Tremor can be described as a trembling or shaking movement that you cannot control. While it is usually a rhythmic, back-and-forth shaking, tremor can also be irregular and unpredictable. Tremors can also be either ‘fine’ – small, shaking movements – or ‘gross’ – larger movements.
Everyone has a small level of tremor – known as ‘physiological tremor’ – that caffeine, alcohol or stress can make more noticeable.
It’s not clear exactly how many people with MS are affected by tremor, although studies have suggested it’s between 25 and 60 per cent. If tremor is affecting your day-to-day life, you can speak to your GP or MS nurse. If you are already in contact with a physiotherapist or occupational therapist, you could also discuss it with them.
Tremor is one of the more difficult symptoms of MS to manage, but there are things that can make a difference. Rehabilitation involving physical or occupational therapy, drug treatments and, in some cases, surgery, have all been shown to help some people. There is no single approach that works for everyone, so you may have to try a number of different treatment options before you find what’s best for you. There are two kinds of tremor that are most common as a result of MS:
Intention tremor - most common in MS
Intention tremor comes on when you want to do something or reach for something. It often gets worse the closer you get to the object. This is the type of tremor people most often experience in MS.
Postural tremor is when you shake when you are sitting or standing. It comes on while your muscles are trying to hold part of your body still against the forces of gravity.
You may come across the word ‘ataxia’ used instead of, or as well as, tremor. This is a medical term for a group of symptoms that includes problems with balance and coordination alongside tremor. Many people with MS experience ataxia, and the term is often used in relation to MS-related tremor.