Understanding Tremors and Shaking in Multiple Sclerosis
Multiple sclerosis (MS) is an autoimmune disease that affects the central nervous system. The immune system attacks the protective covering around the nerves, known as myelin, causing communication issues between the brain and body. This disruption in nerve signals produces an array of symptoms, including possible tremors or uncontrollable shaking.
What Causes Tremors and Shaking?
Tremors occur when there is a problem with the neural pathways that control coordinated muscle movement. When nerve signals in the brain that stimulate muscle contraction are delayed or interrupted, it causes the muscles to contract and relax involuntarily. The result is uncontrollable shaking or tremors in parts of the body.
In MS patients, tremors and shaking most often occur when nerve fibers in the brain, brainstem, or spinal cord are damaged by inflammation and demyelination. The areas affected determine the type of tremor and shaking pattern that develops.
Types of Tremors and Shaking
There are several types of tremors that people with MS may experience:
- Intention tremor - Shaking that happens when reaching for or using an object with the hands.
- Postural tremor - Shaking when trying to hold the body upright against gravity, such as when standing or sitting.
- Resting tremor - Shaking that continues even when the affected body part is fully supported and relaxed.
- Cerebellar tremor - A slow, broad shaking pattern usually affecting the extremities and head.
- Dysarthria - Slurred or slowed speech caused by poor control of the mouth and throat muscles.
Who Gets MS Tremors and Shaking?
Around 75% of people with MS will experience tremors or shaking at some point during the course of their disease. Those who are more prone to developing tremors include:
- People living with the disease for 10 years or longer
- Those with moderate to severe disability from MS symptoms
- People over the age of 40
- Those with cerebellar, brainstem, or spinal cord lesions visible on MRI
Managing MS Tremors and Shaking
While tremors cannot be cured, there are ways to reduce shaking episodes and improve function. An integrated treatment approach focused on medications, adaptive tools, physical therapy, and lifestyle changes helps many MS patients minimize tremors.
Medications to Control MS Tremors
If MS tremors and shaking are severe enough to impact daily activities, medications may help. Some options include:
- Isoniazid - Originally used to treat tuberculosis, this drug has anticonvulsant effects that calm tremors.
- Anti-seizure drugs like gabapentin can reduce shaking by regulating nerve signals.
- Botox injections - When injected into tremoring muscles, Botox blocks the nerve signals causing contraction.
- Beta blockers such as propranolol help control tremors triggered by stress or anxiety.
- Clonazepam - This benzodiazepine depresses the central nervous system to relieve intention tremors.
Supportive Devices for Shaky Hands and Arms
There are also many devices that can help stabilize MS tremors, including:
- Weighted utensils
- Plate guards and non-slip table mats
- Universal cuffs
- Adapted cups, scissors, and writing aids
- Walking canes or forearm crutches
Occupational therapists are very helpful for identifying useful tremor aids and teaching adaptation techniques.
Lifestyle Changes to Lessen MS Shaking
Certain lifestyle measures can also reduce MS shaking intensity for some patients:
- Avoiding caffeine, smoking, and medications that aggravate tremors
- Trying relaxation techniques during flare-ups
- Getting plenty of rest and staying warm
- Reducing stress and anxiety triggers
- Engaging in gentle regular exercise like yoga or tai chi
Physical and Speech Therapy for MS Tremors
Working with physical and speech therapists can help MS patients gain strength, coordination, and control over tremoring limbs or speech muscles. This may involve:
- Targeted muscle strengthening exercises
- Task-oriented training for hands and arms
- Gait training to improve stability
- Practicing communication techniques
- Learning to use residual motor control through feedback
Techniques taught in therapy can alleviate shaking and improve function at home, work, and in the community.
Outlook for People with MS Tremors
While tremors can certainly impact quality of life for those with MS, the condition is manageable. Being proactive with treatment and self-care helps many patients successfully minimize shaking episodes.
By understanding the causes of MS tremors, exploring medication options, using assistive devices, adapting routines, and participating in physical therapy, it’s possible to regain control over shaky limbs.
With time and consistent effort, most people living with MS tremors can achieve positive outcomes when it comes to function, independence, and well-being.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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