I am a young man, just turned 31 years old. About a year and a half ago, I started to develop a slight tremor in my left forearm/hand. Over time, the tremor has gotten more exaggerated. Just recently I have noticed that my left lower leg/foot has felt heavy and stiff and I cannot move or rotate my foot as well as my right one. I have jogged a couple of times recently and although, while running I was okay, afterwards, this caused lower back ankle/foot pain. When I stand or walk for an extended period of time, I have pain in my lower back and ankle/foot. Sometimes when turning my head quickly, I get a pinching type pain in my neck on both sides of my neck.
When I sleep, the tremor goes away. When I wake up with the sensation of pins-and-needles in my arm from sleeping on it, although it is numb, as it normally would be, I have complete use of my hand and fingers, normal dexterity, without the tremor, until normal feeling comes back, usually up to about 5 minutes. The more relaxed I am, it seems, the less the tremor. But the stiffness or lack of dexterity of my fingers stays the same. Also, a drink or two of alcohol suppresses the tremor.
As a twelve year old, I had scoliosis surgery, placing rods in my back, from “T-4 to the end plate of T-10 and T-11 through L-3’. Also, about 10 years ago, from a target shooting gun accident, I have a .22 caliber bullet fragments remaining in my upper left arm. At first, we thought the bullet fragments were the cause since only my lower left arm was affected but since the EMG shows normal nerve conductivity and now that my left leg seems to be affected we don’t think this is a factor..
I was told, when I had the scoliosis surgery that possibly, down the road, I could experience problems from my neck. Currently, as stated earlier, I get some neck pain and stiffness and lower back pain. Earlier, in the summer, after doing some strenuous yard work, I had acute lower back pain that lasted for several weeks. I took Skelaxin, a muscle relaxer, which helped. This is the first time I have ever had that extensive pain in my back.
We have been to several different neurologists, without much success. I have had a brain MRI done, a neck MRI, 2 different EMG’s, extensive blood work and an EEG done as well. All reports are included. You will see that the Brain MRI shows normal. The EMG shows that the nerves and muscles of my lower arm are normal. The blood work and EEG are normal as well. The Neck MRI is, we believe now is the area of focus, as the report says that I have “significant reversal of the cervical lordosis and a moderate to large, right sided disc herniation at C6-C7. The neck problems seems to have been overlooked to date by doctors as originally, the diagnosis was that I had an anxiety related tremor because when I concentrated on something else, the tremor went away, briefly. Also, there was some concern from just one of the doctors that it may be Parkinson’s disease. However, most of the doctors felt that the frequency of the tremor, 10 Hz doesn’t suggest it. Also, in trying Cararbidopa-levodopa, 25-100MG tablet, which should have stopped the tremor, if it was Parkinson’s, did nothing but made me nauseous. It had no affect on the tremor.
Speaking of medicines, to date, I have been prescribed the following medications with literally no results. Starting from earliest date to most recent…
Trihexyphenidyl – 2MG, taken twice daily – (this made me dizzy, headachy,weak.)
Pramipexole Dihydrochloride, (Mirapex) - .5MG, taken 1 tab, 3 times daily – (this caused
Lorazepam - .5MG, taken one tab, twice daily. (this lessened the tremor slightly for just
a day or two but it kept me awake).
Carbidopa-Levodopa – 25-100MG, taken 1 tab, three times daily, (Made me very
Nauseous, with no affect).
Clonazepam - .5MG tab, taken 1 tab, twice daily. (no affect)
Amantadine – 100MG, taken 1 tab twice daily. (Lessened tremor for just a day or tow but
then made me nauseous, headachy).
Propranolol – 20MB tabs, taken 1 tab daily. Since there was no affect, this was
Increased to 3 tabs, 3 times daily. (No affect at either dosage).
Prednizone – Tried a metered dose pack to see if it would reduce inflammation hoping
to reduce the tremor some. (There was no significant affect).
I am currently not taking any medications other than occasional Advil for pain in my lower back and neck stiffness. Additionally, I tried acupuncture for 8 appointments. While on the table, relaxing, the tremor went away, then, after getting up, the tremor came back.
my newest mri report says:
c4-c5: posterior disc bulge. Mild left uncovertebral hypertrophy. No significant central or foraminal narrowing.
c5-c6: Mild posterior disc bulge. Mild right neuroforaminal narrowing. central canal is patent.
c6-c7: Small right foraminal disc herniation and eccentric right uncovertebral hypertrophy causing moderate right neuroforaminal narrowing. this effaces the ventral thesal sac. there is no significant central spinal stenosis
my question is could this cause the problem of my left arm tremor/weakness and stiffness?
I am not too familiar with your tremor, but I can tell you that to rule out another cause on your list, an endocrinologist might need to do the several lengthy tests for hypoglycemia, altho I do not think your tremor has anything to do with that. Get you some lifesaver candies and suck on a few of those whenever you notice your tremor, and if it helps, then could be hypoglycemia. Then there is a remote possibility you have MS or some other autoimmune disorder, that tremor is a signal of that like Parkinson's is, but MS plaques would have shown up in the MRI you've had done. And I have a vague memory that a lumbar puncture can detect other immune problems, but you can ask the endocrinologist, even tho it's not his specialty.
Now, despite your EMG coming up okay, I just plain think your tore-up spine is indeed what's doing this to you. In addition, your leg problems and lower back pain come from the same thing. Your low back and leg problems are like mine, I take Lyrica for it, it has to be increased several times initially, to reach a plateau of comfort, and takes some getting used to, sort of throws you off balance and causes your eyes to glass over. I was already on opiates for leg pain from a neuromuscular disorder and it never did touch that lumbosacral spine problem I have, but the Lyrica helped overnight. But in your situation, if this tremor is really bothersome, it can't hurt to get those bulging discs fixed in your neck, and they ought to doublecheck your lumbar spine and see if the pictures show anything dangerous going on there, and in addition to medicine, they can fit you with a proper back brace to wear when you do strenuous activity.
But if it's just tremor without a cause, I think the kind you have is an essential tremor because the alcohol you mentioned reduced the intensity. The National Institutes of Health are testing 1-octanol, similar to alcohol, to treat essential tremor with success, go to this website and see if they've got a trial you can sign up for relating to essential tremor for that medicine:
Lastly, here is a website that talks about pretty much everything you never wanted to know about tremor, it's a good one:
thanks, for the info the tremor is really bothersome, i cannot hold or do anything in that arm/hand (left). They ruled out everything even parkinsons they (neurologists said its not that I think very strongly that it has to do with my narrowing foraminal of the neck because i have been doing extensive research for neck problems and most of the info that came up said tremors do occur with neck problems im going to hopkins hospital on tuesday to find out. Im running out of options everyone in my family is healthy as can be but im the only one that had scoliosis and now 18yrs later i have a tremor i think the scoliosis is whats causing my neck problems and the neck problems are causing my arm problem. All the doctors i had been to said its none of the major symptoms?
On reflection, those bullets in your arm MAY be causing your muscles to act up, whenever you move your arm, basically. You can have a normal EMG and still have a tremor... in fact, you have to have good electrical impulses to even have a tremor to begin with. But for all I know, an EMG registers any spikes in electrical/ muscular activity, I don't know.
But as I said in my first post, I still think it's your tore-up neck that's doing this, AND I think your lumbar pain is a totally separate problem. Your whole spine is subject to having individual vertebral problems, perhaps from your scoliosis, therefore you can have a change in position of your spine for whatever reason, and get bulging disks (by the way, you had two posterior ones, which would affect both right and left sides, so one of those could be the source of tremor), and if the bulges are in the cervical spine, that gives you trouble in the upper body, and if there's bulges in the lumbar spine, then low back and legs have problems (altho could be your lumbar spine has an abnormality diff from bulging discs). In other words, your left-sided problems are not necessarily connected, unless the spinal canal was invaded, which the cervical spine reports don't say that.
The folks at Johns Hopkins (I assume you meant that hospital) will be able to do some tests to determine perhaps which one or two cervical problems are most likely the source of your tremor, I don't care what the other docs said, and neither will they. They may also want to get those bullet fragments out of your arm first, just in case that is indeed figuring into this, like poisoning of muscle tissue, irritation. It would save them a lot of trouble, wouldn't have to do spine surgery... then as for pain, could be some great medicine would also prevent need for any procedure. But if it's not the bullets, then I think they will wind up doing something with those bulging discs, whichever ones they think are causing tremor. Of course, if it's the other part of your scan report, straightening of the normal neck curvature doing this, they cannot do anything for that, other than declare that's what is causing the tremor.
I would like to say to you, SunShane, that you say you're the only sick person in your family. Well, so am I. I was in a car accident that caused compression fractures of three vertebrae in the thoracic spine, and many years afterwards, my spine began to settle more and more from the unstable area of crushed bone and vaporized discs, and I'm now disabled. I WANT to do things, but I cannot. And took me FOREVER to explain to my happy and healthy elderly parents that I was in worse shape than them! Ha! So, son, these things happen, that's all. And you have a whale of a problem right now, pain in your neck, pain in your low back and legs, and an awful tremor that I consider disabling, personally. If you don't already receive government assistance, perhaps you can get some.
I think when you go to Johns Hopkins this coming week, see will they at least (a) suggest a source(s) of your tremor and any solution, (b) provide proper pain control (opiates, pregabalin, anti-spasmodics), and (c) don't leave until they do both those things. Also, might be one of the orthopedist docs will be a likeable chatty fellow, and you can inquire about how your scoliosis rods are doing, just so you have a full picture of your entire spinal situation. Oh, and they'll do some lumbar spine pictures, so they can settle on what is causing all that misery in your low back and legs, and then treat that also.
I honestly do not know how you have been putting up with all this for so long. I cannot tell you how annoyed I get when I hear people's stories about being passed around from doc to doc, being given drugs that don't kill pain (drug war opiates), and unwilling to go the distance for you to figure out what part of your spine is doing the tremor or if it's indeed the bullet fragments. You need a holistic look at your spine, a few adjustments here and there, some pain killers, and for gosh sakes they gotta please be able to stop that tremor.
I will be VERY interested in how things go at Johns Hopkins. You really couldn't have picked a better hospital. And I hope they come up with some plans to help you out. Keep us posted.
I've had similar tremors and muscle twitches in my right arm until I had neck surgery in 2007 for severe instability (c4 - c6 fused). Although it did help with the twitches it did not relieve the pain. I have been told that my EMG shows that my (R) carpal tunnel has returned but I am not sure if the symptoms are really from my neck or my hands. I do know that if I use my hands to hold a weed wacker or a leaf blower after about ten minutes my hands and trembling so much that I cannot hold a cup of coffee.
Your best bet is to see a spine specialtist who is familiar with both your previous scoliosis surgery and your current neck issues. I've been told by PT people and chiropractors that nerve pain can traverse to the unaffected side kinda like a toothache - the destist tests the affected tooth on both sides to make sure the issue is correctly identified. Originally back in 2000 my mri showed a disc bulge on the left side but all of my pain was on the right side. Finally in 2007 I had an MRI in which I sat instead of laying down and that showed the severe instability (showed the actual effects of gravilty). I too know what it is like to try and inform my mother that I am in worse shape than she is - she just doesn't get it - that I can't stand for more than a couple of minutes - that I can't walk a full block without going down in pain - that I can't hold a phone to my ear without arm pain and numbness - that I can't hold a book up to read. I know my father had a bad back but not to the extent that I have and his showed up at a later age. I know I would not have taken all of that Parkinson's meds without a confirmed diagnosis. I saw that you noted that when you lie down on the table that your tremors calmed down but when you got up they started again - I think that is gravity making your symptoms worse. Best of luck to you and make sure you see a spine specialist - either a neurosurgeon or othopedic who has extensive training with the spine.
curr age = 49
2005 - l4 - l5 fusion for spinal stenosis - good results
2007 - c4 - c6 fusion for severe instability - not good results
2009 - l1 - l2 laminectomy for blown disc and l3 - l4 miscrodiscectomy for blown disc (done during the same surgery) - bad results
I know you wrote to SunShane, and I don't want to hijack this thread, but I wanted to say how sorry I am your last two surgeries didn't go well. I assume at least the fusion of C4-6 and the lumbar disc repairs were accomplished, but that you still have lots of discomfort from that. I hope they gave you some good medications to help with that. If I didn't have mine, I'd go crazy, and it never really does take it all away. And I'm the one who said my folks took a while to finally see just how much trouble my back is in. I, too, cannot hardly even walk around in the yard for more than about ten minutes, my back gives out.
Also wanted to tell you I'm glad you mentioned the sitting position for your MRI, so I'm thinking I too need to have that done... I'm getting a scan in the spring, I think the CT scan is cheaper, doc wants MRI (I hate those tight machines), altho my Medicare will pay for the whole thing either way as long as it's connected to the hospital. I shall ask my doc to order the scan whilst I stand.
I think SunShane is going to Johns Hopkins Tuesday specifically to find out if his tremors are coming from his neck (in case he doesn't get back on here until after that), so he's doing what you suggested. The main thing I concern myself with is just how much more my lumbar spine can take before it comes undone, it's like it's not part of the rest of me anymore, and in fact I think an in-between orthopedist misread my pictures, my lumbosacral spine is so far out of alignment, I'm thinking it's barely connected anymore.
Yes, I also had hand tremors, arm weakness/aches and multiple other neuro symptoms that all stemed from my neck. Once you have a problem with one part of your spine it can trigger the whole spine.I am a perfect example. I had 2 herniated discs in neck 2 in thoracic and degenerative, bulging lumbar.My neck problems over the course of several months triggered all my other spinal issues. I have found that Doctors of Osteopathic medicine to be very helpful with working on your spine. Only 5% of doctors that graduate from Osteopathic Medicine actually practice it so you may have to dig to find them. Start with your local hospitals.
well just came back from johns hopkins appointment they think it has nothing to do with the neck it has to do with the brain he is calling it an essential tremor but i dont get that everything has a cause but what causes ET ? he also thinks i should get Deep brain stimulation surgery but before i decide that i want to try botox and a few other things first. I herd that botox injections can reduce tremors/stiffness?
You got two user names. I thought your Johns Hopkins visit was today instead of yesterday. If you want to know more about essential tremor, just go to that link I gave you at the end of my first reply.
I am wondering if the docs there did any tests on you, or maybe they just went by other people's reports. If the latter is the case, I think I would seek out a surgeon who will fix all your cervical spine problems...they are painful and some of us think your tremor comes from the abnormalities there. But far be it from me to question Johns Hopkins. Still, I cannot see where it would not hurt to at least get pain under control in your neck.
As for botox injections, also there are steroid type injections and other nerve block shots, could indeed be you can give something like that a try first, too, before neck surgery or brain operation. I am truly puzzled by what these docs are telling you, and I wonder if one of the above posters, Kay, found relief from her tremor after they did some sort of procedure. Well, just wanted to give you my thoughts. I've pretty much said what I think is going on already, that your neck is the source of the tremor. Keep us posted.
hey all i found out that my tremors are from my neck herniations i have three. I was speaking with a doctor from california spine center and he said that the doctors out here are worthless he said that my neck is not a normal curve from my scoliosis surgery, he said ill need to get cortisone shots in my herniated area in my neck to see which disc is causing the tremor thats a relief finally found a decent doctor who knows what the hell they are doing. He also wants to do a work up of my blood to see if i have any thyroid / liver/ toxins in there before we move to surgery.
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