Ess. Tremor, carpal or worse?

[dexterslab]

I've started having problems with my thumb and wrist over the last few days or so. I did a little research and found this forum. Fogive me if this isn't the proper way of doing this.

My thumb in my left hand seems to shake a lot when in certain positions, like when holding a remote, a pen or a newspaper in just the right way. It will usually go away by moving it or turning my wrist and I notice it more sitting than standing. Is this what's known as a postural essential tremor? My right hand does it a little too, but it's so minor it can barely be noticed.

I should note that my wrist and thumb has felt strained for a bit too and can be sore and painful. Could this be some sort of carpal tunnel syndrome?

I'm so worried this could be something severe like Parkinsons, MS or ALS and I just don't have the resources right now to see a doctor.

Can someone help me?

[CCF Neuro[P]-M.D.-RPS]

Dear Dexterslab:

Sorry that your having problems with your thumb and that your financially unable to seek medical attention.  As you have read on this forum, ALS is not tremor but fasciculations that is not accompanied by sensory changes.  Parkinson's is a resting tremor foremost, but one can see an action or postural tremor.  The characterists of the tremor are very characteristic, pill rolling that when seen, is pretty diagnostic and without it one would need further evidence that a patient has Parkinson disease.  It doesn't sound like what your describing.  MS is always in the picture when one talks about waxing and waning sensory or muscular symptoms and action tremor is certainly seen in MS.  Howvever, the short duration of your symptoms would make this a premature diagnosis.  Your thumb movement is positional, not postural.  From your description it is difficult to tell what sort of positional movement your thumb might be.  There are various types of dystonia that can be positional, but I can't tell much without seeing what your movement looks like.  Sorry, I can't be of more help.

Sincerely,

CCF Neuro MD

[dexterslab]

Thank you for your response. Maybe I can add more for your help.

The trembling occurs when I grasp something like a pen between my index and thumb and then if I hold it just in the right position and the right amount of pressure, like rolling it down the length of the index, my thumb shakes back and forth. Is this "pill rolling"?

Are fascilations and twitches the same thing? I have had those for many years all over my body and never thought anything about them.

I don't have any weakness that I know of, but my thumb and index finger does feel almost numb sometimes. I think it usually goes away for a while by "cracking" the joint. My hand is usually worse first thing in the morning with that too, sometimes being asleep.

As for MS, does it run in families? My uncle (mother's brother) had it.

Sorry for so many questions, but being currently unemployed makes visiting a doctor difficult. My biggest concern (besides it being the start of something like ALS, MS or PD) would be some sort of nerve damage.

[Croz]

MS runs in families, but it is thought to be a genetic susceptibility.  Many people with no family history have it.  Also, your odds probably only increase if you have a "primary" relative with the disease, ie. father, mother, sibling.  So, your odds of having it are probably as long as the general public.  Hope everything turns out benign for you.

[Judy1]

Regarding the numbness after sleeping. You might try wrist splints at night. I have numbness in my hands. It was explained to me that people frequently bend their wrists when sleeping. This can result in numbness, if this is carpul tunnel.

A quick test is to hold your bent wrists together to see if the symptoms increase. If so, carpul tunnel is likely.

Judy

[outdoorlover]

Hi dex,
your shaking/pain problem sounds similar to mine.
    I started(years ago) with what was diagnosed as carpal tunnel; didn't really have the repetitive motion type of job or hobbies that would precipitate.  Still have the symptoms at times but as long as I wear wrist braces at night I am fine.  I did find that I do sleep with my wrists bent at night at the braces prevent this.
    I also have an essential tremor.  This became noticible some years ago with initial slight shaking when I would write.  Now I have thumb/finger shaking when thumb is in certain positions (holding a fork or coffee cup is difficult.)  I also am aware of slight head shaking at times.  My symptoms are lessened with a medicine called Klonipin.
    Possibly the wrist probs are associated with the tremor-not diagnosed.  
    If this sounds like your experience, you should know that essential tremors are not life-threatening, and while the condition originates in the same part of the brain as Parkinsons there is no medical evidence that tremors precipitate Parkinsons. Hope this helps.  Aside from serching the net on tremors, you might also search dystonia.