Featuring Barry A. Hendin, MD 

MSAA’s Chief Medical Officer 

Question: How do tremors with MS differ and what types of treatments help?

Answer: Tremor or shaking is relatively common in multiple sclerosis, affecting as many as one quarter to one half of people living with MS. Tremors may range from a mild nuisance, to moderate or severe, and affect activities of daily living.

The most common tremors that occur in MS are called “intention tremors” or “postural tremors.” These are as opposed to the resting tremor of Parkinson’s disease. Simply stated, an intention tremor is generally triggered when reaching for an object; it is the most common form of tremor in people with MS. A postural tremor is often triggered by sitting or standing. Either may be associated with lesions in the cerebellum or its connections. The cerebellum is the coordination center of the brain, so tremor may also be associated with imbalance.

Identifying appropriate treatments for tremor in MS has been difficult. No single medication has been consistently beneficial, although many have been tried, including Inderal^® (propranolol), Botox, and anticonvulsants. Surgical interventions have also shown mixed results. Conservative interventions have been the most consistently beneficial to date, including physical therapy and occupational therapy utilizing motor training, bracing, and weighted tools for hand tremor. 

Research continues, and I am hopeful that we will have better and more consistent treatments in the future.

For more information about tremors and MS, please visit MSAA’s webpage dedicated to this symptom.

Barry A. Hendin, MD, is a neurologist and Director of the Arizona Integrated Neurology MS Center. He is also Director of the Multiple Sclerosis Clinic at Banner University Medical Center and Clinical Professor of Neurology at the University of Arizona Medical School.

MSAA’s Ask the Expert series received a Merit Award from the 26th Annual Digital Health Awards!