Understanding and Managing Tremors in Multiple Sclerosis (MS)

Tremors are a common symptom experienced by many people with multiple sclerosis (MS). A tremor is an involuntary shaking or movement of a body part, such as the head, arms, or legs. These tremors can be frustrating and impact daily activities, but there are various treatment options available to help manage them.

Types of MS Tremors

There are several types of tremors associated with MS:

• Intention tremor: This tremor occurs when you attempt to reach, grasp, or move a body part to a specific location. It is the most common type of MS tremor and can significantly impact daily life.

• Postural tremor: This tremor is present when sitting or standing but disappears when lying down.

• Resting tremor: Less common in MS, this tremor is more noticeable when the body is at rest and may decrease with movement. It is more frequently associated with Parkinson's disease.

• Nystagmus: This type of tremor affects the eyes, causing rapid, uncontrollable eye movements.

Causes of MS Tremors

MS damages the protective myelin sheath that covers nerves in the brain and spinal cord. Tremors can result from damage to the cerebellum, a part of the brain responsible for balance, coordination, and smoothing out movements of the limbs, eyes, and speech.

Medications for Treating MS Tremors

While there are no medications specifically designed for MS tremors, doctors may prescribe drugs used for other conditions that could help, such as:

• Acetazolamide (Diamox)

• Buspirone (Buspar) and clonazepam (Klonopin)

• Beta blockers (propranolol)

• Primidone (Mysoline)

• Antiepileptics: oxcarbazepine, topiramate

Non-medicinal Treatments for MS Tremors

In addition to medications, several non-medicinal treatments can help manage MS tremors:

• Braces: Wearing a brace on the affected joint can help stabilize the body part and reduce excess movement, making it easier to walk or perform daily tasks.

• Deep brain stimulation: This experimental treatment involves implanting electrodes in the brain to send signals that stop tremors. It is primarily used for Parkinson's disease tremors.

• Physical therapy: A physical therapist can teach exercises to improve range of motion, posture, balance, and overall body stability.

• Speech therapy: For tremors affecting the lips, tongue, or jaw, a speech therapist can help slow speech, improve clarity, and control volume.

• Occupational therapy: An occupational therapist can provide adaptive or assistive devices to help with daily tasks, such as grabbing objects, zipping up clothing, or using utensils.

• Weights: Adding extra weight to a body part or commonly used items like utensils, pens, or walking aids can help stabilize the affected area.

Coping with Tremors and Depression

Tremors can be challenging to manage in social situations, leading to feelings of isolation and depression. A psychologist or counselor can help develop strategies to feel more comfortable in public and prevent tremors from impacting your quality of life.

If you are experiencing tremors due to MS, consult your healthcare provider to discuss the most appropriate treatment options for your specific needs. With proper management and support, it is possible to minimize the impact of tremors on your daily life and maintain a high quality of life.

For more information on MS tremors and their management, visit:

• National Multiple Sclerosis Society - Tremor

• Multiple Sclerosis International Federation - Tremor

• Mayo Clinic - MS and Tremors

The Bottom Line

Treatment success depends on accurately identifying tremor type, as intention tremors respond poorly to medications but benefit significantly from occupational therapy and adaptive equipment. Early intervention with physical therapy and assistive devices often provides better functional outcomes than waiting for symptoms to worsen. If you're experiencing new shaking or movement difficulties, Doctronic can help evaluate your symptoms and guide next steps.