Have you ever felt like your legs were going numb, shaking, or losing your balance when you stood up, especially after standing for a long time? But if, surprisingly, this discomfort subsides when you sit down or walk, you may have a condition called ``Orthostatic Tremor''. This may be a strange word to hear, but let's talk about it simply.
What is `(Orthostatic Tremor)`? To put it very simply...
Simply put, Orthostatic Tremor is a rare nervous system disorder that causes the muscles in your legs to contract rapidly (shake) when you stand. This tremor can make you feel unsteady when you stand, lose your balance, and feel like you're about to fall. But surprisingly, this tremor usually lessens or disappears completely when you walk, sit, or lean on something.
This condition is most common in people over the age of 60. However, research has shown that it can affect anyone from 13 to 85 years old. Just think, doctors first discovered and described this condition called ``Orthostatic Tremor'' in 1984. So that means it's a relatively new condition. Doctors are still learning a lot about it.
What are the symptoms of this? How do you feel?
The main symptom that people with `(Orthostatic Tremor)` most often report is an unsteadiness that they feel when standing. That is, a feeling that the ground is shaking, or that their body is off balance. However, they do not feel this discomfort when sitting or walking. If they sit up from a standing position, start walking, lean against something like a wall, or lie down, this shaking, that unsteadiness, is greatly reduced or disappears completely.
To reduce this instability, you may unconsciously try to keep your legs slightly apart, as if you were touching the ground with your toes . Think of it like you're standing on a bus or train and struggling to keep your balance.
Most of the time, you may not notice or even realize that your legs are shaking rapidly when you are standing. You may just feel the unsteadiness or loss of balance that I mentioned. However, if you place your hands on your thighs or buttocks, you may feel the muscles contracting rapidly, like waves . This shaking is usually painless. However, over time, pain in the leg muscles can develop.
Some people with ``Primary Orthostatic Tremor'' (we'll talk about this later) may also experience tremors in their arms or trunk in addition to their legs. However, they may not experience any other neurological symptoms.
The severity of ``Orthostatic Tremor'' can vary from person to person. Some people may start shaking as soon as they stand up. For others, the shaking may start after a few minutes of standing. For many people, the shaking gradually increases over time.
Why does this `(Orthostatic Tremor)` occur? What are the causes?
In fact, doctors and researchers are still studying ``Orthostatic Tremor'', so the exact cause is not yet known. Some experts believe that it is a variant of another type of tremor called ``Essential Tremor''. Others believe that ``Orthostatic Tremor'' is a completely different, independent condition.
Most of the time, this condition occurs randomly, without any particular cause. However, there have been rare reports of it occurring in family members. For example, in twins, siblings, or a parent and child. So, researchers are looking into whether genetic factors, such as mutations, play a role.
Are there types of `(Orthostatic Tremor)`?
Yes, doctors usually divide `(Orthostatic Tremor)` into two main types:
1. Primary Orthostatic Tremor: This is also called idiopathic. This means that the exact cause is unknown. People with primary orthostatic tremor do not experience symptoms of any other nervous system disease.
2. Secondary Orthostatic Tremor: This is caused by another medical condition. Studies have shown that secondary orthostatic tremor can be caused by a variety of medical conditions. Some of these conditions include:
- Graves' disease (a disease of the thyroid gland)
- Head trauma
- `Multiple Sclerosis (MS)` (a disease that affects the nervous system)
- `Parkinsonism` (a condition that causes symptoms similar to Parkinson's disease)
- Restless Legs Syndrome (a condition that causes restlessness in the legs)
- Damage to certain parts of the brain (e.g., Pontine and midbrain lesions)
- Spinal cord lesions
- `Stiff person syndrome`
- Vitamin B12 deficiency
The most important thing is to seek medical advice if you have these symptoms. Do not self-diagnose.
How do you diagnose this exactly? (Diagnosis)
To diagnose orthostatic tremor, your doctor will first ask you about your symptoms and medical history. Then, they will perform a physical exam and a neurological exam to assess how and when the tremor occurs.
In some specialized centers, a test called `Surface EMG (Electromyography)` is performed to confirm the diagnosis of `(Orthostatic Tremor)`. However, sometimes `(Movement Disorders Specialists)` also identify it based on clinical signs. An `(EMG)` test assesses the health and function of your skeletal muscles and the nerves that control them. Specifically, it involves attaching small `(Sensors)` to the surface of the skin of your leg and measuring the electrical activity of the muscles.
Your doctor may also recommend other tests – such as blood tests and imaging tests (e.g., MRI scan) – to rule out other conditions that could be causing your tremors.
Unfortunately, because Orthostatic Tremor is such a rare condition, doctors sometimes misdiagnose it as something else. In particular, it is often confused with Functional Tremor (also called Psychogenic Tremor), a movement disorder that can be caused by things like stress. So, getting an accurate diagnosis can be a bit challenging.
What are the treatments? Can it be cured?
There is no cure for Orthostatic Tremor. However, there are some medications that can help control your symptoms, that is, reduce the shaking and unsteadiness.
The first medication often prescribed is `Clonazepam` (a drug in the `(Benzodiazepine)` class). However, this medication does not work for everyone. Therefore, there are other alternative medications:
- `Gabapentin`
- `Primidone`
- `Propranolol`
- `Pregabalin`
- `Phenobarbital`
Treatments that help with other types of tremor may also help with symptoms of ``Orthostatic Tremor''. However, this is still in the research stage. Such treatments include:
- Deep Brain Stimulation (DBS)
- Spinal Cord Stimulation
Because researchers are still actively studying Orthostatic Tremor, you may be eligible to participate in a clinical trial. Ask your doctor if this is an option for you.
How do you live with this situation? What can you expect?
Orthostatic Tremor is mainly a problem when standing, but it can affect your quality of life. For example, you may start to avoid situations where you have to stand, such as taking a shower, waiting in line, doing housework, or cooking. This can be really annoying.
However, making some changes to your daily routine can make living with this condition a little easier. For example, using a shower seat in the bathroom or a wheelchair when you have to wait in line. An occupational therapist can help you find ways to do your daily activities more easily.
Because this is a very rare condition, it can sometimes be difficult for others to understand this `(Orthostatic Tremor)`, as well as for doctors to accurately diagnose it. Therefore, it is very important to get the support of your loved ones. If you are experiencing mental health problems such as `(Orthostatic Tremor)`, `(Anxiety)`, or if you feel like you are being isolated from society, do not hesitate to see a mental health counselor such as a `(Psychologist)`. That will give you a lot of relief.
Is there a way to prevent this?
Unfortunately, since the exact cause of Orthostatic Tremor is unknown, there is nothing you can do to prevent it.
It is only when it becomes difficult that we realize how valuable it is to be able to stand steadily and without any discomfort. Since Orthostatic Tremor is a rare condition, the journey to an accurate diagnosis can be a long one. You may have to speak up for yourself and seek information. However, getting an accurate diagnosis is worth the effort. Remember, some medications and mobility aids can make living with Orthostatic Tremor easier.
Finally, things to remember
Well, I hope you now have some idea about the ``Orthostatic Tremor'' we were talking about.
This is a somewhat complex and rare condition, but with the right understanding and support, it can be successfully lived with.
A few things to remember are:
- If you feel your legs shaking or you feel like you're losing your balance while standing, don't ignore it. See a doctor.
- Only a doctor can say for sure if this is mild ``Orthostatic Tremor''.
- Treatment can control symptoms.
- You are not alone. Get help from family, friends, and, if necessary, mental health professionals.
If you have any further questions about this, don't hesitate to talk to your doctor. He/she can explain this to you better.
` orthostatic tremor, tremor, leg tremor, difficulty standing, loss of balance, neurological disorders, movement disorders
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