Understanding Muscle Tremors: Causes And Effects

Muscle tremors are unintentional, involuntary, or uncontrollable trembling or shaking movements in one or more parts of the body. Tremors can be caused by strenuous exercise, fatigue, hypoglycemia, stress, anxiety, alcohol consumption, alcohol withdrawal, caffeine intake, medication, or medical conditions such as multiple sclerosis, Parkinson's disease, or orthostatic tremor. Understanding the underlying causes of muscle tremors can help individuals manage their symptoms and improve their overall well-being.

Why do muscles tremble?

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Muscle fatigue

During physical activity, muscle fatigue can set in as the muscles are worked beyond their capacity. This can happen when the intensity of the exercise is too high, or when the muscles are not accustomed to the level or type of activity being performed. For example, if you are trying a new exercise move or lifting heavier weights, your muscles may start to tremble as they fatigue and struggle to keep up with the demands being placed on them. This is a result of motor units, which are groups of muscles and motor nerves in the spine that work together to create smooth muscle contractions, ceasing to function properly. As more motor units become fatigued and drop out, the remaining units contract and relax in a more synchronous and less smoothly organized manner, resulting in trembling.

To prevent or reduce muscle fatigue, it is important to properly fuel your body before and after exercise. Eating a nutritious meal at least an hour before working out can help prevent muscle shaking by ensuring your body has the necessary nutrients and energy to sustain the activity. Additionally, it is important to listen to your body and adjust your workout routine as needed. Lowering the intensity of your workout, reducing the number of reps per set, or increasing the rest time between sets can help manage muscle fatigue and reduce the risk of injury.

While muscle fatigue is often associated with physical exertion, it is important to note that it can also occur during periods of rest, particularly in individuals with certain medical conditions such as Parkinson's disease, where tremors are commonly experienced during rest.

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Motor units

The size of the motor unit will also determine the precision of movement that a particular muscle can produce. For instance, the muscles in the larynx or voice box have very small motor units, allowing for fine gradations of strength and precise control over vocal volume. Larger muscles that serve gross movement, such as the gastrocnemius muscle in the lower leg, have much larger motor units, with each nerve controlling a large number of muscle cells.

When an action is performed, the motor units do not move together. Instead, they move in an asynchronous, irregular pattern. This means that while some motor units contract, others will expand or relax. This asynchronous motion gives the appearance of smooth muscle movement. However, when muscular fatigue occurs, some motor units stop functioning temporarily, and the remaining motor units begin to work in a more synchronous fashion, resulting in sudden jerky movements that are felt as trembling.

Motor unit fatigue can be caused by a lack of nutrients or dehydration, leading to a decline in the force and power capacity of skeletal muscle. As more motor units become fatigued, the muscle contraction becomes dependent on fewer motor units, resulting in trembling. This trembling is a signal from the body to slow down and be ready to take a break.

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Muscle recruitment

During exercise, muscle cells contract as groups of muscle cells connected to a motor nerve originating from the spinal cord. The motor nerve cells and the muscle cells they innervate are known as motor units. The size of the motor units determines the precision of movement that a particular muscle can produce. For example, in the muscles of the larynx, each motor nerve connects to only two or three individual muscle cells, allowing fine gradations of strength. On the other hand, large muscles that serve gross movement, such as the gastrocnemius muscle in the lower leg, have motor units made up of motor nerves that each control 2,000 or more muscle cells.

When muscles become fatigued during exercise, the body needs to stimulate more muscle fibres, which require more motor neurons to fire. This is where muscle recruitment comes into play. As some motor units become fatigued and drop out of service, more motor units are recruited to take their place. This process is what causes the shaking and trembling sensation during exercise. The muscle is constantly alternating between states of contraction and relaxation as it tries to complete the task.

The recruitment of motor units during locomotion can match the contractile properties of the muscle fibres to the mechanical demands of the contraction. The excitability of the α-motorneurons is related to the size of their cell bodies. The smallest α-motorneurons have the lowest thresholds for excitation, and innervate the slowest muscle fibres. Thus, a weak stimulus to the motorneuron pool results in the slowest muscle fibres being recruited. As the stimulus strength increases, faster motor units are sequentially recruited, following the size principle of motor unit recruitment.

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Stress and anxiety

Anxiety can cause nervousness, difficulty concentrating, and muscle tension. It can also make existing tremors more pronounced. For example, those with essential tremors may develop anxiety due to concerns about their health condition, such as the effectiveness of their treatment or the perception of their tremors by others. Similarly, people with essential tremors may experience increased anxiety in situations where their tremors are more noticeable, such as during social activities or presentations.

Anxiety tremors can occur during sleep when underlying stress affects the body, even during rest. Night tremors, restless sleep, and sleep disturbances, such as nightmares or vivid dreams caused by anxiety, can lead to physical reactions, including shaking.

To manage stress and anxiety-related muscle tremors, various techniques can be employed:

• Relaxation techniques: This includes finding a quiet location, assuming a comfortable body position, and focusing on deep breathing to calm the body and mind.
• Mindfulness and meditation: Mindfulness exercises, such as meditation and yoga, can help control anxiety tremors by promoting relaxation and reducing overall anxiety levels.
• Lifestyle changes: Identifying and reducing stressors, improving sleep habits, and maintaining a healthy lifestyle through regular exercise, sensible eating, and avoiding bad habits like smoking, can help manage stress and anxiety.
• Medical intervention: In cases of severe or persistent tremors that interfere with daily activities, it is important to consult a doctor to determine the underlying cause and explore treatment options, which may include medication and therapy.

Medical disorders

Muscle tremors can be caused by a variety of medical disorders. They are often part of medical conditions that affect the brain, nervous system, or muscles.

Parkinson's Disease

One of the first signs of Parkinson's disease is a Parkinsonian tremor, which is a common form of tremor. It usually starts in the hands and may look like someone is trying to roll a pill between their thumb and finger. As the disease progresses, the tremor may spread to other parts of the body, including the chin, lips, face, and legs. Parkinson's disease is a neurodegenerative condition that can cause brain damage and affect the cerebellum, the part of the brain that controls movement.

Multiple Sclerosis

Multiple sclerosis (MS) is a progressive condition that affects the central nervous system and the brain. It can cause damage to the cerebellum and its pathways, leading to tremors. MS is also associated with kinetic tremors, which occur with voluntary movements such as closing and opening the eyes or lifting a hand to touch the nose.

Dystonia

Dystonia is a movement disorder characterized by involuntary muscle contractions that result in twisting and repetitive motions or abnormal postures. Dystonic tremors are usually irregular and jerky, and they can be relieved by complete rest or certain hand or arm positions. They are often caused by damage to the basal ganglia in the brain.

Orthostatic Tremor

Orthostatic tremor is a rare disorder characterized by rapid muscle contractions in the legs when a person stands up. The contractions are very fast and may not be visible to the naked eye, but they can be felt by touching the person's thighs or calves. The tremor usually stops when the person sits down or walks. The cause of orthostatic tremor is unknown.

Other Medical Conditions

Tremors can also be caused by other medical conditions, including an overactive thyroid, liver or kidney failure, diabetes, high or low blood sugar, stress, anxiety, and fatigue. Certain medications, such as asthma medicines, chemotherapy drugs, corticosteroids, and psychiatric medications, can also cause tremors. Poisoning from toxic substances, including pesticides and heavy metals like mercury and lead, may also lead to tremors.

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