Posted by: Thixia | October 22, 2008

Causes and types of tremor 4 of 4

 Practical ways to manage tremor

What can I do to actively help manage tremor?

Learning to live with tremor is an on-going process.  You may need to try different approaches at different times and as your needs change.  Be prepared to experiment and work alongside the professionals involved in your care – it may take some time to find out what helps most.  Find out all you can and be prepared to be persistent.


The professionals involved in your care will be concerned to find out if there are things that make your tremor worse, what helps and which activities tremor affects most for you.  The more you know, the more you can help the professionals to help you.


Many people find their own solutions for particular activities – using a ‘good’ arm to steady a shaky one, for example, or propping their elbows on the table in order to eat.  


How can rehabilitation medicine help manage tremor?

Rehabilitation medicine brings together nursing, physiotherapy, occupational therapy and other disciplines in a team approach.  It combines their different expertise in a holistic way for the benefit of the person with MS.


Rehabilitation can help all people with MS at every stage of their condition.  It can help minimise some of the effects of MS and can improve quality of life.  It can help you make the most of your functional ability, achieve the maximum independence and gain relief from distressing symptoms.  For many people with MS tremor, rehabilitation can help with managing day-to-day activities.  


How can physiotherapists and occupational therapists help manage tremor?

Physiotherapy and occupational therapy cannot make tremor disappear but they can and do reduce its disabling effects.  A physiotherapist helps you maintain and make the most use of your strength and range of movement.  An occupational therapist helps you find practical ways to manage particular tasks and minimise the effort involved.  Physiotherapists and occupational therapists may assess jointly the problems that tremor and other movement difficulties are causing for you and find ways to make them interfere less with daily activities.  


What sort of techniques will physiotherapists use to help manage tremor?

Posture and balance:


How you stand or sit – your posture – affects the range of movements you can make, the muscles you use for each activity, and therefore the tasks you can do.  A physiotherapist can help you develop stable and controlled posture, both standing and sitting down.  Being upright can help develop your balance and help to align muscles so that they work together efficiently.  If you use a wheelchair, a physiotherapist may help you stand using supportive equipment as part of developing better postural control.



Seating and support:


The right support for your back and trunk is important, in both armchairs and wheelchairs.  If you are swimming around in a chair that is too big, you expend unnecessary effort to balance and hold yourself against gravity.  This results in tension in the muscles or the need to use muscles that are not designed for the job of balance, which can make tremor worse.  The right support can relax the muscles and calm the tremor.  Arm rests that are too high for you may restrict how you use your shoulders.  When they are at the right height they can enable your movements to be more co-ordinated.





Whatever your level of disability and MS fatigue, keeping up exercise is important and an exercise programme can maximise the range of movement you have in specific muscles.  A physiotherapist can devise a movement or exercise programme for you to carry out either at home or in the gym.  An occupational therapist can help you learn to carry out functional daily tasks in ways that help you keep the body as aligned and well-balanced as possible.  



What kind of things might an occupational therapist suggest?

An occupational therapist can help you find other practical ways to manage and to minimise the effort involved.  The solution may include learning to do the activity in a different way, changing the equipment or utensils you use and making changes to your environment.  It can also involve learning to identify and avoid any personal triggers that make your tremor worse, such as heat or stress.


Even small things can make a real difference – like making sure your clothes don’t have fiddly zips or buttons, for example.  A wide variety of equipment can help with particular tasks – from two-handed cups and non-slip working surfaces to electrical labour-saving gadgets in the kitchen.  Techniques to reduce effort can be as simple as boiling vegetables in a wire basket so that you don’t have to lift a heavy pan to drain them.


Additional weight, in the form of weighted wristbands or weighted cutlery for example, can be used to dampen down a tremor and provides a temporary or partial solution for some people.  Weights do not appear to have a lasting benefit, however, and an important consideration is that they could add to problems of fatigue.


Some people have found that a splint or a brace, used to immobilise the affected part of the body, can help them to carry out a specific task, such as writing.  Other solutions people have found for writing difficulties include, for example, using plastic overlays to position their signature when they sign cheques, and using voice recognition software – now widely available – to write with a word processor.


These are just some of the aids and techniques available.  An occupational therapist can advise on what may be appropriate for you.  



Emotional and financial support with managing tremor


If you need help to manage independently at home you may be entitled to care at home provided by your Social Services department.   This is called ‘care in the community’ and you may have to pay towards the cost.   To receive help, you will need to have an assessment.   Depending on where you live, you may have to wait to be assessed.   If you qualify for help, for example, carers will come to your home for a certain number of hours per week to help you with agreed tasks.


You may find you are eligible for benefits to help with this.




Is there any counselling and emotional support available to help manage tremor?

In a world where people are so conscious of body image, it can be difficult to live with tremor.   It can directly affect some people’s general well-being, work and social life.


Whatever you feel – and it may be different at different times – you don’t have to cope alone.   An MS nurse for example, may be able to find further support for you and your family.   Some people also find that counselling helps in the longer term.   Your MS nurse or GP should be able to refer you to a counsellor, or you can speak to the MS Helpline.


Some people find it helpful to socialise with other people with MS.   You could ask any of the professionals involved in your care or your local MS Society branch about support and activities near you. 






Compliments of:




  1. gosh people- exercise can throw us into tremors!! just a little to much is like here i go again- its very frustrating

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