Do You Ever Get ‘The Shakes’? 4 Puzzling Questions Answered

Tremors don’t always mean Parkinson’s disease

A fear of public speaking. Too much coffee. A plunge in your blood sugar. All of these can cause “the shakes,” aka tremors, those involuntary shaking movements that can affect any part of your body.

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Though tremors are quite common, their appearance often conjures a scary possibility — could this be Parkinson’s disease?

“Though Parkinson’s disease is what people often think of when they have tremors, there are actually many other causes,” says neurologist Anwar Ahmed, MD. “Of all of the patients I see with tremors, perhaps the most common tremor is essential tremor and not Parkinson’s disease.”

These common tremors are called essential tremors, which have no clear cause but could run in families. Here, Dr. Ahmed answers your tremor-related questions.

1. What could be causing my tremors?

It’s easiest to figure out what’s not causing your tremors, he says, by gradually eliminating possibilities.

It could be too much caffeine — try cutting back. It could be the result of a new medication, or a stressful situation at home, work or school. Or it could coincide with times when you’ve skipped a meal.

Tremor can also occur with high level of thyroid hormone.

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“All of these have to be excluded so you can make the right diagnosis,” says Dr. Ahmed. Treatment can include medications that either calm the muscles causing the tremors or treat the part of the brain that’s causing them.

RELATED: Movement Disorders Treatment Guide

2. Could my tremors be “all in my head”?

It’s true that tremors frequently accompany anxiety and nervousness. That’s why Dr. Ahmed always conducts a thorough psychiatric evaluation to rule out anxiety in patients with tremors. He says medication or therapy can be an effective treatment.

Sometimes, tremors can be the result of conversion disorder, a mental health condition affecting the nervous system that can cause intermittent neurological symptoms with no clear medical cause. This disorder is  treated with psychotherapy.

RELATED: Best Tips for Treating, Living With Essential Tremor

3. What are the signs that it could be Parkinson’s?

Tremors tend to come on quickly or all of sudden, particularly when anxiety and conversion reaction are the causes.

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As a chronic and neurodegenerative illness, Parkinson’s disease progresses gradually. Initially tremor usually occur only on one side of a body  in Parkinson’s disease.

“Every tremor provides important clinical signs,” says Dr. Ahmed. “In essential tremor, we see tremor with activity. In Parkinson’s, we see tremor at rest. Parkinson’s cause slowness in activity. Essential tremor is shaky, not slow.”

4. When should I see my doctor about tremors?

First, try to control the factors that could be causing your tremors on your own. For example, you might try eating on a more consistent schedule or cutting back on caffeine.

If tremors still persist, then it’s time to visit your primary care physician.

RELATED: How Deep Brain Stimulation Can Restore Your Steady Hands