Musculoskeletal system

Leg shaking or leg tremors: 7 Types, 7 Causes, Diagnosis, and 5 Treatments

Sometimes, when you are standing still talking to friends, suddenly, your legs start trembling.  They may shake and oscillate to and fro without any voluntary effort on your side!

Are you surprised, afraid or embarrassed?  Yes, all the three occur at the same time.

“Why are my legs shaking”, you wonder.  Leg shaking or Leg tremors are involuntary movements that are caused due to many reasons.  It occurs to even healthy people and is not a cause for concern, always!

4 common symptoms of Leg Shaking and tremors:

leg shaking
Leg shaking
Image source: livestrong.com

You would sometimes have experienced the following symptoms along with Leg shaking:

  • Stiff and aching muscles, especially in the leg
  • Movement becomes limited
  • You are unable to move fast when you want to
  • Balancing is hard, and you might fall down

What does it mean when your legs shake?

To answer your question let us first understand the different kind of Leg shaking or Tremors that occur in individuals:

1.Dystonic Tremors:

People suffering from dystonia face Dystonic leg tremors.  You can get relief using medicines and sometimes touch the affected leg.

The leg shaking, in this case, is jerky and not rhythmic like other types of tremors.

Dystonic tremor resembles Resting tremor experienced in Parkinson disease

2. Parkinson Tremors:

More than 70% of Parkinson patients experience tremors.  This usually occurs in the starting stages of the disease.  Parkinson tremor is further divided into

A. Action tremor:

Very few patients with this disease experience this Action tremor.  It happens when you are moving or exercising.

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B. Resting Tremor:

Resting tremor occurs when the patient is lying down, or his muscles are in relaxed position.

3. Essential Tremor:

This sort of tremor is the most common tremor which usually affects hands.  Sometimes it has its effect on body parts like head, legs, tongue and trunk. It is mild and benign but sometimes can be severe.

Research is being done to ascertain if the essential tremor is a result of minor degeneration of specific brain areas

4. Psychogenic tremor:

This tremor is experienced suddenly in any part of your body including your legs.  This occurs due to a psychiatric disorder, Post-traumatic stress disorder or Depression.

It appears suddenly and can disappear when the affected person is distracted

5. Physiologic Tremor:

This tremor occurs when you are tired, feel angry or hyper emotional or have low blood sugar.  It also happens when you have alcohol or coffee withdrawal symptoms. They are harmless and go away when you come back to normal.

You might have undoubtedly experienced it during a heated argument with your spouse!

6. Cerebellar Tremor/Intention Tremors:

This type of tremor can happen in any part of your body.  Legs shaking uncontrollably can also be attributed to cerebellar Tremor or Intention tremor.  It is the most visible type of Leg shaking or leg tremor

This is caused due to a stroke, increased alcohol or drug intake or due to withdrawal symptoms.

Intentional tremors drastically increase just as you reach the target you want to get close to.

7. Orthostatic Tremors:

This tremor is the most difficult one to diagnose.  If one is affected by this tremor, he is unsteady while standing.  You will always feel like moving away or sitting as standing still becomes highly difficult.

Shaking, in this case, is very fast and not visible to your eyes.  It can be only felt by the doctor using a stethoscope on your calf muscles or thighs.

7 Causes of leg shaking:

1.Brain injury and Nervous system disorders:

Tremor is caused by damage in part of one’s brain that controls legs and other muscular parts of the body. Some conditions and diseases are

a. Stroke:

Just like heart attack, Stroke is a brain attack.  Leg shaking is one of the symptoms, and it is a medical emergency.

b. Traumatic brain injury:

This may be caused due to head injuries or birth trauma.  Leg tremors are again a symptom highlighting this dangerous problem.

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c. Multiple Sclerosis:

This health problem is caused by loss of myelin, a substance that protects nerve endings.  This causes various health issues that include trembling legs.

d. Nervous system disease like Parkinson Disease:

One of the symptoms of Parkinson disease is tremor or shaking. It occurs when you are awake, standing still or sitting.  Once you move that part, the shaking stops.

e. Damages to brainstem or cerebellum
2. Age factor:

Leg shaking is seen more in middle-aged and older citizens of both genders.

3. Thyroid gland problems:

Thyroid gland produced the thyroid hormone.  Excess production of this hormone due to for example high levels of Iodine intake can result in increased energy production.  This causes handshaking and shaking feet.

4. Liver failure:

The liver has the responsibility of removing toxins from the blood.  When this does not happen, the brain does not function properly.  The nervous system fails, and you can notice legs shaking uncontrollably.

5. Certain medications:

“Why are my legs shaking”? You ask. Another cause is prescribed drugs. Antidepressants, Asthma drugs, antipsychotics, anti-seizure drugs and anticonvulsants are some drugs that cause leg shaking.

Specific movements and actions can cause tremors if you are taking the above drugs.

They sometimes aggravate the tremors experienced due to diseases like Parkinson’s.

6. Hereditary causes:

Some Essential Tremors are called Familial Tremors.  Familial tremor occurs due to a genetic mutation.  It is passed from generation to generation.  But not all essential tremors are hereditary.

7. Indirect causes:
  • Intake of excess Alcohol or caffeine and withdrawal symptoms experienced after stopping it an answer to Leg shaking.
  • Sometimes overstress, and fatigue can make you go weak on your legs.

Why do I shake my leg after surgery?

Trembling legs is a common phenomenon after a surgery.  This is an after effect of anaesthesia.

Some believe the body shakes to increase body temperature and adjust to surroundings after surgery.

4 Diagnosis methods to analyse Leg shaking episodes:

1. Physical examination:

Doctors will diagnose your tremor through physical and neurological examination.  They will also check your medical history.

Physical examination can find out if the tremor is caused

  • During rest or action
  • Origin of tremor
  • Frequency and severity of tremor

The neurological examination will check for

  • Your balancing capabilities
  • Speech problems
  • Muscle stiffness levels
2. Tests:

If they are not satisfied, they will suggest few tests like

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a. Blood test  and Urine test:
  • To check if you have metabolic ailments like thyroid gland problem
  • To check alcohol abuse
  • Drug interference
b. MRI Scan and CT Scan:

These scans provide images of the brain, and your doctor will check if there is any damage to the brain.

3. EMG:

Electromyogram is taken to check unusual muscle electrical activity, nerve damage, carpal tunnel syndrome, and other muscle diseases.

4. Other tests:

Doctors will ask you to do specific activities like walking or writing to check your muscular setup.

5 Treatments methods to combat shaking of legs:

Treatment of Leg shaking or leg termors will be determined by the reason why they occur.

The treatment, especially for essential tremor, is not required.  Doctors advise medicine only when you are not able to perform your daily activities or feel embarrassed in public places.

1. Medication:

Drugs such as Levodopa, dopamine agonists, benzodiazepines are prescribed as the treatment to stop tremors.

  • Sometimes Beta-blocking drug like Propranolol is prescribed.  This drug  blocks neurotransmitter that stimulating leg shaking
  • Primidone controls function of these neurotransmitters.

Of course, these drugs have side effects. Check with the doctor regarding side-effects and take action accordingly.

2. Avoid Triggers:

It is a proved fact that taking excessive alcohol or caffeine can cause leg tremors.   Avoiding these could help you eliminate leg shaking.  Getting overemotional or doing strenuous physical activity should be prevented as much as possible.

3. Physical Therapy:

Doctors advise physical therapy so that there is an improvement in muscle control and coordination.  You can go for the massage.  Meditation helps bring your mind and body under your control

Various physical exercises can be carried out to solve the problem of leg shaking.

4. Surgery in the brain:
  • Deep brain stimulation is a low-risk treatment for severe leg shaking syndrome.
  • Focused ultrasound creations a small lesion in the area of the brain that causes tremors
  • Thalamotomy is one of the surgical options for treating leg shaking.  This treatment is rarely performed due to various side effects.
5. Lifestyle treatment option:

Like every disease or health ailment, one of the best treatments is change in lifestyle.

a. Avoiding excessive tremor-inducing substances:

Most types of tremor are induced by excessive intake of alcohol and caffeine. Preventing or reducing consumption can go a long way in solving the difficult leg shaking problem.

b. Physical therapy:

Taking help of a physical therapist is a great idea.  He can help you improve muscle movement and functioning.  He can make muscle strength inducing exercises.

Some therapists can ask you to take help of adaptive equipment to combat tremors.  Occupational therapists can help you work around your daily activities generally in spite of episodes of leg shaking and tremor.

Conclusion:

Legs shaking episodes or leg tremors are caused due to various reasons.  Some are harmless, and you can ignore them.  Others need doctor’s attention at the earliest.

Doctors suggest Medicine, therapy or surgery depending on the intensity and regularity of these tremors.

So, do not get embarrassed; this field has been well researched, and help is readily accessible.

Reference articles:
  1. https://www.webmd.com/parkinsons-disease/tc/parkinsons-disease-symptoms#1
  2. https://www.medicinenet.com/tremor/article.htm#what_is_tremor
  3. https://www.healthline.com/symptom/tremor
  4. https://www.ncbi.nlm.nih.gov/pubmed/21496602
  5. https://www.news-medical.net/health/Overactive-Thyroid-and-Tremors.aspx
  6. https://medlineplus.gov/ency/article/000302.htm
  7. https://rarediseases.info.nih.gov/diseases/5910/essential-tremor
  8. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Tremor-Fact-Sheet

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