Unintentional hand shaking after stroke could be the sign of a tremor or other health condition.
This can make it difficult to write, hold a beverage in your hand, or complete other activities of daily living.
If tremors are getting in the way of your quality of life, it’s important to take it seriously and seek medical attention for proper diagnosis.
This post will guide you through the symptoms, causes, and treatment for tremors after stroke to help you understand what’s happening.
Symptoms of Tremors After Stroke
Tremors are characterized by unintentional, uncontrollable rhythmic movement in the body.
There are many different types of tremors. The one most commonly seen in stroke patients is called an essential tremor.
After stroke, essential tremors are most commonly seen in the hands and arms. This is when some stroke patients notice their hand shaking after stroke.
It’s important to note that tremors are different from muscle spasms and twitches, which are a sign of spasticity. Tremors are not the same as spasticity.
The best way to correctly identify a tremor is to look for the rhythmic, uncontrollable shaking.
Next you’ll learn about the potential causes of tremors after stroke.
Causes of Tremors After Stroke
If a stroke patient develops tremors, it usually begins months after the stroke.
Because of this delayed onset, it can be difficult to diagnose the cause of the tremors because new conditions may have developed.
For example, shaking hands after stroke could indicate a completely separate medical condition called Parkinson’s disease, which is a neurodegenerative disease that affects movement.
Specifically, a stroke in critical locations, such as the midbrain and basal ganglia, can cause the acute onset of Parkinson’s disease. It’s an unfortunate domino effect of neurological degeneration.
Aside from Parkinson’s disease, there are 16 other possible conditions that can cause tremors. Therefore, working with a doctor is essential to properly diagnose your condition.
If it turns out that stroke is the only cause of your tremors after stroke (and not a separate medical condition), then the following treatments can help.
Treatment for Tremors After Stroke
It’s important to note that treatment for tremors may only slow the progression.
However, there’s hope for partially or fully resolving tremors after stroke, especially since 90% of cases resolve on their own within 6 months. This is known as spontaneous recovery.
While we hope that you get to achieve spontaneous recovery, it’s important to take action along with hoping for the best. That will maximize recovery.
So, here are the best treatment options that you can present to your medical team to resolve tremors after stroke:
1. Physical Therapy
A physical therapist can help you improve strength, coordination, and control in the muscles affected by tremors.
The goal of physical therapy is to both strengthen the muscles and rewire the brain through massed practice.
By retraining the brain to properly send signals to your hand (or other affected body part), coordination will improve and the tremors may go down.
If you don’t have access to physical therapy services, you can also try doing hand therapy exercises on your own at home.
If your tremors don’t respond to physical therapy, then you can talk to your doctor about possible medication that can help. (S)he may prescribe anti-seizure medication, tranquilizers, or beta blockers to help reduce the shaking.
These medications are known to help with essential tremors, but not specifically to stroke. Further studies are still needed for the effect of medication on tremors after stroke.
However, if you are not responding to physical therapy, medication could be worth considering.
It’s also important to note that these medications can cause unwanted side effects like fatigue and nausea. Make sure you talk with your doctor about these potential side effects.
3. Deep Brain Stimulation
While physical therapy and medication are the first line of defense against tremors, sometimes further treatment is needed.
In severe cases, deep brain stimulation may be used to treat essential tremors. During this surgical procedure, doctors insert a long, thin electrical probe to the region of the brain that causes tremors (the thalamus).
This probe is connected to a stimulator device that’s then implanted in your chest. It transmits painless electrical pulses to interrupt the signals from the thalamus that might be causing the tremors.
Deep brain stimulation is an invasive, risky procedure, so it’s only used in severe cases.
However, it’s also promising as the treatment has been useful in more than 70% of patients with post-stroke tremors or other involuntary movements.
4. Botox Injections
While Botox is a popular (short-term) treatment for spasticity after stroke, it’s also used to treat tremors in some cases.
However, Botox is contra-indicated for hand tremors as it can cause weakness in your fingers.
To determine whether Botox is effective for hand tremors after stroke, further studies are needed.
If this treatment option appeals to you, talk with your neurologist or physical therapist.
5. Behavioral Relaxation Training
An alternative treatment for tremors is behavioral relaxation training. This form of relaxation training focuses on labeling sensations along with therapist feedback.
Since stress and anxiety can worsen tremors, this alternative form of therapy may help.
Baclofen is a muscle relaxing drug is commonly used for spasticity after stroke. Some stroke patients report improvement in their tremors after taking Baclofen.
These results, however, are not backed by clinical trials. More studies are needed to determine if Baclofen is suitable for treating tremors after stroke.
If you struggle with both spasticity and tremors after stroke, then it could be worth trying Baclofen to see if it improves either condition. Talk to your doctor to see if it’s a good fit for you.
The Solution for Hand Shaking After Stroke
Overall, tremors after stroke involve uncontrollable, rhythmic shaking movements that often affect the hand and arms, but can occur anywhere in the body.
Diagnosis requires the help of a medical team, since other tremor-causing conditions like Parkinson’s disease may have developed since the stroke.
Common treatments for tremors after stroke involves physical therapy, medication, or deep brain stimulation, in order of least to most risky.
Be sure to communicate with your medical team for an accurate and efficient diagnosis and treatment plan!