If you have Parkinson’s disease, you may find that you have a common symptom: shaky hands and feet. This isn’t a voluntary movement -- it’s a tremor. About 80% of people with Parkinson’s have them. While tremors can be annoying, they aren’t disabling.
What Is a Parkinson’s Tremor?
- Resting. Parkinson’s tremors happen when your muscles are still. They go away when you move. They also lessen while you sleep. For example, if you’re sitting in a chair with your arm relaxed, you may notice that your fingers twitch. But if you’re using your hand, like when you shake someone else’s hand, the tremor eases or stops.
- Rhythmic. Parkinson’s tremors are slow and continuous. They aren’t random tics, jerks, or spasms.
- Asymmetric. They tend to start on one side of your body. But they can spread to both sides of the body.
Which Body Parts Do Parkinson’s Tremors Affect?
There are five main places you’ll have Parkinson’s tremors:
1. Hands. Parkinson’s disease tremors often start in the fingers or hands with what’s called a pill-rolling motion. Imagine holding a pill between your thumb and index finger and rolling it back and forth.
2. Foot. A Parkinson’s foot tremor is more likely to happen while you’re sitting or lying down with your feet at rest. If the tremor moves into your thigh muscles. It could look like your whole leg is shaking.
Foot tremors disappear when you stand or walk because those are active movements. A foot or leg tremor while you’re standing may be another condition.
3. Jaw. This is common in people with Parkinson’s. It may look like you’re shivering. It can become bothersome if the tremor makes your teeth chatter. If you wear dentures, it could make them shift or fall out.
Chewing eases the tremor, so gum might help.
4. Tongue. It’s rare, but a tongue tremor can cause your entire head to shake.
5. Internal. Some people with Parkinson’s say they can feel a shaking sensation in their chest or abdomen. But can’t be seen from the outside.
Can Parkinson’s Tremors Go Away?
Generally, tremors level off and stop getting worse at some point. How quickly this happens varies from person to person. Tremors may even go away after a while.
How Are Parkinson’s Tremors Treated?
Tremor can be unpredictable. Some experts say it’s the toughest symptom to treat with medication. Your doctor may prescribe medication for your tremors:
- Levodopa/carbidopa combination medicines (Parcopa, Sinemet, Stalevo). This treatment is a type of medication called a dopamine agonist. It’s usually the first treatment for Parkinson’s.
- Bromocriptine (Cycloset, Parlodel), pramipexole (Mirapex), ropinirole (Requip), rotigotine (Neupro), and injectable apomorphine (Apokyn). These dopamine agonists are sometimes used instead of levodopa or can be added to it if needed.
- Benztropine or trihexyphenidyl. These anticholinergic drugs are often used to treat younger patients who have tremor as the main symptom.
- Propranolol (Inderal, InnoPran). This drug is also used to treat high blood pressure, heart disease, and migraine.
- Clozapine (Clozaril, FazaClo, Versacloz). This medication is also used to treat schizophrenia. It requires weekly blood tests for the first 6 months.
Those taking levodopa/carbidopa may occasionally experience OFF periods in which their symptoms return. There are treatment options during these periods including a powder form of levopoda (INBRIJA) which can be inhaled or the medications istradefylline (Nourianz) or safinamide (Xadago).
Is There Surgery for Parkinson’s Tremors?
If medications don’t help, a surgical procedure called deep-brain stimulation (DBS) may be an option. With DBS, a small current is passed with high frequency through areas of the brain that are believed to block motor function. The procedure has a success rate of about 90% in decreasing or getting rid of Parkinson’s tremors.