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I Have Recently Started Having Tremors In Both Of My
Question: I have recently started having tremors in both of my hands and cramping in my left shin and foot. My toes on the left foot are contracting and painful. I also have back spasms and see a pain management physician for treatment. I have some significant degenerative disc disease from L4-S1 on the right side. I don't take any opioid medication, but have been on Gabapentin, Tizanidine and Mobic for some time for my back. I also use Voltaren gel on my right thumb for an injury I sustained in January of this year when I was in a car accident and dislocated that thumb. The pain in that digit has increased significantly in the last month or so. I'm concerned about whether these new symptoms could be indicative of progression of my degenerative disc disease or if it could be something even more troubling such as MS or Parkinson's.
Brief Answer:
It is not possible for L4-S1 disc disease to cause tremors in hands- further details below
Detailed Answer:
Hello and welcome to 'Ask A Doctor' service,
I carefully read your query and understand your concern.
Tremors can be caused by several conditions and MS and Parkinson are among them.
In your case, because you use gabapentin, possible side effects of it are tremors.
As for the degenerative disc disease, it may cause problems in the legs (as it is L4-S1) but should not affect the hands so it is unlikely the tremors are related to degenerative disc disease.
Parkinson causes tremors at rest. It is called pill-rolling tremor (it gives the impression as if the patient is rolling a pill between his fingers) and is worse at rest and improves with movements (when the patient wants to hold something or do something with his fingers and hands).
MS may cause tremor as well but is not the most common symptom. It would happen with other neurological symptoms such as vision changes, weakness, numbness in limbs, etc.
To conclude:
- It is unlikely that L4-S1 disc disease will cause neurological symptoms (tremor) in the hands and fingers
- Gabapentin may cause tremors as potential side effects, this needs to be discussed with your doctor
- MS would be associated with a few other neurological symptoms and tremors are not the most typical presentation. To rule it out for sure an MRI of the brain and spine may be indicated
- Parkinson causes continuous tremor, worse at rest, which improves with movements (using the hands)
- The possible cause of tremors is benign tremors which are worse during activities (when you want to grab something). These are familial (inherited) and are not dangerous (do not indicate a serious neurological disease)
- If a thorough physical examination (including a thorough neurological exam) does not clearly determine the cause of your symptoms, other than the MRI mentioned above, you may also need to have some blood tests such as electrolytes (Ca++, K+, Na+, etc), basic metabolic profile (including liver and kidney function tests), fasting glucose, CBC, ESR, TSH, etc.
I hope this answers your query. I remain at your disposal in case further medical assistance is needed.
Regards,
Dr. Antoneta Zotaj
General and Family Physician
It is not possible for L4-S1 disc disease to cause tremors in hands- further details below
Detailed Answer:
Hello and welcome to 'Ask A Doctor' service,
I carefully read your query and understand your concern.
Tremors can be caused by several conditions and MS and Parkinson are among them.
In your case, because you use gabapentin, possible side effects of it are tremors.
As for the degenerative disc disease, it may cause problems in the legs (as it is L4-S1) but should not affect the hands so it is unlikely the tremors are related to degenerative disc disease.
Parkinson causes tremors at rest. It is called pill-rolling tremor (it gives the impression as if the patient is rolling a pill between his fingers) and is worse at rest and improves with movements (when the patient wants to hold something or do something with his fingers and hands).
MS may cause tremor as well but is not the most common symptom. It would happen with other neurological symptoms such as vision changes, weakness, numbness in limbs, etc.
To conclude:
- It is unlikely that L4-S1 disc disease will cause neurological symptoms (tremor) in the hands and fingers
- Gabapentin may cause tremors as potential side effects, this needs to be discussed with your doctor
- MS would be associated with a few other neurological symptoms and tremors are not the most typical presentation. To rule it out for sure an MRI of the brain and spine may be indicated
- Parkinson causes continuous tremor, worse at rest, which improves with movements (using the hands)
- The possible cause of tremors is benign tremors which are worse during activities (when you want to grab something). These are familial (inherited) and are not dangerous (do not indicate a serious neurological disease)
- If a thorough physical examination (including a thorough neurological exam) does not clearly determine the cause of your symptoms, other than the MRI mentioned above, you may also need to have some blood tests such as electrolytes (Ca++, K+, Na+, etc), basic metabolic profile (including liver and kidney function tests), fasting glucose, CBC, ESR, TSH, etc.
I hope this answers your query. I remain at your disposal in case further medical assistance is needed.
Regards,
Dr. Antoneta Zotaj
General and Family Physician
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
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