Muscle Tremors: Causes and When to Seek Help

Muscle twitching

Hello, I would like to ask about a condition I've been experiencing for the past two weeks.
I've been feeling slight tremors in my body that are not visible externally, but I can sense them, similar to a low-frequency vibration as if a machine is nearby.
It started in my feet and has progressed to my upper arms, back, and now I feel it throughout my body.
The tremors are rapid but very subtle.
Recently, I've been waking up after a few hours of sleep, feeling a continuous tremor in my upper body.
When I touch the area, it feels like there's shaking, but others might not notice it.
Initially, when I felt the tremors in my feet, massaging them seemed to stop the sensation temporarily, but it would return after a while.
Now, it feels like the tremors are present all over my body, and my sleep has been poor.
I would like to know what kind of condition this might indicate.
I do not feel any muscle weakness, but I read online that amyotrophic lateral sclerosis (ALS) can also cause muscle twitching that is visible.
Should I see a doctor about this? Thank you.

JJ/Male/35, 30~39 year old female. Ask Date: 2017/05/17

Dr. Jiang Junyi reply Neurology

Hello, the causes of tremors can be categorized into four types: physiological tremors, psychological tremors, essential tremors, and pathological tremors.

1.
Physiological tremors: These do not occur under normal circumstances and only arise in specific situations such as stress, anxiety, or anger.
Other factors like side effects from certain medications or the consumption of beverages like coffee, tea, or cola also fall under physiological tremors.
2.
Psychological tremors: These may occur intermittently without a fixed pattern.
Treatment primarily focuses on addressing the underlying mental health condition.
3.
Essential tremors: The exact cause of these tremors cannot be determined.
They may be due to unique physical characteristics or hereditary factors.
Typically, tremors are more pronounced when holding objects, and some individuals may experience tremors while writing or performing specific actions.
4.
Pathological tremors: These are caused by dysfunction in the nervous system, such as in Parkinson's disease, lesions in the midbrain, cerebellum, or basal ganglia, and metabolic abnormalities (like hypoglycemia or hyperthyroidism).
These types of tremors tend to be persistent rather than intermittent.
You mentioned that the muscle symptoms of motor neuron disease (ALS) typically involve localized muscle twitching accompanied by muscle atrophy.
I recommend consulting a neurologist for discussion and treatment.
Wishing you good health and peace.

Reply Date: 2017/05/17

More Info

Muscle tremors can be a concerning symptom, especially when they appear suddenly and affect various parts of the body. Based on your description, it sounds like you are experiencing subtle, internal vibrations or tremors that are not visible to others but are noticeable to you. This phenomenon can be attributed to several potential causes, and understanding these can help you determine when to seek medical advice.

Possible Causes of Muscle Tremors
1. Essential Tremor: This is a common neurological disorder that causes rhythmic shaking, often in the hands, but it can also affect other parts of the body. It typically worsens with movement and can be hereditary.

2. Anxiety and Stress: Psychological factors such as anxiety can lead to physical symptoms, including tremors. Stress can cause muscle tension and involuntary movements, which might explain the sensations you are experiencing.

3. Fatigue or Overexertion: If you have been under physical or mental stress, your muscles may react with tremors. This is often temporary and resolves with rest.

4. Caffeine or Stimulants: High intake of caffeine or other stimulants can lead to tremors. If you consume coffee, energy drinks, or certain medications, consider reducing your intake to see if symptoms improve.

5. Neurological Conditions: While conditions like Amyotrophic Lateral Sclerosis (ALS) can cause muscle twitching and tremors, they are usually accompanied by muscle weakness and atrophy. Since you mentioned not experiencing muscle weakness, this may be less likely.

6. Medication Side Effects: Certain medications, especially those affecting the nervous system, can lead to tremors. If you have recently started or changed any medications, consult your doctor.

7. Nutritional Deficiencies: Deficiencies in vitamins such as B12 or minerals like magnesium can lead to muscle spasms and tremors. A balanced diet is essential for muscle and nerve health.

When to Seek Help
Given that your symptoms have persisted for about two weeks and are affecting your sleep, it is advisable to consult a healthcare professional. Here are some specific indicators that warrant a medical evaluation:
- Duration and Frequency: If the tremors continue to persist or worsen over time.

- Impact on Daily Life: If the tremors interfere with your ability to perform daily activities or affect your quality of life.

- Associated Symptoms: If you start experiencing other symptoms such as muscle weakness, significant fatigue, changes in coordination, or any other unusual sensations.

- Sleep Disturbances: Since you mentioned that the tremors disrupt your sleep, this is an important factor to discuss with your doctor.

Conclusion
While muscle tremors can be benign and related to stress or fatigue, they can also indicate underlying neurological issues that require attention. It is essential to keep a record of your symptoms, including when they occur, their intensity, and any associated factors (like stress levels or caffeine intake). This information can be valuable for your healthcare provider in diagnosing the issue.

In summary, while your symptoms may not immediately suggest a severe condition like ALS, it is prudent to seek medical advice to rule out any serious underlying causes and to receive appropriate management for your symptoms. A healthcare professional can conduct a thorough evaluation, which may include neurological examinations and possibly imaging or blood tests, to determine the cause of your tremors and recommend suitable treatment options.

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