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What causes tremors and shaking with Parkinson's disease?

Discover how Parkinson's tremors impact daily life and explore coping strategies to improve independence and well-being.

September 20, 2024

Doctor checking brain x-ray of a Parkinson's patient

Parkinson's disease is an age-related progressive neurological condition that causes parts of the brain to degenerate. It's best known to affect movement, usually leading to tremors, stiffness, and concerns with balance and coordination. Over a period of time, the symptoms can worsen and start affecting the senses, mental health, thinking ability, and more.  

In the UK, it's estimated that around 153,000 people are living with Parkinson's disease. The condition is common overall. It typically begins at the age of 60 and ranks second among age-related degenerative brain disorders. For people living with Parkinson's, managing symptoms and maintaining independence is important.

In this article, we look at symptoms of Parkinson's such as tremors and ways that they can be reduced, along with what to do if you think you or a loved one might be developing Parkinson's and tremors.

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Symptoms of Parkinson's

Nurse helping an elderly with tremors in hands


The symptoms of Parkinson's develop slowly with age. They might begin with a slight shaking in your finger, thumb, or hand and slight stiffness in the body. There's no test to diagnose Parkinson's disease, and it's difficult to diagnose it in the early stages. We have made a list of symptoms that might develop over time.

These symptoms are not definitive signs of Parkinson's, but if you develop more than a few symptoms, please speak to your GP.



Parkinson's tremors

Tremors occur when a part of your body shakes slightly when the muscles relax and rest. They are less noticeable when you are moving around or when sleeping. 

Stiffness in muscles

This symptom is common in Parkinson's. Stiffness in muscles can cause discomfort or pain and affect your posture. Movements in the arms, legs, and neck may seem robotic due to muscle rigidity.

Slowness of movement

With Parkinson's, you might notice that your movements have become slow and more deliberate while performing everyday tasks, like buttoning a shirt, walking, or writing.

Loss of balance and frequent falls

As we get older, our balance and strength often gets affected, but with Parkinson's, balance concerns leading to frequent falls becomes quite prevalent. This might be due to the inability to maintain an upright posture. If the risk of falling increase, a fall alarm can provide reassurance that help will be called when a fall is detected.

Gait problems

Many older adults with Parkinson's experience that their feet get stuck on the floor, and they find it difficult to move, also known as freezing. Some patients might develop a shuffling walk, described as taking shorter steps. 

Facial masking

Even if you are not in a bad mood, your facial expressions might look annoyed, depressed, or serious. Facial masking means it's difficult to show emotions. There might be a reduction in blinking, leading to a fixed stare.

Sleep disturbances

Common sleep-related concerns in Parkinson's are insomnia and restless leg syndrome. You might act out your dreams while you are deep asleep, also known as REM sleep behaviour disorder. You might also feel fatigued and feel excessively sleepy during the day.
 

Smaller handwriting

You might notice that your handwriting has become smaller, and the words are crammed together, making it difficult for you to write legibly. A change in handwriting, known as micrographia, may be a sign of Parkinson's disease.

Speech and swallowing difficulties

You may notice that your speech has become soft, slurred, or monotone, making it difficult for you to communicate. You might also find it challenging to swallow food or have drinks, increasing the risk of choking.

Loss of sense of smell

You may notice that certain foods no longer smell the same. If you start noticing a loss of smell for foods like bananas or pickles, you should check with your doctor about Parkinson's.  

Change in moods, including depression

Parkinson's can also lead to mood changes with anxiety and depression. These mood changes can increase the risk of other physical symptoms and reduce the overall quality of life. These changes are often associated with the chemical imbalances in the brain caused by Parkinson's. 

Cognitive decline and dementia

In the later stages of Parkinson's elderly individuals might experience cognitive decline, leading to memory issues, slow thinking, and concentration troubles. In some cases, this can aggravate to dementia, affecting the ability to perform everyday tasks. Specialist dementia tracker alarms are designed to find people who are living with dementia and may wander or get confused when away from the home.

Doctor doing Parkinson's diagnosis


What causes tremors in Parkinson's disease?

Tremor is one of the major symptoms of Parkinson's. They occur due to the degeneration of nerve cells in the brain, particularly in the substantia nigra, which is responsible for producing dopamine. Dopamine is a neurotransmitter that plays an important part in controlling movement and coordination. The loss of dopamine-producing cells leads to motor symptoms, including tremors.

Types of tremors

Resting tremor

This is the most common type of tremor in Parkinson's. They occur mostly at rest and decrease during sleep, also known as resting tremors. These tremors might also disappear completely when an individual is in deep concentration.

For example, your hand may tremble at rest or even while walking, but the tremor becomes less noticeable or stops entirely when you extend your hand to shake someone else's.


Action tremor

These types of tremors are less common, and older adults with Parkinson's might notice these while they are busy with their daily activities, such as writing or eating.

The impact of tremors in Parkinson's on daily life

Tremors are not life-threatening, but they can significantly affect an older adult's quality of life. The most common resting tremor can impact and disrupt several everyday activities, affecting an individual's physical and emotional well-being.

Difficulty with fine motor skills

With Parkinson's you might notice that tasks that you were able to perform perfectly earlier are not as easy to do anymore. Tremors can make everyday tasks that require fine motor skills - buttoning a shirt, writing, using utensils, or picking up small objects challenging. 

Some elderly people also find it difficult to use electronics. They might find it frustrating to control hand tremors while typing on a phone or computer or using a TV remote.

Challenges with eating and drinking

Elderly individuals with Parkinson's and tremors might find it hard to eat and drink. Holding a cup of coffee or cutlery steady may be challenging, leading to spills or difficulty consuming food and drinks safely. These situations can also cause embarrassment during social gatherings, making people avoid eating in public or dining with others. Even meal preparation at home could feel like a challenge due to Parkinson's symptoms and tremors. 

Occupational Therapist helping with exercises


Impact on balance and mobility

Although tremors commonly occur when the muscles are at rest, they can impact balance and mobility. When tremors occur along with other motor symptoms like slowness of movement and muscle rigidity, tremors can make walking for an older adult quite challenging. In more progressive instances, tremors can affect your posture, increasing the risk of falls.

Social isolation and impact on emotional well-being

Tremors can lead to self-consciousness and embarrassment, particularly in social situations. Individuals may avoid social gatherings or public activities because they fear being noticed or judged. Dealing with constant tremors can result in anxiety, frustration, or depression as people struggle to manage symptoms that disrupt their daily lives. Decreased social interaction can contribute to isolation, which can have a negative impact on mental health.

Safety concerns while driving

Increased tremors can raise the risk of accidents and injuries. People may have trouble holding onto objects, making driving challenging. The ability to drive depends on an individual's particular symptoms. Many people can safely continue driving for a long time after being diagnosed.

However, with time and due to medication effects, a person's ability to drive might be compromised. For example, having trouble steering or controlling the vehicle with precision due to tremors. Older adults might also find it difficult to react quickly to a dangerous situation. These conditions might force an older adult to stop driving. 

Loss of independence

As tremors worsen, people may struggle to complete tasks on their own. Simple activities such as getting dressed, grooming, and cooking can become more challenging. Many people with Parkinson's disease require help with daily tasks, impacting their independence and self-confidence. For example, if someone has to stop driving completely, they have to rely on family and friends or other transportation to carry out activities like grocery shopping. This may lead them to feel like a burden on those around them, affecting them mentally and causing a sense of loss of independence

 

Managing everyday tasks with Parkinson's and tremors 

Elderly couple staying active together in their garden


Improving mobility

Moving around might not come naturally to you with Parkinson's, but staying active in your daily life is quite important to manage and live better with Parkinson's. Making continuous movements can help with improving the symptoms and building your confidence.

You can start with easy and gentle exercises that you can do at home. You can also plan outdoor walks with a friend or family member, allowing you to socialise and boost your motivation. You can also add physical activities, such as gardening or washing your car, if you are able to, to your routine.

Help with freezing episodes

All older adults with Parkinson's do not necessarily go through freezing or gait as a symptom, but if you do, it increases your risk of having a fall. Parkinson's falls are majorly related to freezing episodes when a person is in transition from walking to turning or changing directions.

If you experience frequent freezing episodes, talking to your GP is important, as adjusting your treatment may be helpful. You can also seek the help of physiotherapists specially trained in Parkinson's disease who can teach techniques to get out of your freezing episode.



Driving

Parkinson's and tremors can affect you physically, mentally, and emotionally, affecting your ability to drive safely. Driving with PD tends to be safest in the early stages of the disease. Taking medications to manage your symptoms can also enhance your driving ability, and staying active can help you maintain the necessary muscle strength for driving.

You can also take a driving assessment and speak to a specialist who can guide you to manage your symptoms while driving. Unfortunately, if you have to stop driving completely and you don't want to rely on others, you can start using public transportation. There are a lot of concessions available for UK public transport for people over 60.

You can also reach out to local communities to find out if they have a group of volunteers who can drive members locally.

Tips to get dressed

PD and tremors can make it frustrating to get dressed, but taking your time is the best way to not feel anxious and stressed while dressing up. You can choose to get dressed after doing a few simple stretching exercises, as these will help warm up your muscles. If possible, you can decide to dress up after your medications are working well, which is in the later part of the morning. It might also help you to sit down while getting dressed.

There are specific clothing and fabrics that you can choose to make dressing easier, such as wearing pants with elastic waists or replacing buttons with magnetic closures or velcros. To use skincare and haircare products, you can switch to bottles with pump mechanisms.

Managing stress

Stress affects everyone and anyone in an unhealthy way, but it specifically aggravates the symptoms of Parkinson's disease. It is recommended that you get involved in activities that could help you manage your stress levels.

You can start practising mind-body techniques, like meditation, deep breathing, and mindfulness. These techniques help to reduce stress and improve muscle relaxation, helping you to reduce the intensity of tremors.

There might be community groups or local gyms around you that specifically do classes for these activities. Attending a class can help you find motivation and also help to socialise with people going through similar situations.

Meal preparation at home

To make things easier to prepare your meals and clean up at home, you can arrange or modify your kitchen to suit your needs. Occupational therapists often suggest reorganising the kitchen to place the most commonly used items on a counter that's easier to reach.

You can also invest in utensils that have handles that are easier to grasp. Sharp knives can be quite dangerous while experiencing a tremor, so you can use electric knives to help with cutting. Adaptive cutting boards with built-up sides and non-slip backing to help keep items in place when cutting can also be helpful.

Diet and nutrition

Maintaining a balanced diet is important for brain health, providing the necessary energy, protein, vitamins, minerals, and fibre for overall well-being. However, it is always better to speak to your GP about the interactions between certain foods and the medications that you are on. For example, for some older adults, taking a specific PD medication with a protein-rich meal may interfere with the absorption of the drugs.

 

Exercises by Parkinson's patient

 

Peace of mind for anyone experiencing symptoms of Parkinson's disease

Experiencing frequent freezing episodes or tremors affecting your daily tasks can be a real concern for you, along with family, friends or neighbours. The situation can especially get tense when no one is around while you are alone at home or when you are out and about.

A wearable personal alarm system or fall alarm from TakingCare could be a great option to bring real peace of mind that help will always be available if it is needed. With a range of devices that have different features to suit everyone's different needs, the alarms are monitored 24/7 so that if the wearer needs help or reassurance at any time of the day or night, they can reach assistance easily.

View our full range of personal alarms online. If you have any questions or concerns about choosing an alarm, you can call our customer service team for more information on which product would be best suited to your circumstances. Our team is available on 0800 085 7371 (Mon – Fri, 9am5pm).

Download our free guide

Get your essential guide to staying independent. Explore how personal alarms provide the confidence to live safely.

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Ways to support independent living

Download our free guide

Get your essential guide to staying independent. Explore how personal alarms provide the confidence to live safely.

Download brochure


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