Parkinson's disease

Tremor and loss of physical control in Parkinson's disease

Often, the first symptoms of Parkinson’s disease to appear are in the upper limbs. People had discovered there were things that they had always done without a second thought, like opening a door or combing their hair, that for some reason they now have difficulty doing or may not be able to do at all. What they can’t understand is why they can no longer do them. As Natalia described it, “To move papers around, the message doesn’t get to my hands and my brain doesn’t give the message what to do.” Khadim said it felt as though someone was pulling at his hand stopping him from moving it.

Dressing and eating are daily problems, as are many other things for which we rely on our hands and arms. Previously simple tasks such as cutting up food, putting on socks, tying shoe laces or doing up buttons now took much longer to do and required a great deal of concentration.
Hydrotherapy offers people with PD an opportunity to relax. But swimming can be affected by the defective action in one upper limb. Elaine remembered an episode in a swimming pool before she realised she had PD, when she suddenly found that she could not reach out to touch the side of the pool. Fred said that for him being in water offered a release from all his problems with walking. On the other hand he, and several others, discovered that they were unable to swim in a straight line but found they went round in circles.
Several people described problems they had had at supermarket checkouts when their fingers just wouldn’t do what they told them to do. In this situation things were made worse because any stress or pressure seemed to increase the clumsiness.
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Tremor may occur at the same time as the sense that your arm is no longer obeying your instructions as described above, or it may occur alone.
Tremor is usually what is known as resting tremor but it may only come on during activity such as reaching out for something. Tremor disappears during sleep. Rex noticed his tremor during the night - it came on each time he moved and lasted for a few minutes. Keith’s tremor can sometimes be so vigorous that it shakes his whole body.
Elaine’s tremor occurred at rest, and since it meant that the muscles were repeatedly contracting and relaxing this was both exhausting and painful. It stopped when she deliberately moved her arm. Other people could deal with their tremor by sitting on their hands, or lying on them when they were in bed. Stephen used to have to sit on his hands to keep them still. Geraldine would shove her hands into her pockets or sit on them or hang on to the straps of her rucksack. Tom found that if he pressed on a computer key more than once he would end up not able to stop pressing until he used his other hand to pull his finger off the keyboard. Ann holds a conker in her pocket while out walking which helps to ease the tenseness and ache she has in her hand.

Some people joked that they could make use of their tremor; David said he could when stirring his tea, both Tom and Wendy said they didn’t need an electric toothbrush as the tremor did that for them.
In most cases Parkinson’s medications work very well for tremor so that it stopped being a problem once treatment was started. Usually, after some time, the tremor would return and the dose of medication had to be increased to control them. Some people however had had less success in getting their tremor controlled. Many noticed that the tremor was worse when they felt stressed.
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Each person with Parkinson’s disease has a slightly differently experience of how movement is affected. Humphrey found that he couldn’t cope with the fine finger movements on the saxophone, but that when he was keeping the beat on the bass guitar he would feel increasingly relaxed and competent, ending the session feeling as though he had nothing the matter with him. Typing however had become slow and difficult. He had to buy voice recognition software for his computer so he no longer needed to write or type.
Many people had noticed that their writing had changed. It would become increasingly small. Rachel described how she tried to tell herself to write properly and it just didn’t happen. Philip said that it took him so long to write now that taking down telephone messages was hopeless. Brian had noticed early on that he could not form a satisfactory ‘w’. Since Brian’s problems with movement are confined to one side he found himself questioning why Parkinson’s symptoms often affect only one side. Unfortunately there seem to be no helpful answers to this question.

Last reviewed May 2017.
last updated May 2017.



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