Do Internal Tremors turn into Visible Tremors?

For several years I have suffered from internal tremors which mainly affect my right hand and foot, and now also a couple of areas on the left side of my body. They generally "stay hidden", and it's only me who is aware of them. Occasionally my hand does visibly shake when it's in certain positions, like holding a very fine teacup, but this has only happened a couple of times.

So my question is do these internal tremors, if left unchecked (by tablets or other measures), tend to turn into external, visible ones as time progresses?

28 Replies

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  • Hi earthdweller. I don't really understand what you mean by 'internal tremors' Do you mean that only when you use your hand it shakes? Or do you mean that when you use your hand it shakes but nobody can see it?

    A resting tremor happens when you are doing nothing, just sitting or standing still and one of your hands shakes. The moment you start using the hand, the shakes disappear.

    The other kind of tremor, which happens when you try to fasten a button or clean your teeth, is called an essential tremor (I think!).

    John

  • Hi, internal tremors are tremors that are pretty much invisible to anybody else but me. To me it feels as if my hand, foot, neck etc.. is shaking, but when you look at them they're not actually outwardly shaking.

    For me these tremors tend to happen most when the areas are at rest.

  • Hi earthdweller. I have never come across this before. What does your neurologist tell you about it?

    John

  • Hi, when I saw a neurologist a while ago they dismissed all of my symptoms as probably stress-related. When I recently visited the GP to be referred to another neurologist she also thought they were probably related to stress. I do have a lot of stress in my life, but my symptoms are very consistent with how my mum's Parkinson's developed.

    I also have EDS, which can have similar but, (as far as I can tell), subtle differences, so it's very confusing.

    I've just seen that there is quite a bit on internal tremors on this site. This is a useful page discussing internal tremors in Parkinsons: healthunlocked.com/parkinso...

  • The ONLY thing that deals with the inside tremor (answering my cellphone when it vibrating)problem has been Acupuncture. Once every 2 weeks or so does the for me.

  • For me this happens when a muscle is being used and it tends to be when the muscle concerned is already exhausted perhaps because of minor tremors that you may be unaware of exercising the relevant muscle.

    The sensation is just like that when you have exerted yourself in some way more than you are used to. Just as when exercising at the start of a fitness drive and you perhaps overdo it and you feel all weak and wobbly and perhaps a little sick. .

    I find that if I get a sensation like this it augments any feelings of anxiety or fear that I already have..

    Bit tricky to adequately describe this internal tremor thing.

  • I think that most of us with confirmed cases of Parkinson's are not confused by the term "internal tremor". The sensation of subtle neuro-muscular turbulance (internal tremor) typically precedes the more outwardly visible tremor in the course of the disease. 'Parkinsons.org.uk' answers your question as follows ('Will my tremor get worse as my Parkinson’s progresses?'):

    "Medication may help control this symptom, but Parkinson’s tremor does usually get worse over time.

    However, generally this is quite a slow process that occurs over several years. For many people with

    Parkinson’s, their tremor isn’t constant and comes and goes. How it affects them can also change a lot.

    "Some people also experience an ‘internal tremor’. This is a feeling of tremor within the body, but it isn’t noticeable to other people."

    parkinsons.org.uk/sites/def...

  • Thanks metacognito. Yes, I do mean tremors that are pretty much invisible to anybody else but me.

    That description that you've given does sound a lot like me, as the internal tremors aren't constant, they come and go, and at some points over the last few years have gone away for months and then come back again.

    It's annoying, to say the least that this internal tremor usually proceeds an outward one. I think I could cope better knowing that I'll only have these internal ones. Hm.. well, here's hoping for very slow progression!

  • Have you found out anything new in 2 yrs since this post as I have been having internal tremors and vibrations for past 2 yrs with no real progress on finding out why tried many different meds no change and just started Xanax as one dr thinks may be stress and anxiety . It's strongest on the left side of body but can be felt throughout .

  • Hi Mars,

    I still don't actually have a diagnosis of parkinson's, so I'm not sure my answer will be very helpful.

    I've had lots of parkinson's related symptoms for a long time and I still have them, (rigidity, facial 'stiffness', dragging leg sometimes, GI issues etc..), but the GP thinks it might be down to stress, my ehlers danlos syndrome or some kind of autoimmune disorder. I still think I have early PD, my symptoms certainly match up to a lot of PD symptoms, and are similar to my mum's early symptoms. But I'm not really pushing a diagnosis as there's not much that can slow things down, other than exercise. And I've been doing lots of pilates/balance type exercises and boxercise, as well as fast walking when I get the chance. While it's manageable I'd rather just carry on like this.

    As far as the right-sided internal tremor is concerned, I still notice it sometimes, particularly when my stress is very bad, (I manage my mum's care so life is v. stressful). And I can definitely tell that my right side is weaker than my left.

    Over the last two years though this hasn't got any worse or progressed to visible tremors. Of course I don't know how long this will continue for, who's to say what's round the corner. I think that the exercises have definitely been helping things, in terms of improved balance, stress relief and core strength.

    But like I say, I don't know for sure that I have PD, so I'm not sure how useful this long answer actually is!

  • Still frustrating to not know why I feel these internal vibrations and tremors .

  • Yes, I've wondered about that as well.

  • From my quick bit of research it seems that some people think that these internal tremors do worsen and become visible tremors as the disease progresses, (see above post by metacognito about parkinsons.co.uk).

    But some sources say that these types of tremors are unrelated to visible 'external' tremors. For example, in this discussion at healthunlocked.com/parkinso... olpilot quotes a study by the Department of Neurology at the University of Miami School of Medicine that says internal tremors seem to be part of the sensory symptoms that some people get with Parksinson's, but are "unrelated to Unified Parkinson's Disease Rating Scale score, Hoehn and Yahr stage, duration of disease, or the presence of observable tremor"

    I'm not sure about the credibility of this survey as it was quite small. But I guess like anything this probably differs with each person.

  • Yes, I've wondered about that as well.

  • I know what are you talkink, my english is very little but i'll try to explain that happens the same to me, I fell the tremor "inside my body" since my feet until the heath, some times is less. I associated with anxiety.

    No body notes but as I fell it my unbalance increassing.

    Today i´ll visit my psychiatric and tomorrow my neurologist for this purpouse.

    If you wish, I can write what they tell me about it.

    Regards

    Guadalupe

  • My initial (and still worse) symptom was a stiffness in a muscle that runs from inside my thigh and into my abdomen. Causes me to walk like dr. frankinstein's assistant, Igor. The pain it causes in my ab is like an internal tremor. But I've never had tremor. Thanks to sinimet I can move my ankle and than ks to exercise and pt I can walk pretty good most of the time. DX 10 years on sinimet 7. Maybe your 'internal tremor ' is a kind of dystonia. Is it painful? Tremors are tiring, but my pwp friends tell me they are not painful.

  • The feeling that I was "shaking inside" was the first symptom I reported to my doctor, almost 10 years prior to my diagnosis. For me, It was a whole body feeling, not confined to an extremity. The tremors in my hands, jaw and legs followed.

  • Thank you Susie01, that's very interesting to me. I haven't been diagnosed yet, and have found it difficult to get anywhere with all my symptoms so far being ones that nobody can see. It seems like you had these shaky feelings a long time before anybody took you seriously.

    Yours sound a bit different in that they were a whole body feeling. My internal tremors seem to be progressing like regular Parkinson's tremors do, starting with one side of the body, staying a while and then spreading to the other side. So I wonder what this means for the future. Will I have visible tremors that take this same path? Probably impossible to predict. And in some ways I suppose that's a good thing!

  • Looking back, my earliest symptoms were the sense of internal tremors, stooped posture, vocal changes and lack of facial expression. Friends remember a tremor which I discounted as due to my carpal tunnel syndrome (sigh!). Retrospectively, these signs were there for almost 10 years prior to diagnosis. By the time I was diagnosed, I had bilateral tremors, worse on the left and was hardly able to walk at times. It was scary.

  • A side note, I still have the sensation of my whole body shaking when I lie down at night to sleep. Even after diagnosis and treatment with Sinemet and Azilect. Also, though I may not appear to have a visible tremor, if I hold something it will shake.

  • Yes, I really feel these internal tremor sensations when I'm lying in bed at night. That's weird that your medication doesn't turn them off. Does that mean they're not related to dopamine loss?

    I can sometimes silence them with relaxation exercises, but I think that's because with all of our symptoms stress really brings them out, and conversely when we're calm they can go back in again.

  • Susie, I know you wrote this 2 months ago, but I just read it. I'm curious about your comment about whole body tremors. My neurologist recently told me he now has some doubts that I have Parkinson's because I have whole body tremors in addition to one sided tremors. What do you think about that? I'm so confused by him.

    Leilani

  • Leilani, I have recently started having full body tremors at night (last 6 mths). I was dxd 11 yrs ago & only started having tremors in the last year or so on my left side & my head & mouth sometime shake (PD started on my right side). Haven't mentioned the full body shakes with my doctor yet, but I will in January & let you know what she says. Did your doctor say what else it could be?

  • No, Laglag. Because I've had a 30-plus-pound weight loss this year in addition to the full body tremors, which he says are NOT PD, he thinks it could be a neurological symptom that is possibly related to cancer. So I'm undergoing a lot of tests of other parts of my body that have so far all been normal. Based on my other symptoms (jaw tremor, one sided arm/hand tremor, constant fatigue, constipation, incontinence, shoulder and hip pain), it seems I fit within the original diagnosis of PD.

    Please do let me know what your doctor says about the full body shakes. I'd really like to know. Thanks!

  • Wish I knew what the cause is! I have talked with others with PD who have the same sensation. It does make it more difficult to fall asleep when you feel like your whole body is shaking!

  • I know! And my husband complains about the bed vibrating!

  • I feel like bed is vibrating but husband doesn't feel it or vibrations in my leg .

  • I had, prior to PD diagnosis, internal tremors and still have internal and external tremors. Since I am on Parkinson's meds & have both I would surmise that a drug/treatment has nothing to do with whether or not there would be progression.

    I do have the same positional aspect of tremor you noted.

    I think I recall another person here talk about 'invisible' tremor. If you can find that post he/she might have other information on this.

    Regards,

    Peter

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