Could my tremors be a sign of Parkinson’s disease, and when should I see a doctor?

Involuntary movements like a tremor can feel embarrassing or trigger anxiety, and many people choose to hide them out of fear of how others might perceive them – an experience Canadian-American actor Michael J. Fox and Coronation Street actor Rob Mallard have both publicly spoken out about and know too well.

However, seeking professional help is one of the best things you can do, as tremors can be a sign of a neurological condition, such as Parkinson’s disease.

Ahead of World Parkinson’s Day (April 11), we spoke to Laura Phillips, senior helpline advisor at Parkinson’s UK, who shared some advice about when to seek help about a tremor.

What is a tremor and how can it impact someone’s daily life? 

Parkinson’s UK defines a tremor as an uncontrollable repetitive shaking movement affecting a part of your body, such as your hand or arm.

Having a tremor can significantly interfere with a person’s ability to carry out daily tasks, says Phillips.

“For example, doing something fairly straightforward without a tremor, like doing up a zip, buttons or your shoelaces, might be quite difficult for someone who’s experiencing a tremor,” says Phillips.

“In addition, a lot of people also express concern about how their tremor might impact their ability to drive safely and a Parkinson’s diagnosis would have to be reported to the DVLA immediately.”

Is a tremor always a sign of Parkinson’s disease?

“A tremor is one of the most common types of motor symptoms that people experience with Parkinson’s, but a tremor isn’t always a sign of Parkison’s,” clarifies Phillips. “Some people with Parkinson’s never even experience a tremor.

“Also, it’s important to add that some other neurological conditions such as Multiple Sclerosis (MS) can also led to tremors.”

According to the NHS website, a tremor often becomes more noticeable under specific physiological and emotional stressors, for example, when you are stressed, tired, anxious or angry, after drinking caffeine or alcohol, after smoking, as you get older, or if you’re very hot or cold.

“Tiredness, stress and anxiety can all have a significant impact on people who have Parkinson’s symptoms,” says Phillips. “People with a tremor who have Parkinson’s often say that their tremor is much worse when they’re experiencing any period of stress or anxiety or if they’ve had a bad night’s sleep.”

The NHS website also states that some medicines and conditions can also cause a tremor, but recommends speaking to your GP before you stop taking any prescribed medication.

What might indicate that a tremor could be a sign of Parkinson’s disease?

While everyone experiences Parkinson’s differently, a lot of people living with the condition experience resting tremors.

“With Parkinson’s, usually someone will experience a tremor at rest, as opposed to an action tremor (which occurs during voluntary muscle movement) or an intense tremor,” says Phillips.

According to Parkinson’s UK’s website, a resting tremor often affects your hands and legs and usually appears as a “pill-rolling” tremor, which looks like you’re trying to roll a pill between your thumb and the finger next to it (your index finger).

While a resting tremor is a hallmark of Parkinson’s disease, it is rarely the only symptom. Therefore, it’s important to note down any other accompanying symptoms that you are experiencing.

“Other less noticeable symptoms include your speech getting quieter, handwriting getting smaller (often referred to as micrographia) and losing your sense of smell,” says Phillips. “Trouble with balance, pain, stiffness and fatigue are also very common, but more subtle, symptoms of Parkinson’s.”

When should someone seek medical attention about a tremor?

The NHS website recommends seeing a GP if you have a tremor or shaking hands and it’s getting worse over time, and is affecting your daily activities.

“You know yourself better than anyone else so it’s important to seek help if something is not normal for you,” says Phillips. “It may not be Parkinson’s, there could be other reasons for the symptoms that you are experiencing, but it’s always good to go and get it checked out.”

Making notes of any symptoms that frequently appear and when they happen can be helpful.

“Keeping a timeline of symptoms can really help medical professionals distinguish any patterns and identify whether it looks like a common pattern for Parkinson’s or if something else is potentially going on,” says Phillips.

What questions is a doctor likely to ask?

“Firstly, a doctor will want to ask lots of different types of questions about your general health to rule out key things like dehydration and medical infections that could be causing similar symptoms,” says Phillips.

“It’s also likely that they will ask questions about when you first noticed the tremor and when it tends to happen. For example, is it happening when you’re sitting and watching the TV, or is it happening when you’re reaching for something in the cupboard? Is it worse or better at different times of day?”

If a GP suspects Parkinson’s, they will refer you to a specialist.

“The consultant will continue to rule out other things and may send you for particular types of scans, such as CT scans or MRI scans to see if there’s any underlying things that could be causing the symptoms,” says Phillips.

“Some people will also have a specialist type of scan, called a DAT scan (Dopamine Transporter Scan), which helps identify the activity of dopamine in a person’s brain, which is the neurotransmitter that is lacking in the person’s brain when they have got Parkinson’s.”