What Causes Tremors in Parkinson’s? ✋🧠 A Complete Guide by mr.hotsia
For more than 30 years, I have traveled through Thailand, Laos, Cambodia, Vietnam, Myanmar, and India 🌏. Along the way, I met countless older adults, monks, farmers, fishermen, and street vendors who shared their experiences with tremors. Some told me their hands shook while sitting, while others said they noticed their fingers moving on their own. During these conversations, one question came up often:
“What exactly causes tremors in Parkinson’s disease?”
Many people think tremor is just “shaking from age,” but Parkinson’s tremor is very different.
It starts in the brain, spreads slowly, and follows a unique pattern.
This article explains what causes tremors in Parkinson’s, why they happen, how they differ from other tremors, and real stories I witnessed during my travels as mr.hotsia.
What Is a Parkinson’s Tremor? ✋❓
A Parkinson’s tremor is an involuntary rhythmic shaking, usually starting in one hand.
It is one of the most recognizable symptoms of Parkinson’s disease.
Key features:
✔ Happens when the body is at rest
✔ Often starts on one side
✔ Looks like “pill rolling” between thumb and finger
✔ Decreases during movement
✔ Returns when resting again
✔ Worsens under stress
During my travels in Myanmar and Thailand, I saw many elders with this classic resting tremor, especially shaking in the thumb and fingers.
What Causes Tremors in Parkinson’s? 🧠 The Science Explained
Parkinson’s tremor comes from changes deep inside the brain, especially in areas that control movement.
Here are the main causes.
1. Loss of Dopamine Producing Cells 🧠🟡
This is the primary cause.
The brain region called the substantia nigra produces dopamine, a chemical that helps control:
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Movement
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Coordination
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Muscle rhythm
In Parkinson’s, these dopamine producing cells slowly die.
As dopamine decreases:
✔ The brain cannot send smooth movement signals
✔ Muscles receive “mixed messages”
✔ Tremors begin, especially at rest
I once sat with an elderly man in Laos whose thumb tremor appeared whenever he relaxed. Dopamine loss was the reason.
2. Overactive Brain Circuits ⚡
With low dopamine, certain brain circuits become overactive.
This includes the:
✔ Thalamus
✔ Basal ganglia
✔ Globus pallidus
These regions begin sending rhythmical signals, causing shaking.
It is similar to a radio receiving static instead of clear signals.
3. Imbalance Between Brain Chemicals ⚖️
When dopamine decreases, other chemicals like acetylcholine become unbalanced.
This imbalance causes the muscles to alternate between:
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Contraction
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Relaxation
in a rhythmic pattern, creating tremors.
4. The “Oscillator Effect” 🔁
Researchers believe Parkinson’s tremor comes from an internal “oscillator” in the brain.
When dopamine drops, this oscillator becomes unstable and creates:
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Repetitive
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Rhythmic
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Involuntary movements
During my travels in Cambodia, I met a doctor who explained that the tremor works like a drumbeat that the brain cannot stop.
5. Genetics and Brain Vulnerability 🧬
Some people have genes that make their brain cells more vulnerable to dopamine loss.
While most Parkinson’s is not genetic, genetics can influence how easily someone develops tremor.
6. Stress and Anxiety Increase Tremors 😥
Stress does not cause Parkinson’s, but it intensifies tremors dramatically.
Why?
Stress hormones affect:
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Muscle tension
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Brain circuits
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Nervous system stability
In Myanmar, I saw an elderly monk whose tremor nearly disappeared during meditation but returned when he felt anxious.
Why Parkinson’s Tremor Starts on One Side First ✋➡️
Parkinson’s usually affects one side of the brain more than the other early on.
Because each side of the brain controls the opposite side of the body, this leads to:
✔ Tremor in one hand or foot first
✔ Asymmetry that lasts for years
✔ Slow progression to both sides
In Vietnam and Thailand, many elders showed me tremor only in the right hand for years before it spread.
Why Tremors Happen at Rest and Improve With Movement 🧘♂️
Parkinson’s tremor is unique because:
✔ It appears at rest
✔ It decreases during movement
✔ It returns when resting again
Why?
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Movement activates different brain pathways
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These pathways override the tremor circuits
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Once movement stops, tremor returns
This is why many people in Laos and Cambodia told me,
“My hand shakes when I relax, but not when I use it.”
Types of Tremors in Parkinson’s ✋
There are several types.
1. Resting Tremor
The most common. Happens when muscles are relaxed.
2. Reemergent Tremor
Appears when holding a posture (like holding a cup) after a few seconds.
3. Jaw Tremor
Rhythmic movement of the jaw, especially when sitting quietly.
4. Chin Tremor
Subtle shaking under the lip.
5. Leg Tremor
Occurs when sitting.
I saw these different forms across Myanmar, Laos, and India while meeting people living with Parkinson’s.
Differences Between Parkinson’s Tremor and Essential Tremor ⚖️
Essential tremor is extremely common in Asia, and many people confuse it with Parkinson’s.
Here are the differences:
Parkinson’s Tremor
✔ Happens at rest
✔ Starts on one side
✔ Accompanied by stiffness and slow movement
✔ Pill rolling pattern
✔ Improves with movement
Essential Tremor
✔ Happens during movement
✔ Affects both hands early
✔ No stiffness or slowness
✔ Worsens when trying to do tasks
✔ Improves with alcohol (in some people)
During my travels, many villagers in Laos and Cambodia thought they had Parkinson’s but actually had essential tremor.
How Tremors Progress Over Time ⏳
Parkinson’s tremor usually:
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Starts mild
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Occurs in one hand
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Spreads slowly
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Becomes more noticeable during stress
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May affect both sides over years
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May spread to legs, jaw, or chin
However, tremor progression varies.
Some people have tremor for decades without severe disability.
Real Stories From My Travels 🌏👣
Thailand
A man in Chiang Rai showed me a tremor that appeared only in his right hand at rest. It was classic Parkinson’s resting tremor.
Laos
A grandmother’s hand shook while sitting but stopped when she cooked. A clear sign of Parkinson’s tremor behavior.
Cambodia
A fisherman had essential tremor, not Parkinson’s. His tremor was worse when holding tools.
Myanmar
A monk’s tremor almost disappeared during meditation, showing how stress influences tremor strength.
Vietnam
A shop owner developed jaw tremor years after hand tremor began.
India
A man had tremor in his legs when sitting, which later spread to both hands, consistent with Parkinson’s progression.
These stories mirror the scientific patterns of Parkinson’s tremors.
Can Parkinson’s Tremor Be Treated? ✔️ Yes
While the underlying disease cannot be reversed, tremor can be managed.
1. Levodopa (L Dopa)
Most effective medication for overall Parkinson’s symptoms.
2. Dopamine Agonists
Stimulate dopamine receptors.
3. Anticholinergic Drugs
Help balance dopamine and acetylcholine (best for younger patients).
4. Beta Blockers
Sometimes used for tremor control.
5. Deep Brain Stimulation (DBS)
Very effective for severe tremor.
6. Exercise
Walking, tai chi, and stretching help stabilize muscles.
7. Stress Management
Meditation, breathing exercises, and staying calm reduce tremor intensity.
10 FAQs About Parkinson’s Tremors
1. What causes Parkinson’s tremor?
Loss of dopamine and overactive brain circuits.
2. Why does tremor start on one side?
Because one side of the brain is affected earlier.
3. Is tremor the first sign of Parkinson’s?
Often yes, but not always. Some people start with stiffness or slow movement.
4. Why is the tremor worse when resting?
Because motor circuits are quieter, allowing tremor signals to dominate.
5. Does tremor always mean Parkinson’s?
No. Essential tremor and anxiety tremor are very common.
6. Can stress make tremor worse?
Yes. Stress amplifies tremor significantly.
7. Does tremor go away with movement?
Yes, Parkinson’s tremor improves with movement.
8. Can tremor spread to other body parts?
Yes, over years it may spread.
9. Can medication reduce tremor?
Yes, especially levodopa.
10. Is tremor the most disabling symptom?
Not always. Slow movement and balance issues can become more challenging.
I’m Mr.Hotsia, sharing 30 years of travel experiences with readers worldwide. This review is based on my personal journey and what I’ve learned along the way. Learn more |