Imagine waking up one morning, reaching for your cup of coffee, only to find your hand shaking uncontrollably. This involuntary, rhythmic muscle contraction is known as a tremor—a movement disorder that can disrupt daily life. As a chiropractic neurology patient, it’s essential to understand the various types of tremors, the brain regions involved, their clinical presentations, and how chiropractic neurology can offer effective, non-invasive treatment options.
Prevalence of Tremors in the United States
Tremors are among the most common movement disorders, affecting millions of people in the United States. Essential tremor (ET) is the most prevalent type, impacting an estimated 7 million Americans. It is about 20 times more common than Parkinson’s disease, which affects approximately 1 million individuals in the U.S. The prevalence of tremors increases with age, with studies suggesting that up to 4% of people over 40 years old and as many as 20% of those over 65 experience some form of tremor. While essential tremor is often genetic, other tremor types, including those associated with neurodegenerative conditions, can develop due to environmental and lifestyle factors. Given its widespread occurrence, tremor represents a significant public health concern, affecting quality of life and daily activities for many individuals.
Types of Tremors
Tremors are categorized based on their activation and characteristics:
- Rest Tremor
Occurs when muscles are at rest and subsides with voluntary movement. Commonly associated with Parkinson’s disease, rest tremors typically affect the hands and fingers, presenting as a “pill-rolling” motion.
- Action Tremor
Manifests during voluntary muscle contractions and includes several subtypes:
- Postural Tremor: Appears when maintaining a position against gravity, such as holding the arms outstretched.
- Kinetic Tremor: Occurs during any voluntary movement, like writing or lifting objects.
- Intention Tremor: Becomes more pronounced as one approaches a target, such as touching one’s nose.
- Task-Specific Tremor: Emerges during specific tasks, like speaking or playing an instrument.
- Isometric Tremor: Arises during muscle contraction without movement, such as holding a heavy book steady.
Understanding these distinctions is crucial for accurate diagnosis and treatment planning.
Brain Regions Involved
Tremors result from dysfunctions in specific brain areas:
- Basal Ganglia: Involved in movement regulation, its impairment is linked to rest tremors, notably in Parkinson’s disease.
- Cerebellum: Responsible for coordination and balance, cerebellar damage can lead to intention tremors, often observed in conditions like multiple sclerosis.
- Thalamus: Acts as a relay station for motor signals; abnormalities here can contribute to various tremor types.
- Motor Cortex: Plays a role in voluntary movement; disruptions here can impact the control of tremor frequency and amplitude.
Clinical Presentations
The manifestation of tremors varies:
- Essential Tremor (ET): The most prevalent movement disorder, ET primarily causes postural and kinetic tremors, especially in the hands, head, and voice. Unlike Parkinson’s, ET worsens with movement and is often familial.
- Parkinsonian Tremor: Characterized by rest tremors, muscle rigidity, and bradykinesia (slowness of movement). Tremors typically diminish with purposeful action.
- Dystonic Tremor: Occurs in individuals with dystonia, presenting as irregular tremors accompanied by abnormal postures due to sustained muscle contractions.
- Physiologic Tremor: A mild, often imperceptible tremor that can be exaggerated by fatigue, anxiety, or caffeine consumption.
- Psychogenic Tremor: Tremor with sudden onset and variability, often associated with psychological stress or trauma.
Age Differences and Underlying Conditions
Tremors can affect all age groups but are more prevalent with advancing age. Essential tremor often emerges in individuals over 40, with its frequency increasing in those over 65. Parkinsonian tremors typically develop around age 60. However, certain tremors, such as dystonic tremors, can appear earlier in life.
Underlying conditions influencing tremor onset include:
- Genetic Predisposition: Family history plays a significant role, especially in essential tremor.
- Neurological Disorders: Diseases like Parkinson’s, multiple sclerosis, and dystonia are closely associated with specific tremor types.
- Metabolic Imbalances: Conditions such as hyperthyroidism or hypoglycemia can induce tremors.
- Toxin Exposure: Heavy metal poisoning (e.g., mercury or lead) can contribute to neurological tremors.
Chiropractic Neurology Treatment Options
Chiropractic neurology offers a holistic approach to managing tremors, focusing on non-invasive therapies that enhance nervous system function. Treatment strategies include:
- Sensorimotor Integration Exercises
Tailored activities that improve coordination and proprioception, aiming to recalibrate the nervous system and reduce tremor intensity. These exercises help strengthen the connection between the sensory and motor systems, reducing involuntary muscle contractions.
- Vestibular Rehabilitation
Techniques designed to address balance disorders by stimulating the vestibular system, potentially alleviating tremors associated with vestibular dysfunction. This involves specific head movements, balance training, and gaze stabilization exercises.
- Neuromuscular Re-education
Exercises that enhance muscle control and reduce involuntary movements by retraining the nervous system’s communication with muscles. This includes resistance training and biofeedback techniques to help patients regain motor stability.
- Somatosensory Stimulation
Tactile and vibration therapy can help modulate sensory input, potentially reducing tremor severity. By altering the way sensory information is processed, these therapies can promote better motor control.
- Red Light Therapy
Emerging evidence suggests that red and near-infrared light therapy may support neuronal health and reduce neurodegeneration, which can be beneficial for conditions like Parkinsonian tremors.
- Eye Movement Therapy
Saccadic eye movement exercises are used to improve brain function, especially in cases where the cerebellum is involved. These exercises can enhance neural plasticity and motor control.
- Lifestyle and Nutritional Counseling
Guidance on diet and lifestyle modifications to address metabolic factors contributing to tremors, such as reducing caffeine intake, managing blood sugar levels, and incorporating anti-inflammatory foods. Certain supplements, such as magnesium and B vitamins, may also support nervous system health.
Parkinson’s Disease
Parkinson’s disease is a progressive neurodegenerative disorder that primarily affects movement. It is characterized by the gradual loss of dopamine-producing neurons in the substantia nigra, a region of the brain responsible for motor control. Common symptoms include tremors at rest, muscle rigidity, bradykinesia (slowed movement), and postural instability. As the disease progresses, non-motor symptoms such as cognitive decline, mood disorders, and autonomic dysfunction may also develop. While the exact cause of Parkinson’s remains unclear, genetic and environmental factors are believed to play a role.
Among various treatments, Tai Chi has emerged as one of the most effective non-pharmaceutical interventions for Parkinson’s disease. Research has shown that Tai Chi improves balance, flexibility, gait stability, and overall motor function, significantly reducing the risk of falls in Parkinson’s patients. A landmark study published in the New England Journal of Medicine found that individuals practicing Tai Chi demonstrated greater improvements in postural control and mobility compared to those undergoing traditional physical therapy. Tai Chi’s slow, deliberate movements help strengthen neuromuscular coordination, making it an ideal therapy for managing Parkinson’s symptoms. While there is no cure for the disease, incorporating Tai Chi into a treatment plan can significantly enhance a patient’s quality of life by promoting stability, mobility, and overall well-being.
Tremors, while challenging, can be effectively managed through a comprehensive understanding of their types, underlying neurological causes, and tailored chiropractic neurology interventions. By addressing the root causes and employing non-invasive therapies, patients can experience significant improvements in their quality of life.
If you or someone you love is suffering from tremors and you would like to learn how chiropractic neurology can help, contact the team at Georgia Chiropractic Neurology Center today. We look forward to hearing from you.
Written by Sophie Hose, DC, MS, DACNB, CCSP
Peer-Reviewed Sources:
-
- Dorsey, E. R., Bloem, B. R., & Brundin, P. (2020). The Parkinson pandemic—A call to action. JAMA Neurology, 77(7), 871-872. https://doi.org/10.1001/jamaneurol.2020.1127
- Louis, E. D., & Ferreira, J. J. (2010). How common is essential tremor? Update on the worldwide prevalence of essential tremor. Movement Disorders, 25(5), 534-541. https://doi.org/10.1002/mds.22838
- Louis, E. D., & McCreary, M. (2021). How common is essential tremor? Update on the worldwide prevalence of essential tremor. Tremor and Other Hyperkinetic Movements, 11, 28. https://doi.org/10.5334/tohm.632
- Louis, E. D., & Ottman, R. (2014). How many people in the USA have essential tremor? Deriving a population estimate based on epidemiological data. Tremor and Other Hyperkinetic Movements, 4, 259. https://doi.org/10.5334/tohm.198
- Li, F., Harmer, P., Fitzgerald, K., Eckstrom, E., Stock, R., Galver, J., Maddalozzo, G., & Batya, S. S. (2012). Tai Chi and postural stability in patients with Parkinson’s disease. The New England Journal of Medicine, 366(6), 511-519. https://doi.org/10.1056/NEJMoa1107911