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Have you ever noticed your hand shaking while holding a cup of coffee or writing a note? Occasional tremors are fine, but persistent shaking can be a symptom of an underlying problem. Tremors can affect your daily life, but do you know that chiropractic care might help? Let’s explore what tremors are, their symptoms, causes, available treatment options, and how chiropractic care in Singapore can help.
What are Tremors?
Tremor is a neurological condition that causes involuntary rhythmic shaking or movement. It is a symptom of multiple movement disorders and can affect one or more parts of your body. It most commonly occurs in hands, but can also affect your legs, arms, vocal cords, and torso. While most cases are not life-threatening, they can significantly impact your daily life, such as your ability to eat food and walk.
Tremor can vary in intensity, ranging from mild to severe. It may be constant or can happen intermittently. You may have observed people with a slight tremor in their hands. This is called physiological tremor and is absolutely normal. It may become greater in intensity when you consume alcohol, caffeine, or certain medications.
Tremor Types
Experts classify tremors into two types based on when and how it is activated. These include:
1. Resting tremor:
This type of tremor usually occurs when your body is completely relaxed and supported against gravity. For example, you might notice a tremor in your hand when it is resting on the arm of a chair.
Resting tremor is usually associated with Parkinson’s disease. It gets more noticeable when you are stressed and are relieved by voluntary movement.
2. Action Tremor:
Action tremors usually occur during voluntary movement, such as when lifting a cup or writing. It is further classified into the following subtypes:
Postural Tumor
This type of action tremor usually occurs when you try to maintain your body part in a specific position. For example, holding your arms outstretched can trigger postural tremor.
Isometric Tremor:
Isometric tremors usually happen when you contract your muscles voluntarily against a fixed object, without moving any body parts. For example, holding a heavy book in your hands can trigger this kind of tremor.
3. Kinetic Tremor:
This kind of tremor usually gets activated during voluntary movement, such as writing or closing and opening your eyes. It is usually uniform in nature.
4. Intention Tremor:
You get intention tremor when you make a targeted movement. For example, when you try to touch your nose with your finger, you may notice shaking that may get intensified as you reach closer to the target.
Tremor Causes
Tremors can be caused by a variety of factors, ranging from neurological disorders to genetic conditions. Some of the common causes of tremors include:
- Parkinson’s Syndrome (often causes resting tremor)
- Multiple Sclerosis
- Brain tumors
- Cerebellar disorders
- Hyperthyroidism
- Hypoglycemia
- Hypocalcemia
- Traumatic brain injuries
- Genetic disorders
- Alcohol withdrawal
- Excessive caffeine and nicotine consumption
- Age-related brain changes
- Kidney and liver failure (causes brain damage)
Certain medications can also induce tremors. Some of them include:
- Antipsychotics
- Sedatives
- Antidepressants
- Cancer medications
- Immunosuppressants
Tremors Symptoms
Tremor can manifest in various forms depending on the cause, but some of the common symptoms include:
- Involuntary shaking of specific body parts, such as hands and legs
- Difficulty in carrying out tasks that require precision movements, such as buttoning clothes
- Inability to maintain a specific posture
- Impaired ability to hold or control objects like utensils
- Shaky voice
Tremor Categories
Besides basic types, tremors are further categorized on the basis of their pattern. Healthcare professionals diagnose tremors based on these categories. Some of them include:
1. Essential Tremors
It is the most common form of tremor that causes involuntary shaking of different body parts. It worsens over time and can affect your daily life activities. Hand tremor is the most prominent symptom of essential tremor, but it can also affect your head, voice, legs, and trunk.
Essential tremor symptoms usually appear during movement rather than at rest. There is no specific cause, but 50% of the cases are hereditary. While essential tremors can occur at any age, they are most common over the age of 40.
2. Cerebellar Tremor
As the name suggests, cerebellar tremor is a movement disorder that occurs due to damage to the cerebellum. The damage to the cerebellum can happen as a result of stroke, brain tumor, or alcohol use disorder.
Cerebellar tremors are characterized by the slow and high-amplitude tremors of the feet, hands, legs, or arms. The tremors might get worse when you voluntarily move.
3. Parkinsonian Tremor
Parkinsonian tremor is a prominent feature of Parkinson’s disease, which is a neurological condition characterized by the deficiency of dopamine producing neurons. It usually occurs at rest and is often described as rolling and pill motion, as if someone is trying to roll the pill between the forefinger and thumb.
It first begins in one part of the body (hand, feet, and legs) and gradually progresses to other parts of the body. It tends to diminish during sleep and lessens when you engage the affected body part in movement.
4. Dystonic Tremor
Dystonic tremor usually occurs in people with a movement disorder known as dystonia. It develops as a result of faulty signals from the brain, causing abnormal muscle contractions. Dystonic tremors are usually jerky and irregular and appear during voluntary movement or posture maintenance.
5. Orthostatic Tremor
Orthostatic tremor is a rare movement disorder that causes rapid muscle contractions in the legs when you stand. It is invisible to the naked eye as the contractions are very fast. But, you might feel vibrating and crippling sensations in the legs. This kind of tremor usually disappears when you sit, walk, lie down, or stand against a support.
Tremor Diagnosis
Your healthcare professional will use a combination of medical history, physical examination, and tests to diagnose tremors. They might ask questions about your symptoms, such as:
- What triggers your symptoms
- If your tremor slowly worsens over time
- If they occur during movement or rest
- Which body parts have tremors
During the physical examination, your doctor might look for muscle stiffness, speech restriction and gait abnormalities. They might ask you to perform tasks like holding your arms outstretched and touching your finger to the nose to assess tremor patterns.
Further, your healthcare provider will order different tests to diagnose the specific type and cause of tremor. Some of them might include:
- MRI to detect any brain abnormalities
- Urine and blood tests to check drug abuse and interactions
- Electromyography to measure muscle activity
Tremor Treatment
The goal of treatment of tremors is to reduce their frequency and severity. Your healthcare professional will choose the treatment option depending on the specific type and cause of tremor. This may include:
1. Medications:
- Beta-Blockers: These medications are usually prescribed to treat high blood pressure, but are also helpful in treating essential tremor and action tremor in some people. Common examples include metoprolol, atenolol and propranolol.
- Anti-Seizure Medications: Your doctor might prescribe anti-seizure medications, such as primidone and gabapentin if beta-blockers are not effective.
- Dopaminergic drugs: These are the drugs that are prescribed to control Parkinsonian tremor. They work by either restoring or mimicking the action of dopamine, thus improving motor control.
- Benzodiazepines: These drugs can temporarily help some people with tremor, especially in those whose tremors get worsened by movement. But it’s important to be aware of the side effects of these drugs, such as sedation and physical dependence.
2. Surgical Procedures
Your doctor may recommend surgery if your tremor is not responsive to medications. The following are the procedures that can help with tremors:
● Deep Brain Stimulation:
In this procedure, your surgeon will implant electrodes in the thalamus, a part of your brain that controls coordination and involuntary movement. He will connect these electrodes to the pulse generator device, like a pacemaker, via wires under the skin near the chest. This device sends controlled electrical impulses to the thalamus and reduces abnormal movements.
● Focused Ultrasound Thalamotomy
It is a non-invasive surgery that uses high-intensity focused ultrasound waves to create a lesion in the part of the thalamus. This helps stop tremors.
3. Physical And Occupational Therapy
Physical and occupational therapy can help people with tremors. It shows them specific exercises to improve muscle strength and coordination. Your physical therapist will evaluate your motor skills and muscle strength to develop an individualized plan. They might recommend you adaptive devices, such as a cane, if your balance is impaired.
How Chiropractic Care Can Help With Tremors?
Chiropractic Care can help people manage tremors by addressing spinal misalignment (subluxation). A spinal subluxation is the misalignment of the spine vertebrae from their normal position. This puts pressure on the nerve roots and disrupts the transmission of nerve signals between the brain and body. When these improper signals from a dysfunctioning central nervous system reach muscles, it causes twitching and muscle spasms.
Furthermore, misaligned nerves can disrupt the flow of cerebrospinal fluid around the brain and spinal cord. CSF is responsible for cushioning your brain and protecting it from any damage due to injury. As a result of vertebral subluxations, the leakage of CSF can occur and contribute to tremors. However, Chiropractic care can improve the circulation of CSF by removing spinal obstructions and addressing any pressure imbalances that contribute to tremors.
Spinal manipulation also helps stimulate joint mechanoreceptors. This helps recalibrate motor pathways and reduce any abnormal muscle activity. Moreover, chiropractic services also include rehabilitative exercises that strengthen muscles, improve posture, and remove cervical strain.
At Vitality Chiropractic Centre in Singapore, our experts specialize in Upper Cervical Chiropractic Care. Our clinic is the first of its kind in Singapore, focusing on the upper cervical region to address a variety of health issues, including tremor. We believe that proper spinal alignment is the key to a person’s health and well-being. Our team provides personalized care plans tailored to your individual needs. So what are you waiting for? Contact us right now to improve your tremor and coordination.
References
- Buijink AW, Contarino MF, Koelman JH, Speelman JD, van Rootselaar AF. How to tackle tremor – systematic review of the literature and diagnostic work-up. Front Neurol. 2012 Oct 23;3:146. doi: 10.3389/fneur.2012.00146. PMID: 23109928; PMCID: PMC3478569.
- Tremor. (n.d.). National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/health-information/disorders/tremor
Call 8438 9550 or email help@vitalitychiropracticcentres.com today!
Meet Our Chiropractor Specializing in Tremors Care in Singapore
Dr Shaan (Traditional and Complimentary Therapy Qualification) is a Chiropractor from London (UK) who graduated from the Anglo-European College of Chiropractic (UK) as a Doctor of Chiropractic (not medical doctor or dentist). He has completed post-graduate studies and has been serving patients in Singapore since 2015.
He founded Vitality Chiropractic Centres to open the first Upper Cervical clinic in Singapore, and the only practicing Knee Chest Upper Cervical Technique in South East Asia.
He is the Alliance of Chiropractic (AoC) Chairman for Outreach, organising events within Singapore with the People’s Association and other charities. Shaan has served thousands of patients, with experience in patients with headaches, migraines, vertigo, Meniere’s, trigeminal neuralgia, whiplash, IBS and other chronic nervous system problems.
Dr Jessey (黄钰心矫正师) (Traditional and Complimentary Therapy Qualification) is a Chiropractor from Kuala Lumpur (Malaysia), graduated from Anglo-European College of Chiropractic (UK) as a Doctor of Chiropractic (not medical doctor or dentist). She has experience serving patients from 2 weeks old to 96 years old prior to moving to Singapore and joining Vitality Chiropractic (活力脊椎矫正中心).
She has completed post-graduate studies and is Singapore’s first female Upper Cervical Chiropractor (上颈椎矫正护理).
Jessey is active in outreach, participating in charitable trips to Cambodia and within Singapore. Jessey has experience helping patients with headaches, migraines, dizziness (眩晕/头晕), Meniere’s (美尼尔氏综合症), slipped disc, anxiety, fibrillations, IBS and other chronic nerve system problems. She also has a special interest in children and younger patients.
If you’ve been struggling with tremors in Singapore, call 8438 9550, email help@vitalitychiropracticcentres.com or fill in your information below to book your appointment.
Chiropractic Care for Tremors – Treatment Rates in Singapore
Here are the expected rates for the Treatment of Tremors care in Singapore
at Vitality Chiropractic centres.
Discovery Call
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Jump on a call to discuss your concerns and determine if we are the right fit for you.
Consultation
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During the initial consultation, we will run a physical examination, postural assessment, and nerve system test.
Test Results
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Our chiropractor will explain the findings and test results from the consultation. A customised care plan will then be developed for you.
Single Session
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We will perform a nerve scan and adjustment as needed. Re-examinations and rehab exercises might be implemented.
Written by
Shaan Rai (Chiropractor, Singapore)
Shaan is a British Chiropractor, based in Singapore. He is an Alliance of Chiropractic (AOC) registered Singapore Chiropractor, completing a 5 year course at AECC (UK), attaining his Masters in Chiropractic. He is the Vice President and Chairman for Outreach & Charity for Alliance of Chiropractic (AOC) and is the founder of Vitality Chiropractic Singapore. He developed the NeuroPro method, combining Upper Cervical techniques with Functional Neurology Rehab, with published research coming in 2025.
Dizziness Research in Singapore
Read our case report about our patient with dizziness and hearing loss, and the improvements seen with our care. This was produced by the Australian Spinal Research Foundation, and published in the Asia-Pacific Chiropractic Journal.
Read Our Book
Shaan authored the book, ‘Dealing With Dizziness – Holistic Solutions For Unexplained Chronic Dizziness, Vertigo, and Balance Problems’.
You can find it on Amazon, or available in our Singapore Chiropractic clinic.
FAQS
Chiropractors are trained doctors of Chiropractic. They train exclusively as doctors of Chiropractic, not as medical doctors or dentists.
This is the same as how a Dentist, TCM or PhD graduate are trained as doctors in their field, but are also not medical doctors.
If you have any previous scans, x-rays, MRI’s or other imaging, please bring them to your appointment. We would also recommend bringing a family member or friend if you need support or to discuss finances.
Your initial Consultation will take approximately 1 hour, your Results will take approximately 45 minutes and follow up Appointments will take 20-35 minutes depending on your case.
After Chiropractic adjustments there can occasionally be side effects. The most common feelings after corrections (especially in the beginning) are:
- No changes yet
- Some stiffness in the muscles or light soreness
- Feeling relief
If there are any other symptoms or sensations experienced, please ensure to consult with your Chiropractor.
Absolutely! If you book using our online system you should get an email immediately then a WhatsApp confirmation from our staff.
For follow up appointments you should receive an email 48 hours before your appointment. If you do not, and you would like reminders, please let us know and we will be able to help. If you receive reminders but do not want to, you can also opt out of these emeails.
On any day you receive an adjustment we would advise taking it easy and drinking plenty of water. Give it at least 2 hours before exercising. If you feel tired then listen to your body and get to sleep early. Upon starting care, we will share a guide for you to take home, with a long list of do’s and don’ts, so you can take an active part in your care.
We recommend wearing something comfortable that you can bend in. While you don’t need to wear gym clothes, clothes which you can move in freely will be helpful for any tests or techniques the doctor will need to perform. For women, if you are wearing a dress or skirt we will provide blankets to cover you.
Chiropractic, and any health approach, will not be the answer for every patient and every health concern. Other Chiropractors may use different techniques and methods which may not produce the same results as Upper Cervical Chiropractic.
Our Chiropractors conduct a thorough history, physical assessment, nerve scans and biomechanical x-rays to determine if this is a case they can help.
If we are not the right fit for you, we will do our best to find the right practitioner for you.
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