Tremors

Types include resting, action, intention, and pill-rolling tremors

Tremors are involuntary muscle movements that you may briefly experience when you feel anxious, and they are also a symptom of movement disorders, illness, or a medication side effect. Tremors aren’t harmful, but they can be uncomfortable and get worse if the cause isn’t treated.

If you have recurring or chronic tremors, you need to know there is treatment. This article will discuss the symptom of tremors, possible causes, tests, and treatment. 

Healthcare provider holding hand of a person with a tremor

boonchai wedmakawand / Getty Images

Symptoms of Tremors

A tremor is a rapid, shaky, usually rhythmic, back and forth movement that can affect any part of the body, on one or both sides. Tremors can occur during movement or at rest, depending on the cause. 

Usually, tremors are not constant, and they tend to go away during sleep. Tremors do not affect consciousness. 

Tremors can affect:

  • One or both hands or arms 
  • The jaw or neck 
  • One or both legs or feet 
  • The trunk 

Generally, tremors do not affect the whole body; they affect one area or just a few areas of the body at a time. Chronic or recurrent tremors usually have the same pattern or a few different patterns every time they occur. 

Type of Tremors

Types of tremors include:

  • Pill-rolling tremors, which appear as if a person is holding and rolling a pill in the fingers 
  • Resting tremor that goes away when you move the affected area 
  • Intention tremor that occurs when trying to make a deliberate movement
  • Action tremor that begins when you start moving the affected area of the body

Causes of Tremors 

Parkinson’s disease and benign essential tremor are the most common causes of chronic tremors. These two conditions and other conditions can be differentiated by the pattern of tremors, other associated symptoms, and age of onset. 

Common causes of tremors include: 

Parkinson’s disease: This neurodegenerative movement disorder has many effects. The most common and earliest are resting tremors of any part of the body, pill-rolling tremors, and motor stiffness. 

Benign essential tremor: This common type of action tremor, also called essential tremor, can be worsened by stress or fatigue. It is usually more prominent with action than at rest. The condition often begins to cause symptoms during young adulthood. 

Parkinsonism: A resting tremor similar to the resting tremor of Parkinson’s disease can occur due to brain damage from a stroke or head trauma. In these situations, tremors will not be the initial or only effect. If the damage only affects one side of the brain, the symptoms will often be unilateral (on one side). Some medications can cause bilateral (on both sides) parkinsonism. This condition usually doesn’t cause a pill-rolling tremor and often remains stable in severity, unlike Parkinson’s disease, which worsens over time.

Neurological disorders: Sometimes neurological conditions, such as multiple sclerosis (MS), meningitis, or cerebellar degeneration, can cause tremors as a symptom.

Anxiety: Some people have tremors in association with anxiety. It’s most commonly an intention tremor or a tremor of the voice, but resting or action tremors can occur due to anxiety. 

Medications: Certain medications, particularly those used to treat psychiatric conditions, can cause tremors. 

Severe illness: A major systemic (whole-body) infection, metabolic problems, or organ failure can cause shivering, shaking, and tremors. The symptoms generally resolve when the underlying condition improves. 

How Do Tremors Occur?

Tremors occur due to alterations in brain function. This can be associated with defects in certain areas of the brain, like the basal ganglia in Parkinson’s disease and parkinsonism. Tremors can also occur due to neurotransmitter irregularities (as in Parkinson’s disease), medication, and anxiety. 

How to Treat Tremors 

Tremors are not dangerous, but they can be distressing and may interfere with regular activities. You might notice muscle tightness or develop aching from trying to counteract your tremors. Usually, it’s necessary to get treatment for comfort. The treatment of tremors depends on the cause. 

Treatments include:

  • Many different prescription medications, such as Sinemet (carbidopa/levodopa), Symmetrel (amantadine), or surgery for treatment of tremors induced by Parkinson’s disease or parkinsonism
  • Inderal (propranolol) or Mysoline (primidone) for treatment of benign essential tremor
  • Treating the underlying illness for any tremor that is caused by another condition (such as infection or metabolic disease)
  • Physical therapy for improving control of movement and reducing physically uncomfortable effects associated with chronic tremors 

Are There Tests to Diagnose the Cause of Tremors? 

Usually, tremors are diagnosed clinically based on the history of symptoms and the healthcare provider’s observations and physical examination during your visit. 

Since tremors and other symptoms can come and go, pay close attention to the features so you can tell your healthcare provider during your visit. 

Be prepared to answer the following: 

  • How long have you been having tremors? 
  • Have your tremors changed over time? 
  • How often do the tremors occur?
  • What part of the body is affected? 
  • Are the tremors happening at rest or with certain actions? 
  • Does stress or any other emotion affect your tremors? 
  • Is there anything that you’ve noticed that reduces your tremors?
  • Do you have other motor symptoms (stiffness, trouble walking) or cognitive symptoms (emotional changes or hallucinations)?

If you have signs of a condition affecting the brain, such as a stroke or MS, you might need to have one or more brain imaging studies.

When to See a Healthcare Provider

You should make an appointment to see a healthcare provider if you develop new tremors or if your tremors get worse. If you suddenly start to develop tremors while taking a new medication, you should call your healthcare provider to find out if you need to be seen right away. 

Summary 

Tremors are rapid, rhythmic, involuntary movements of one or more areas of the body. Tremors are usually chronic and intermittent. Parkinson’s disease and benign essential tremor are the most common causes. Some medications and medical conditions can cause tremors.

If you have tremors, it’s important to see a healthcare provider to get a diagnosis and treatment. Depending on the cause, certain prescription medications can reduce tremors. 

A Word From Verywell 

Living with tremors can be challenging. It can affect your ability to move your body how you want to, and it often negatively affects your quality of life. There are medications, surgical interventions, and exercises that can help reduce the impact of tremors on your life.

Sometimes the doses and treatments need to be adjusted as the underlying disease progresses—but treatments can be highly effective in helping you achieve physical comfort and better control of your movements. 

Frequently Asked Questions

  • Are spasms the same as tremors?

    Spasms and tremors are not the same. They are different types of involuntary movements. Spasms tend to affect large muscle groups, and they are generally sudden and without a rhythmic pattern. 

  • Does epilepsy cause tremors?

    Epilepsy does not cause tremors. Epilepsy causes seizures involving involuntary jerking, stiff muscle movements, and/or impaired awareness.  

  • Can tremors cause stuttering?

    Tremors can affect a person’s speech pattern, but it is not the same as stuttering. Stuttering is a specific speech pattern that involves hesitation and repeating of parts of words. Tremors that affect speech cause a quiet shakiness of the voice.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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