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Q. All my reports are normal. Why do I still have tremors in my hands?

Answered by
Dr. Ashok Kumar Choudhary
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 13, 2017 and last reviewed on: Sep 14, 2021

Hi doctor,

I am a 32 year old male nurse, and I started having tremors in my hands when holding small objects like needles and catheters, since 3 to 4 years. It made me anxious as the tremors got worse every time I inject. Before, I had to hold my head still to hear the Korotkoff's sound while measuring BP.  I always used to feel my head shaking. I remember being a kid and trying to play flute and trembling like crazy. My thyroid, calcium, sodium, potassium, chloride, magnesium, copper, antinuclear antibodies, rheumatoid factor, GGT, CK, etc., are all normal.

I got an ECG done a year back, and the reports said derivations in the muscles deltoid, biceps, common extensor of the fingers, and first inter-bone dorsal shows no signs of neurogenic or myogenic atrophy. My tremors get worse after exercise, and they are horrible when I am nervous. If I am opening a heavy door, the arm shakes, if I am doing push-ups or planks, my whole body trembles like crazy. If I need to push a little harder on the syringe while injection, the tremor starts. When I draw a medicine from a vial before administrating, I have to close my arms to elbows, so I do not tremble.

I do not smoke and drink, not even coffee or tea and eat the best I can. I am only taking Finasteride and topical Minoxidil for male hair loss from 10 years. I am very sad because it is getting difficult to perform my job and no one in my family understands. I never missed one day in work, I have passed through three neurologists. The first diagnosed it as essential tremor, and asked me to take Primidone, it was horrible and I had to quit. The second said that it was an exacerbated physiologic tremor, and the prescription was Rivotril (Clonazepam). This diagnosis made me sad, as my family said over and over that it was all stress. Rivotril did calm me, but the tremor went on, so I quit it. The last neurologist after getting the electromyography said it was an essential tremor.

I am confused now, as my mom trembles from hand but only when she is stressed. This tremor is not here all the time. When I hold my arm on a table and get down to get something, my arm trembles instantly. My writing is fine, and I only have asthma, male alopecia, and a history of septoplasty. I took Valerian, phytotherapy, acupuncture, but nothing helped. Why do I have these tremors? I often feel my muscles tired, so I took vitamin D. The tiredness felt better but the tremor is still on. Is it essential tremor?

#

Hello,

Welcome to icliniq.com.

  • I read your query with keen interest, and understand your concerns.
  • From the available description, I am of the opinion that you are suffering from essential tremor. My observation is based on the following facts.
  1. Exacerbation of symptoms when you are distressed
  2. Worsening of symptoms when you carry out activities like injecting, holding the syringe, etc.
  3. Presence of tremor in certain positions.
  4. The absence of lower body tremor, and lack of stress.
  5. Increased tremor after physical activity.

I hope this answers you, and If you have more questions feel free to write back.

For further queries consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist


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