Hand Tremors and Numbness: When to Seek Help

Tremors and hand numbness?

Dear Vice Director,
In the past, my hand tremors would only occur after drinking coffee or when my blood sugar was low.
However, the situation has worsened; the tremors have become more pronounced and now occur even outside of those two conditions.
Additionally, two months ago, I discovered that I have spinal compression during a visit to a rehabilitation clinic.
I have been undergoing spinal traction daily, and this week the doctor mentioned that the compression has improved.

Recently, however, the frequency and intensity of my hand tremors have increased, and I have also started experiencing hand numbness.
Initially, it was limited to my left arm, but now both of my hands and fingers are affected.
The tremors and numbness are gradually impacting my work.
I work in real estate, and the tremors often lead clients and colleagues to ask, "Are you nervous?" I am very concerned about what might be happening to me.

Lü Xiaowen, 30~39 year old female. Ask Date: 2015/12/22

Dr. Lan Shengxing reply Neurology

Dear Miss Lu, if your hand tremors occur without physiological causes, it may be essential tremor, which requires pharmacological treatment.
Additionally, the symptoms of hand numbness necessitate a nerve conduction velocity test for proper evaluation, so you should visit a neurology clinic for diagnosis and treatment.

Reply Date: 2015/12/22

More Info

Understanding hand tremors and numbness can be quite complex, especially when these symptoms start to interfere with daily activities and work. In your case, the progression from occasional tremors associated with caffeine or blood sugar fluctuations to more frequent and pronounced tremors, along with the onset of numbness in your hands, is concerning and warrants further evaluation.

Tremors can arise from various causes, including essential tremor, Parkinson's disease, anxiety, or even side effects from medications. Given that your tremors have become more pronounced and are now accompanied by numbness, it is essential to consider several factors. The fact that you have a history of lumbar spine issues, which you mentioned is improving with traction therapy, may also play a role. Nerve compression in the cervical spine can lead to symptoms in the arms and hands, including tremors and numbness.

The numbness you are experiencing, particularly if it is bilateral (affecting both hands), could suggest a neurological issue. Conditions such as carpal tunnel syndrome, cervical radiculopathy, or peripheral neuropathy could be contributing to these symptoms. It’s also important to consider metabolic factors, such as diabetes, which can lead to peripheral neuropathy and may exacerbate numbness and tingling sensations.

Given your profession in real estate, where fine motor skills and a steady hand are crucial, the impact of these symptoms on your work is understandable. The perception of being nervous due to tremors can also add psychological stress, potentially exacerbating the situation.
Here are some steps you should consider taking:
1. Consult a Neurologist: Since your symptoms have progressed, it is advisable to seek a thorough evaluation from a neurologist. They can perform a detailed neurological examination and may recommend imaging studies, such as an MRI of the cervical spine, to assess for any nerve compression or other abnormalities.

2. Monitor Symptoms: Keep a detailed log of your symptoms, noting when they occur, their severity, and any potential triggers. This information can be invaluable for your healthcare provider in determining the underlying cause.

3. Consider Occupational Therapy: An occupational therapist can help you develop strategies to manage your symptoms at work, including adaptive techniques to minimize the impact of tremors on your tasks.

4. Stress Management: Since anxiety can exacerbate tremors, consider incorporating stress-reducing techniques into your routine, such as mindfulness, yoga, or deep-breathing exercises.

5. Review Medications: If you are on any medications, discuss with your healthcare provider whether they could be contributing to your symptoms. Sometimes, adjustments can lead to significant improvements.

6. Lifestyle Modifications: Ensure you are maintaining a balanced diet, staying hydrated, and managing your caffeine intake, as these factors can influence tremor severity.

In summary, while hand tremors and numbness can stem from various causes, the combination of worsening symptoms and their impact on your daily life necessitates a proactive approach. Seeking medical advice promptly will help you identify the underlying issue and develop an appropriate treatment plan to manage your symptoms effectively. Remember, early intervention can often lead to better outcomes, so don’t hesitate to reach out for help.

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