Tremor

Tremor can be described as an involuntary and uncontrolled trembling or shaking movement, often in the upper limbs. 

There are different types of tremors, depending on where you experience it. The most common for people with MS, is intention or action tremor which gets worse as you use the affected limb e.g. your arm shakes as you reach for something, try to touch your nose, or move your foot to a precise spot.

Others may experience postural tremor which, as the name suggests, means that the person experiences a tremor when maintaining a posture against gravity, such as sitting or standing, but it doesn’t occur when lying down. 

You may hear ‘ataxia’ as another word instead of, or associated with, tremor. Ataxia is a separate symptom related to balance and coordination, which you can read about here. 

In MS, damage to the coatings around nerves, called myelin, causes messages to be distributed slower or not at all through the body. MS-related tremor is caused by this damage to myelin in the part of the brain that controls movement and coordination, called the cerebellum. 

The damage in this area means messages to your limbs are disrupted and result in uncontrolled movements or shaking. 

If you experience tremor symptoms, talk to your neurologist, MS Nurse or GP. A thorough assessment can determine what treatment or management options are available for your individual circumstance. 

Managing and adapting your lifestyle is key to helping tremor. An MS Nurse and/or an occupational therapist can help you to find the right techniques for managing tremor day-to-day. 

Some management strategies include: 

• Plan movements in your head before doing them 
• Concentrate on one thing at a time 
• Make sure clothes don’t have fiddly zips or buttons
• Incorporate non-slip surfaces in your kitchen or bathroom to minimise falls if you lose your balance 
• Use limb weights to help diminish tremor

There are currently no drug treatments for tremor. However, some people with MS find that treatments for other conditions help minimise tremor. Physiotherapy has also been shown to improve tremor. For severe cases, deep brain stimulation (electrodes in the brain connected to a small device like a pacemaker) can help to turn off parts of the brain responsible for tremor.  

In all cases, a discussion with your neurologist, MS Nurse or GP is essential, to work out the treatment that is best suited to your individual circumstance.