Parkinson’s disease is a progressive neurological condition that affects movement and balance. It’s believed to develop when cells in the brain that make dopamine — a chemical in the body that helps control movement and mood — gradually break down.
One of the most recognizable symptoms of Parkinson’s disease is tremor.
Read on to learn about the types of tremors you can experience with Parkinson’s disease, other symptoms to watch for, and how to manage Parkinson’s.
Parkinson’s disease affects a wide variety of body systems because the chemical most affected by Parkinson’s is a neurotransmitter called dopamine.
Dopamine is used in functions throughout the body, including:
- heart rate
- blood pressure
Because of dopamine’s wide use throughout the body, early signs of Parkinson’s can take numerous forms that you may not recognize at first, such as:
- decreased sense of smell (anosmia)
- small, cramped handwriting
- voice changes
- stooped posture
In many cases, Parkinson’s isn’t identified until later stages when symptoms become more pronounced and recognizable, including:
- tremors or shaking while at rest
- slow movements
- stiffness of arms, legs, and trunk
- problems with balance and tendency to fall
- blank or rigid facial expressions
- muffled, quiet speech
- difficulty blinking or swallowing
- increased falls
- sleep problems
- memory problems
Parkinson’s can begin years before it’s diagnosed. Symptoms like tremor can change in their intensity as the disease progresses.
For many people, Parkinson’s doesn’t become evident until after the age of 50, with most cases being diagnosed between ages
The presence of tremors can also change throughout the various stages of Parkinson’s. These stages can gradually progress over the course of months or even years.
5 stages of Parkinson’s
- Stage 1. Mild tremors may begin, but symptoms typically don’t interfere with daily activities.
- Stage 2. Moderate symptoms now affect both sides of the body, but independent living is still possible.
- Stage 3. This is the turning point to severe symptoms. They increase and greatly affect daily activities. Falls and movement restrictions also tend to increase at this stage.
- Stage 4. Significant symptoms are now severe, but you may still be able to stand without assistance. Living alone may be difficult due to movement restrictions and falls.
- Stage 5. Severe symptoms may mean you’re unable to move on your own and experience severe hallucinations or dementia.
There are many types of tremors. The type and location of a tremor can help give clues as to why the tremor is occurring and what it could mean for the development of other conditions later on.
Tremors are generally split into two categories: resting and action tremors.
Resting tremors are those that happen when the body is at rest.
In many cases, these tremors only affect the muscles in the hands or fingers, causing them to shake when the muscles in that area are resting.
These tremors can sometimes appear as “pill-rolling” tremors because of their circular finger and hand movements.
These tremors occur when the body is moving, specifically during voluntary muscle actions.
There are several types of action tremors. It’s possible to experience more than one:
- Postural tremor happens when you act against gravity, like holding your arms out in front of you.
- Kinetic tremor happens with voluntary movement, even with something minor like opening and closing the eyes.
- Intention tremor happens when you’re making a purposeful movement, like touching a finger to your nose. For many people, this tremor gets worse as you move your limb closer to the targeted location or intended action.
- Task-specific tremor targets certain skilled tasks. For example, these tremors may only appear when you’re writing or speaking.
- Isometric tremor happens when you contract a muscle without moving, like holding a dumbbell in a steady position.
Categories of tremors
There are more than 20 categories and subcategories of tremors. The most common include:
- Essential tremors: an action tremor that appears on both sides of the body but is often more noticeable in the dominant limb
- Dystonic tremors: unwanted movements that occur when the brain sends incorrect signals to certain muscles
- Cerebellar tremor: a slow-moving action tremor that occurs during purposeful movement, as with an intentional tremor
- Parkinsonian tremor: typically affects one or both hands, but can also impact other areas of the body, spread to both sides, or progress into an action tremor
The exact cause of tremors in Parkinson’s isn’t fully understood. It may be tied to the degradation of cells that produce dopamine in the brain. And the causes may vary for different tremors.
Symptoms of Parkinson’s can also differ among people. About 75 percent of people with Parkinson’s disease report the presence of some kind of tremor, but not everyone who has the condition experiences tremors.
Rest tremors are frequently an early sign of the condition and are often used to make a Parkinson’s diagnosis. But studies have shown that several types of tremors can affect people with Parkinson’s.
For example, in a 2018 study involving nearly 400 people with Parkinson’s:
- 20 percent of the participants had no rest tremor at the start of the study
- almost 90 percent had some sort of tremor
- about 70 percent reported rest tremors
- 50 percent reported both postural and kinetic tremors
Many people have also reported changes in the type, severity, and location of tremors throughout the course of their experience with Parkinson’s disease.
Tremors in the hands are most common, but some people may also have Parkinson’s tremors in the:
In the early stages of the disease, tremors usually only appear on one side of the body, but tremors can spread to both sides of the body as the condition progresses.
Other factors like stress or difficult emotional events can also affect the strength or frequency of tremors.
There are no specific tests or procedures to diagnose Parkinson’s disease.
Diagnosis typically relies on a doctor’s observation of your symptoms and medical history. A diagnosis of Parkinson’s disease is typically confirmed with:
- the presence of two or three primary symptoms of the disease
- other diseases can be excluded as the cause of symptoms
- no history of injury or medication use that could lead to Parkinsonian symptoms
- some improvement in response to medications used to treat Parkinson’s
Some imaging techniques, such as PET scans, can help confirm a diagnosis. But these aren’t used to make one.
If your doctor wants to pinpoint the type of tremor you’re having before making a Parkinson’s diagnosis, some testing methods for
- an observation of whether the tremor occurs with movement or at rest
- the location of the tremor
- the frequency and magnitude of the tremor
Your doctor will also examine how well you balance, walk, talk, and whether you experience any muscle stiffness.
Other tests, including blood tests and X-rays, may also be done during the diagnosis process. But this is typically done to rule out other diseases rather than to confirm a Parkinson’s diagnosis.
Medications that can help lessen the severity or frequency of different diagnoses of tremors include:
- beta blockers
- seizure medications
- botulinum toxin
- Parkinson’s medications
Each medication is used to treat a different condition that causes tremor.
Parkinson’s medications are also sometimes used to help diagnose the condition. Specific medications, like levodopa, are used to treat Parkinson’s. A response to these medications may support the diagnosis.
A list of medications commonly used to treat Parkinson’s disease includes:
- COMT inhibitors
- dopamine agonists
- MAO-B inhibitors
Treatments are usually adjusted to achieve the best relief for each person’s symptoms and medical history.
Clinical trials for Parkinson’s
A number of clinical trials investigating the cause of Parkinson’s, how the disease progresses, and new medications are also underway.
One ongoing study involves the use of a molecular medication that can cross the blood-brain barrier to target early Parkinson’s to stop the progression of the disease to later stages.
Refer to the Parkinson’s Foundation or ClinicalTrials.gov for information on additional clinical trials.
No home remedies can cure or reverse Parkinson’s disease development or progress.
The following home remedies are being studied as possible promising therapies for Parkinson’s disease:
- H2 water. H2 water is water with added hydrogen gas. It’s being examined in experimental trials as a potential way to
help improve symptomswhen used alongside levodopa.
- Antioxidant-rich foods. In
animal studies, antioxidants have been shown to reduce oxidative stress that can accelerate brain damage.
- Magnesium sulfate. It may help prevent progression of the disease, according to
- Curcumin. Found in turmeric, curcumin might help reduce inflammation and help protect the brain from degeneration, based on preliminary laboratory research.
- Fava beans. They
may increaseblood levels of levodopa.
- Vitamin D supplements. Vitamin D deficiency can
lead to early death of cellsin the area of the brain associated with Parkinson’s.
Talk with a doctor before beginning any new medications or supplements to make sure they are safe for you. For example, fava beans may not be safe to eat if you have a G6PD deficiency.
Tremors have been reported by people who have Parkinson’s as one of the most common symptoms of the disease, but the type, location, and frequency of tremors varies for different people.
Likewise, Parkinson’s medications may be used in a number of combinations to find the right solution for each person’s symptoms, including tremors.
Talk with a doctor about how well your medications are managing your tremors to help find the best fit for you.