MS hand tremors look like involuntary, rhythmic shaking, trembling, or twitching, ranging from subtle (fine tremor) to large, uncontrolled movements (gross tremor), often worsening with action (like reaching) or when holding a posture, making tasks difficult like writing, eating, or holding objects, and can sometimes feel like internal buzzing.
Fine tremor in MS can be a more noticeable version of that. It might be a shaking in the hands, feet or other part of the body. If you have the bigger movements of gross tremor, that might be in the arms or legs. This can make it harder to balance or perform certain active movements, like reaching for something.
Involuntary trembling or shaking, known as tremors, can occur in individuals with MS. These tremors may be mild or severe and can affect various parts of the body, such as the hands, legs, or head. Occupational therapy, medication, and assistive devices can assist in reducing tremors and improving overall function.
OBJECTIVES—Postural tremor is a regularly encountered side effect of amitriptyline which can be strong enough to cause discontinuation of therapy. The aim was to characterise amitriptyline induced tremor and to assess if the central or reflex component of physiological tremor was modulated by this drug.
Numbness or tingling: “Numbness and tingling — especially that comes and goes in the hands or feet — is a common symptom,” says Dr. Giesser.
What are the early symptoms of multiple sclerosis?
Hand tremors can happen because of: A lack of sleep. Nutritional deficiency — A lack of vitamin B12, calcium, or magnesium can cause shaking hands. Medication — Some antidepressants, asthma inhalers, certain heart treatments, steroids, and other medications can cause hand tremors as a side effect.
Common side effects
Medicines that can cause tremors include the following:
Tremor can be a sign of a neuropathy, a disorder of the peripheral nerves, or the nerves that bring messages from the brain and spinal cord to rest of the body. In particular, neuropathies caused by autoimmune syndromes such as chronic inflammatory demyelinating polyneuropathy (CIDP) can have tremor as a component.
Tremors are a common symptom of multiple sclerosis (MS), but they can show up in different ways. For some people, it's not a visible shaking or twitching — it's more like an internal vibration or buzzing. This sensation usually isn't painful, but it can be frustrating or unsettling.
Other more advanced symptoms include hand weakness, wrist drop (difficulty raising hand), curling fingers, poor sensation.
💡 Quick Summary
Katherine Hepburn had Essential Tremor, and was originally misdiagnosed with Parkinson's. Ronald Reagan, also, had Essential Tremor. Both had a head tremor and a vocal tremor. With Essential Tremor, the hands are most commonly involved, followed by the head and then the voice.
TREMORS, MUSCLE SPASMS, AND MUSCLE TWITCHES
A muscle spasm is an involuntary contraction of a muscle. A muscle twitch is a fine pulsing movement of a small portion of a muscle. Neither spasms nor twitches result in the visible shaking people see when experiencing tremors.
It's best to take it before you go to bed because it can make you sleepy. If you still feel drowsy in the morning you could try taking it earlier in the evening. Amitriptyline does not usually upset your stomach.
Amitriptyline is not suitable for some people. To make sure it's safe for you, tell your doctor if you: have ever had an allergic reaction to amitriptyline or any other medicine. have a heart problem – amitriptyline can make some heart problems worse.
The low dose of amitriptyline won't treat depression, but it should reduce your pain, relax your muscles and improve your sleep. You may feel a bit better after one or two weeks. But it can take four to six weeks for amitriptyline to work as a painkiller. You'll probably take it for as long as it helps your condition.
Tremor red flags signaling a potentially serious underlying condition include sudden onset, worsening over time, significant functional impairment, or the presence of other neurological symptoms like balance/gait issues (ataxia), slow movements (bradykinesia), muscle stiffness (rigidity), speech problems (dysarthria), or changes in thinking/memory; unusual age (under 20 or over 80); or association with alcohol withdrawal, certain medications, or systemic illness (e.g., thyroid issues). These signs warrant urgent medical evaluation to differentiate from common tremors.
Essential tremor can be confused with typical Parkinson's disease symptoms, but the two movement disorders are separate conditions. Because these diagnoses can get tangled up, it's helpful to understand their differences.
Vitamins B1, B6 and B12 are integral in keeping the nervous system in strong working order. And, while essential tremors are more hereditary in nature, a deficiency in vitamins B1, B6 or B12 are known to cause shakiness and tremors in the hands.
blood tests. an MRI scan to see if there is damage to the nerves in your brain or spinal cord. taking a small sample of spinal fluid from your lower back using a needle (lumbar puncture) tests that use small sensors attached to your skin to measure how quickly messages from your eyes or ears travel to your brain.
Invisible symptoms of MS – fatigue, pain, blurred vision, numbness, and brain fog – which often go unnoticed by other people, can also interfere with daily functioning and be just as debilitating.
Symptoms of advanced MS