​Tremors

A tremor is an uncontrollable movement in any part of your body. They can occur at any time and are due to a problem in the part of your brain that controls muscle movements. It is usually harmless but sometimes signals a more serious neurological problem (that is, a problem related to the brain). Other factors that may cause tremors include:

  • Side effect of drugs

  • Alcohol abuse or withdrawal

  • Parkinson’s disease

  • Mercury poisoning

  • Overactive thyroid

  • Liver failure

  • Muscle fatigue

  • Consuming too much caffeine

  • Stress

  • Ageing

  • Low blood sugar levels

Tremors are a common occurrence that usually affect the arms, hands, legs, voice and face. Some forms of tremor are inherited and may run in families, while others have no known cause.

There are two main types of tremors - resting tremors and action tremors.

Resting tremors occur when you are sitting or lying still, but when you begin to move around, the tremor goes away on its own. These types of tremors often affect only the hands or fingers.

Action tremors, on the other hand, occur during movement of the affected body part. Action tremors are further divided into:

  • Intention tremor: An intention tremor occurs during targeted movement, such as touching your finger to your nose.

  • Postural tremor: A postural tremor occurs when holding a position against gravity, such as holding your arm or leg outstretched.

  • Task-specific tremor: Task-specific tremors occur during a specific activity, such as writing.

  • Kinetic tremor: Kinetic tremors occur during movement of a body part, such as moving your wrist up and down.

  • Isometric tremor: Isometric tremors occur during the voluntary contraction of a muscle without other movements of the muscle.

Characteristics of tremors include:

  • Rhythmic shaking in the hands, arms, head or legs

  • Shaky voice

  • Difficulty writing or drawing

  • Problems holding and controlling objects (for instance utensils while eating)

Some tremors are triggered by or become exaggerated during times of stress or strong emotions, when the individual is physically exhausted, or during certain postures or movements. 

Tremors may develop at any age but most commonly occur in middle aged and older people.  It may be occasional, temporary, or occur intermittently.  A tremor affects men and women equally.                         ​

If you or a loved one is facing similar symptoms such as displaying involuntary sounds and/or movements, it is recommended that you consult with your doctor immediately. You can obtain additional information and expert medical advice from the Mind and Brain Service Line​ at The Aga Khan University Hospital.​​
Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here​ are some tips to help get you started.​​

Tremors may be normal in some situations, especially if you have been through a stressful or anxiety inducing experience. They usually disappear once the situation improves. However, some tremors indicate an underlying neurological, nervous system or muscular problem that needs to be rectified.

If your doctor suspects that you are suffering from tremors, he/she will first conduct a physical exam, during which your affected area will be observed. You will be asked to perform some physical tasks such as writing, holding objects or putting together a puzzle to gauge the severity and extent of your tremor. Your doctor will also order further tests to diagnose the cause of the tremor such as blood and urine tests to check for underlying diseases that may cause it.

A neurological exam may also be conducted to check the functioning of your brain, muscles and nervous system. These tests will measure your reflexes, coordination, muscle strength etc.

​Your doctor may also conduct a test known as an Electromyogram (EMG). This is a diagnostic procedure to assess the health of muscles and the nerve cells that control them (known as motor neurons). During this test, a thin disposable needle will be inserted into multiple muscles to record their electrical activity.                         ​​

Treatment for tremors is usually to treat the underlying cause of it. Use of medications is a commonly used method, and includes the following:

  • Beta blockers: These are commonly used to treat people with high blood pressure or heart disease, and also help to reduce tremors.

  • Tranquilizers: These are used to relieve tremors caused by anxiety.

  • Anti-seizure medications: These are used if you cannot take beta blockers or they have not been beneficial to you in the past.

Botox Injections are another common way to treat tremors, especially those affecting the face and head.

Physical Therapy is also useful in strengthening your muscles and improving coordination.​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.                         ​

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage ​
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​​The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider. ​