Tremors
Learn about tremors, including common causes, risk factors, prevention, warning signs, treatment options and how physiotherapy may support mobility, balance and coordination.
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What Is It?
A tremor is an involuntary, rhythmic shaking movement of one or more parts of the body. Tremors can vary in severity and may be barely noticeable or significant enough to affect everyday activities.
They commonly affect the hands but can also involve the arms, head, legs, jaw, or voice. Tremors may occur while a person is resting, maintaining a position, or performing activities such as writing, holding a cup, eating, or reaching for an object.
Tremors can have many possible causes. They may be temporary and related to factors such as stress, fatigue, caffeine, certain medications, or low blood sugar. Persistent tremors can also be associated with neurological or other medical conditions.
Because the cause of a tremor cannot be determined from the symptom alone, persistent, new, or worsening tremors should be assessed by an appropriate healthcare professional. Physiotherapy may support mobility, strength, balance, coordination, and functional ability for suitable individuals as part of an overall care plan.
Causes
Stress and Anxiety: Emotional stress or anxiety can increase or make existing tremors more noticeable in some individuals.
Fatigue: Physical exhaustion or lack of adequate rest may temporarily worsen shaking.
Caffeine: High caffeine intake may cause or increase shakiness in some people.
Certain Medications: Some medicines may cause tremors as a side effect. Do not stop prescribed medication without consulting the prescribing healthcare professional.
Low Blood Sugar: A drop in blood sugar may cause shakiness along with symptoms such as sweating, weakness, or dizziness.
Alcohol Withdrawal: Tremors can occur during alcohol withdrawal and may require urgent medical assessment depending on the situation and accompanying symptoms.
Neurological Conditions: Certain conditions affecting the brain and nervous system can cause persistent tremors and require specialist assessment.
Thyroid Problems: An overactive thyroid and other metabolic conditions may sometimes contribute to tremors.
Family History: Some types of tremors may occur more commonly within families.
Other Medical Conditions: Tremors can be associated with a range of medical, metabolic, or neurological conditions, making proper assessment important.
Risk Factors
Increasing Age: Some forms of tremor become more common with increasing age.
Family History: A family history of certain tremor disorders may increase the likelihood of developing similar symptoms.
High Stress Levels: Stress and anxiety may trigger or worsen tremors in some individuals.
Excessive Caffeine Intake: High consumption of caffeine-containing drinks or products may increase shakiness.
Lack of Sleep: Inadequate sleep and fatigue may worsen tremors.
Certain Medications: Some medications can contribute to tremors or make existing tremors more noticeable.
Underlying Medical Conditions: Conditions affecting the nervous system, thyroid, metabolism, or other body systems may increase the risk.
Alcohol or Substance Withdrawal: Withdrawal from alcohol or certain substances can cause tremors and may require medical supervision.
Preventive Measures
Not all tremors can be prevented, especially when related to neurological or medical conditions. However, some lifestyle measures may help reduce factors that trigger or worsen shaking.
Manage Stress: Relaxation techniques, regular activity, adequate rest, and suitable stress-management strategies may help reduce stress-related symptoms.
Get Adequate Sleep: Maintaining a regular sleep routine may help reduce fatigue that can worsen shaking.
Limit Excessive Caffeine: If caffeine appears to worsen your symptoms, reducing intake may be helpful.
Stay Hydrated: Adequate hydration supports overall physical health.
Eat Regular Meals: Regular meals may help avoid symptoms related to low blood sugar for some individuals.
Review Medication Concerns: If tremors begin after starting or changing medication, discuss this with your prescribing healthcare professional.
Stay Physically Active: Appropriate physical activity can support strength, mobility, balance, and overall physical function.
Avoid Self-Diagnosis: Because tremors have many possible causes, professional assessment is important for persistent or unexplained symptoms.
When To Seek Medical Help?
New or persistent tremors should be professionally assessed, particularly when the cause is unclear.
Sudden Onset of Tremors: A sudden new tremor should be medically assessed, especially if accompanied by other neurological symptoms.
Weakness or Numbness: Tremors with new weakness, numbness, or altered sensation require prompt evaluation.
Difficulty Speaking: New speech difficulties, facial changes, confusion, or sudden coordination problems require urgent medical attention.
Loss of Balance: Tremors accompanied by significant difficulty walking, poor coordination, or loss of balance should be assessed promptly.
Symptoms Getting Worse: Tremors that are becoming more frequent, severe, or widespread should not be ignored.
Difficulty With Daily Activities: Seek professional advice if shaking affects writing, eating, drinking, dressing, or other everyday tasks.
New Tremors After Medication Changes: Discuss new or worsening tremors following medication changes with the prescribing healthcare professional.
Tremors With Severe Illness: Shaking accompanied by severe headache, confusion, fever, fainting, or other concerning symptoms requires medical assessment.
Alcohol Withdrawal Symptoms: Tremors occurring after stopping or significantly reducing heavy alcohol use may require urgent medical care.
Treatment Overview
Treatment for tremors depends on the underlying cause. A proper medical assessment is essential because tremors can be related to temporary lifestyle factors, medication effects, metabolic conditions, or neurological disorders.
A healthcare professional may assess your symptoms, medical history, medications, physical and neurological function, and other relevant factors. Further tests or specialist evaluation may be recommended when necessary.
For individuals with an appropriate diagnosis, physiotherapy may support overall movement and physical function. Depending on individual needs and medical guidance, rehabilitation may focus on improving strength, mobility, balance, coordination, posture, walking ability, and confidence during everyday activities.
Physiotherapy does not replace medical or neurological assessment for unexplained tremors. Treatment is always planned according to the underlying condition and individual needs.
Physiotherapy Treatments
Detailed Functional Assessment: A physiotherapist may assess mobility, muscle strength, posture, balance, coordination, walking ability, and how tremors affect daily activities.
Balance Training: Suitable exercises may help improve balance and stability for individuals experiencing movement or coordination difficulties.
Coordination Exercises: Targeted activities may help improve control and coordination of movement.
Strengthening Exercises: Progressive strengthening may help support functional movement and overall physical capacity.
Mobility Exercises: Appropriate exercises may help maintain joint movement and reduce stiffness.
Postural Training: Physiotherapy may provide guidance to improve postural control and positioning during daily activities.
Gait Training: For suitable individuals with walking difficulties, rehabilitation may focus on improving walking safety, confidence, and movement efficiency.
Functional Training: Therapy may focus on everyday activities such as standing, walking, reaching, transferring, and other tasks affected by symptoms.
Hand and Upper Limb Exercises: Suitable exercises may help support functional use of the hands and arms where appropriate.
Fall Prevention Strategies: For individuals with balance difficulties, physiotherapy may include strategies to improve safety and reduce fall risk.
Energy Management: Guidance may help suitable individuals manage fatigue and plan activities according to their physical capacity.
Personalised Home Exercise Programme: A customised exercise programme may support ongoing mobility, strength, balance, coordination, and independence between sessions.
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