trembling hands
October 4, 2009 | 100,00 EUR | answered by Dr. med. Christoph Schmülling
I was born in 1964. As an infant, I had mumps meningitis and several severe lung infections, sinusitis, and chronic bronchitis between the ages of 7 and 11. The respiratory diseases were extensively (and successfully) treated with antibiotics in the 1970s; I remember Penicillin injections and Berlocombin, but there were also other medications prescribed in varying dosages over the years. A clear side effect of the antibiotics is a yellow discoloration of the teeth (Tetracycline) that has remained.
Around the age of 12, I first noticed a slight trembling in my hands. This is slightly stronger on the left side than on the right and intensifies significantly in stressful situations. It does not bother me in everyday life (work...), but it is very uncomfortable, especially when eating and drinking, in self-service restaurants, etc. My surroundings accept this handicap, but I would really, really like to get rid of it.
A doctor I consulted years ago said that the only option was "sedatives". I then tried "Rudotel" a few times. However, this brought almost no improvement and just made me tired.
I would like to add that my hand tremor has nothing to do with alcohol or other drugs, as I drink very little. However, the tremor does actually decrease after consuming even a small amount of alcohol. Since 1975, I have been otherwise completely healthy and do not take any medication.
What can I do?
Dear seeker of advice,
Hand tremor is a very common reason for consultation in general internal medicine practice and usually opens up a wide differential diagnosis. Basically, trembling can be caused by neurological, but very often also by psychosomatic causes (often combined in the course).
One of the most common causes is "essential tremor", the causes of which are not yet fully understood. The onset in youth speaks rather against its presence.
For a more precise classification of the cause of the tremor, it would be necessary to know whether the tremor also occurs during sleep, whether it occurs when you are completely alone, what the frequency of the tremor is, how it changes when you perform goal-directed movements (e.g. bringing a fork to your mouth), etc.
Apart from these more detailed investigations and information, the fact that you have noticed hand tremors since the age of 13 and are now in your mid-forties, without the tremor spreading to other parts of the body or additional neurological symptoms appearing, suggests the following considerations:
Theory 1:
As part of your illnesses in adolescence, for example due to meningitis or medication side effects, a neurological damage has already occurred that no longer shows any dynamics, i.e. is completed. This can usually be diagnosed by a thorough examination by a neurologist including measurement of nerve conduction velocities, EEG, possibly CT, MRI, or SPECT. However, I consider this very unlikely!
Theory 2:
During your childhood and early youth, possibly in the course of your serious illnesses, there may have been traumatization that left a "psychic wound", the expression of which was the trembling. I believe that anyone who imagines having been seriously ill as a child can understand that this is not far-fetched.
This trembling, especially if acquired early in life, can "take on a life of its own" over the course of life and lead to a "trembling out of fear of trembling". The latter is also very common in the context of a general anxiety disorder or a so-called "social phobia".
My recommendation for you is a neurological basic diagnosis, but above all, a visit to a good psychotherapist/psychosomatic specialist who is particularly knowledgeable about anxiety disorders. I know that in Germany there are often difficulties with this recommendation ("... but Doctor, I'm not crazy..."), but rest assured that this has nothing, absolutely nothing, to do with "crazy" - quite the opposite: psychosomatic disorders are one of the most common reasons for consultation in general medicine - they are just slightly misunderstood.
Regarding "medications", because you mentioned them: of course, you can sedate your body, with the effect that your hands will also become calmer - but as far as I can judge currently, this is not the way for you. A non-psychopharmacological medication option would be the administration of a beta-blocker. You should discuss this with your general practitioner to see if there are any contraindications. I cannot give a real recommendation here without knowing you personally and having a longer conversation about possible adverse drug effects. Medication is not seen as the first step.
I believe that the cause most likely lies in the psychosomatic area, and you have the chance, under professional guidance, to "unlearn" the tremor.
With kind regards and best wishes,
Dr. med. Christoph Schmülling
