insertion of a so-called brain pacemaker, can provide relief.
- For task-specific tremor, regular botulinum injections are used in combination with exercise training.
- In the context of occupational therapy can be learned to cope well with everyday actions despite tremor.
- If a drug is suspected of being a trigger of tremor, this can be discontinued after consultation with a doctor.
- Relaxation exercises can reduce the tremor for a short time.
Muscle tremor due to stress
If the muscle tremor is caused by everyday causes such as stress or cold, it usually goes away on its own once the trigger disappears. If one is exposed to constant stress, it may help to relieve it through relaxation methods such as yoga or walking to stop the muscle tremors.
