Parkinson's Tremors

Parkinson’s turned me into James Bond’s favorite bartender. All my drinks are shaken not stirred. Sorry, sorry I know PD and tremors are no joke but I couldn’t help myself. Tremors often are one of the earliest and most noticeable signs of PD. They are caused by reduced levels of dopamine due to the loss of dopamine producing cells in the brain.  About 70% of people with PD have a tremor at the time of diagnosis. Researchers define two main types of PD tremor, resting tremors and action tremors, but PWP know that no two of us are alike so there are as many variations as there are people who have the disease. Tremors can be mild or debilitating or anywhere between. Consider yourself lucky if you don’t have them.

Resting tremors are the most common form of tremors associated with PD. They occur when a body part is at rest against gravity, when the muscles are relaxed or still, when you are lying in bed, or when your hands are resting on your lap or at your side. It is inhibited while moving and not present (thankfully) while sleeping.

Action tremors are less common than resting tremors affecting about 25% of PWP at diagnosis and 40% during the course of the disease. Action tremors occur during any type of movement of an affected body part and are triggered by muscle or muscle group contraction. Action tremors can be task specific caused by the movement they accompany. Writing, for example, often causes the hand to shake. 

Resting tremors are often referred to as pill-rolling tremors because they resemble the motion of rolling a small pill between the thumb and index finger. Tremor amplitude decreases with voluntary activity. Stress, of course, makes them worse. All PWP are different but generally tremors start in one hand, then progress  to the arm and foot on the same side of the body, then go to the other side of the body, and may then go to the whole body including the head. Tremors are not the worst PD symptom but they can be bad. They may be mild or strong. They may continually get worse or they may get worse for a period of time  then level off and improve, and sometimes they may stop. Tremors are slightly less common in younger PWP. PD usually progresses more slowly with those that have tremors than those that don’t.

Tremors are treated medically with drugs and Deep Brain Stimulation. DBS passes a small current with high frequency through areas of the brain that block motor function and has a 90% success rate in decreasing or getting rid of Parkinson’s tremors. There is some evidence that stress reduction techniques like yoga, deep breathing and meditation are helpful. Some people get relief by reading or watching TV, and others find that socialization reduces symptoms. Researchers say that activity lessens tremors which seems true except, like all things PD, when it acts contrary and makes me shake more.