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Suggest Treatment For Essential Tremors
Question: I have essential tremor - .e. shaky hands. Can a chiropractor or acupuncturist help my problem?
Brief Answer:
Chiropractics of no use, acupuncture may be tried.
Detailed Answer:
I read your question carefully and I understand your concern.
Regarding acupuncture I am afraid that there it can't be of much help for essential tremor, joint manipulation doesn't play any role in the mechanism of essential tremor. So I would confidently say it is of no use.
As for acupuncture, in terms of there existing medical evidence about its use in essential tremor, I am afraid that not much evidence exist. Acupuncture is part of alternative medicine so unfortunately there are not many controlled studies for its use in essential tremor or in other diagnoses. However there are some reports of patients feeling improvement and since it can help peripheral nerve system it might be of help. Furthermore it is a safe procedure, so it can be tried. As I said there are no studies to prove its efficacy, no guarantees, but since you seem to already have tried and failed traditionally used drugs, it is worth the attempt.
I remain at your disposal for other questions.
Chiropractics of no use, acupuncture may be tried.
Detailed Answer:
I read your question carefully and I understand your concern.
Regarding acupuncture I am afraid that there it can't be of much help for essential tremor, joint manipulation doesn't play any role in the mechanism of essential tremor. So I would confidently say it is of no use.
As for acupuncture, in terms of there existing medical evidence about its use in essential tremor, I am afraid that not much evidence exist. Acupuncture is part of alternative medicine so unfortunately there are not many controlled studies for its use in essential tremor or in other diagnoses. However there are some reports of patients feeling improvement and since it can help peripheral nerve system it might be of help. Furthermore it is a safe procedure, so it can be tried. As I said there are no studies to prove its efficacy, no guarantees, but since you seem to already have tried and failed traditionally used drugs, it is worth the attempt.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
What drugs to you think are best for essential tremor? I go to a doctor at UCSF and he has put me on a daily dose of the following but it doesn't seem to help very much:
Primodone 300
Propanolol 160
Alpraazalon .25
Primodone 300
Propanolol 160
Alpraazalon .25
Brief Answer:
Primidone and propranolol are first choice drugs.
Detailed Answer:
The 2 first choice drugs used for essential tremor are Propranolol and Primidone. They have similar rates of success, being effective in about 50-70% of patients. Usually Propranolol is preferred in younger patients (due to the effects on heart rate and airways which can be dangerous in the elderly) while Primidone in the elderly. It depends on the individual though, for some patients one may work better than the other, for some others none may work well.
May be used together when they do not work well alone.
Alprazolam is not a preferred medication. It may help a little by relieving anxiety which worsens the tremor, but doesn't do much for the tremor itself. Furthermore with time it creates tolerance and dependence. So I wouldn't recommend it, in particular for long term treatment.
Other medications which may be considered when Primidone and Propranolol do not work as in your case may be anticonvulsants like gabapentin or topiramate.
In some severe cases with disabling tremor, surgery may be considered.
Let me know if I can further assist you.
Primidone and propranolol are first choice drugs.
Detailed Answer:
The 2 first choice drugs used for essential tremor are Propranolol and Primidone. They have similar rates of success, being effective in about 50-70% of patients. Usually Propranolol is preferred in younger patients (due to the effects on heart rate and airways which can be dangerous in the elderly) while Primidone in the elderly. It depends on the individual though, for some patients one may work better than the other, for some others none may work well.
May be used together when they do not work well alone.
Alprazolam is not a preferred medication. It may help a little by relieving anxiety which worsens the tremor, but doesn't do much for the tremor itself. Furthermore with time it creates tolerance and dependence. So I wouldn't recommend it, in particular for long term treatment.
Other medications which may be considered when Primidone and Propranolol do not work as in your case may be anticonvulsants like gabapentin or topiramate.
In some severe cases with disabling tremor, surgery may be considered.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you.
What type of exercise helps! I'm wondering if I get two rubber balls that fit in my hands and squeeze them 50 times each morning if that might help.
Or what else?
What type of exercise helps! I'm wondering if I get two rubber balls that fit in my hands and squeeze them 50 times each morning if that might help.
Or what else?
Brief Answer:
Read below
Detailed Answer:
Rubber ball exercises have some mild benefit. You can press and hold for about 5 seconds then release, repeat that 10-15 times.
Doing wrist dumbbell exercises is another exercise. Use a light dumbbell 1 kg at most, keeping it in your hand, your hand placed over say the edge of a table, move the wrist up and down 15-20 times.
Physical activity like walking, light jogging, yoga helps also by reducing stress levels.
I hope to have been of help.
Read below
Detailed Answer:
Rubber ball exercises have some mild benefit. You can press and hold for about 5 seconds then release, repeat that 10-15 times.
Doing wrist dumbbell exercises is another exercise. Use a light dumbbell 1 kg at most, keeping it in your hand, your hand placed over say the edge of a table, move the wrist up and down 15-20 times.
Physical activity like walking, light jogging, yoga helps also by reducing stress levels.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
That is VERY helpful. Thanks.
One last question: What about Clonezepan? I've tried but it doesn't seem to help much.
One last question: What about Clonezepan? I've tried but it doesn't seem to help much.
Brief Answer:
Similar to Alprazolam
Detailed Answer:
Clonazepam belongs to the same benzodiazepine class such as Alprazolam. So what I said above about Alprazolam applies to it as well. It is commonly used as it alleviates anxiety which may help a little as anxiety worsens tremor, but doesn't do much beyond that. With long term use dependence and tolerance may develop so it isn't recommended for such long term use either.
Similar to Alprazolam
Detailed Answer:
Clonazepam belongs to the same benzodiazepine class such as Alprazolam. So what I said above about Alprazolam applies to it as well. It is commonly used as it alleviates anxiety which may help a little as anxiety worsens tremor, but doesn't do much beyond that. With long term use dependence and tolerance may develop so it isn't recommended for such long term use either.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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