Right-hand Tremor when resting

Hello everyone.

For about eight months now, I’ve been dealing with a Tremor in my right arm whenever I bend it—specifically when it's at a right angle, flexed at the bicep. It’s a fast, jittery Tremor, and I find it difficult to hold my arm steady in that position without shaking. It’s most noticeable when I’m typing on my phone or using an ATM. Or, given my profession, when I’m playing the piano in certain positions.

It tends to flare up when I’m anxious, after having coffee, when I’m hungry, or even after physical activity on an empty stomach.

Once I bend my arm, the rapid shaking starts within a second or two. Interestingly, it doesn't happen when I'm holding something heavy; I have no issues with strength or carrying loads.

Looking back, this started around the time I was doing some light dumbbell workouts at home, suddenly stopped taking my B-complex vitamins, and dealt with some intense performance anxiety during a concert where my hand wouldn't stop shaking. I can't tell if any of that triggered this...

I make my living through music, so this is quite an awkward situation to navigate. The Tremor appears in specific bent postures while playing guitar or piano. When it hits, I lose that fluid ease in my playing, especially if I'm already feeling nervous before a gig.

To be honest, it feels like I've had a sense of instability in my right hand for the last five or six years—like I'm making too many mistakes—though I'm not entirely sure myself.

I do struggle occasionally with anxiety and depression stemming from childhood trauma. I've been working on myself quite a bit, so it's generally improving, but it does resurface. My hypochondria is probably my biggest hurdle; the fear of something serious like cancer... As soon as this Tremor appeared, my mind immediately jumped to a brain tumor 🙂 or MS...

A friend also mentioned that lately, my speech seems a bit more slurred than usual. I’ve always been a bit of a mumbler, so I don't know if this is connected to the Tremor or perhaps just recent dental work on my front teeth...

I've lost a significant amount of weight over the last year or two since I started focusing more on sports and a cleaner diet.

Basically, I've seen a neurologist and undergone an EMG on my arm; the results were perfectly normal. My EKG and blood work came back fine as well. The neurologist also ordered an MRI of my head, but I’m stuck waiting a year for an opening at the Rebro...

I’ve consulted several doctors, and nobody seems to have a definitive answer. My neurologist suggested my Tremor is a rare combination of psychological and physical factors, so he prescribed a Valium pill.

I haven't taken them yet. Some doctor friends have warned me that those meds affect so many different systems, and they suggested that if the Tremor is positional, it might not be worth risking pills that act as partial antidepressants and so on...

Others think it might just be a deficiency in B vitamins or magnesium.

Aside from this, I deal with chronic gastritis and a large hiatal hernia. The hernia gave me a hard time recently because I felt like I was choking at the diaphragm and it was putting pressure on my heart. That has settled down now that I've finished a course of antibiotics for a tooth infection.

So, I'm not sure if anyone here has experienced something similar. I'm 31 years old. Apologies for the long post, but I'm running out of people to ask.

Thank you all very much, and have a good day! 🙂

George Thompson63 said:Greetings to everyone.

For about eight months now, I have been dealing with a Tremor in my right arm whenever I bend it—specifically when it’s held at roughly a right angle, flexed at the bicep. The Tremor is rapid and jittery, making it difficult to hold my arm steady in that position. It is most noticeable when I am typing on my phone or withdrawing cash from an ATM. It also crops up when I am playing the piano in certain positions.

It tends to worsen when I am anxious, after consuming coffee, when I am hungry, or perhaps following physical activity on an empty stomach.

Once I bend my arm, the rapid shaking begins within a second or two. Interestingly, it doesn't happen when I'm holding something heavy; I can carry anything without issue and my strength remains perfectly fine.

Looking back, this started around the time I was doing some light dumbbell work at home to build muscle, then abruptly stopped taking my B-complex vitamins, and experienced such intense performance anxiety during a public appearance that my hand actually shook mid-concert. I honestly don't know if any of those factors triggered this...

Music is my livelihood, so this situation is quite awkward for me professionally. The issue manifests in specific bent postures while playing the guitar or piano. When it hits, I lose that effortless flow required for certain pieces, especially if I'm feeling nervous before a gig.

Furthermore, I feel as though I've had a certain lack of precision in my right hand for the last five or six years—as if I'm overcompensating or making too many mistakes—though even I am no longer certain of that.

I do struggle occasionally with anxiety and depression stemming from childhood traumas... though that has been receding over the years as I do a significant amount of self-work, it still resurfaces from time to time. My hypochondria is perhaps my greatest burden; the fear of tumors is constant. Once this Tremor appeared, my mind immediately jumped to a brain tumor🙂 or MS...

A friend has pointed out that lately, my speech seems a bit more slurred than usual. I've always been a bit of a mumbler, so I can't tell if this is linked to the Tremor or if it's just related to recent dental work I had done on my front teeth...

I have lost quite a bit of weight over the last year or two, having transitioned to a more active lifestyle and a healthier diet.

In any case, I saw a neurologist and underwent an EMG on my arm; the results were perfectly normal. My EKG and blood work came back clear as well. My neurologist also ordered an MRI of my head, but I'm stuck waiting a full year for an appointment at the Mayo Clinic...

I've consulted several doctors, and no one seems to have a definitive answer. My neurologist suggests my Tremor is a rare intersection of psychological and physical factors, and he prescribed a Valium pill.

I haven't taken them, however, because some doctor friends of mine have warned me that they affect so many different systems, and if the Tremor is purely postural, it isn't worth risking medication that acts like a partial antidepressant and so on...

Others suggest it might simply be a deficiency in B vitamins or magnesium.

As for other health issues, I deal with chronic gastritis and a significant sliding hiatal hernia, which recently caused trouble because I felt like I was choking at the diaphragm and it was pressing against my heart. That has settled down now that I've finished a course of antibiotics for a tooth infection.

So, I'm not sure if anyone else has experienced this kind of Tremor. I'm 31 years old, and I apologize for the long post, but I simply don't know who else to ask.

Thank you all very much, and have a pleasant day! 🙂

It seems to me that you are dealing with social phobia, specifically a fear of performing in public. This is typically managed with antidepressants and Misar (or Xanax), which one takes an hour before a performance to steady both the Tremor and the stage fright.

redranger2 said:It sounds to me like you’re dealing with social anxiety—specifically a fear of public performance. Usually, that’s managed with antidepressants and either Misar or Xanax, taken about an hour before you go on stage to steady the tremor and quiet the nerves.

Is it possible for that phobia to bleed into everyday life? Personally, I deal with this tremor all day long, regardless of whether I have a gig scheduled. I haven't performed in a month or two, yet my hand still shakes constantly whenever I bend it or even just try to type on my phone. Even today, I went to the grocery store and was carrying heavy bags; now my arm feels weak compared to my left one, which carried the same load. It keeps shaking when I bend it, and it’s making it difficult to play my instrument.

George Thompson63 said:Is it possible for this phobia to have bled into my everyday life? I feel this Tremor all day long, regardless of whether I’m actually performing or not; I haven't had an episode in a month or two, yet the shaking persists whenever I bend my arm or try typing on my phone. Even today, while I was out running errands and carrying heavy grocery bags, I noticed a distinct weakness in that specific arm compared to my left—which carried an equal load—and now it's shaking again when I flex it, making it nearly impossible to play music.

Since you mentioned things worsen during moments of anxiety, I maintain that antidepressants and Misar could be quite beneficial for you. We need to determine if there is a localized disorder affecting your arm specifically, or if it is simply a case where the tremors have become more pronounced and visible during periods of stress. From what I understand, your neurologist gave you a clean bill of health, though you still haven't undergone an MRI.

Once those results come back clear, you should absolutely consult a psychiatrist with your full medical history and begin treatment; it's evident from what you've shared that you struggle with depression, anxiety, and now this performance phobia. Don't let a fear of medication hold you back—these tools exist so we can live functional lives rather than just enduring constant suffering. :-)

George Thompson63, your symptoms are quite unusual. That mention of a one-sided Tremor really stands out; it’s not typical for physiological or psychological tremors, nor is it standard for essential tremor—which usually starts on one side but eventually spreads to the other hand, even if the intensity varies between them. Given your age, you definitely need more testing to rule out things like thyroid issues, Wilson's disease, or metabolic imbalances...

If you don't mind me asking, did you have your evaluation done at Mayo Clinic? They are essentially the gold standard when it comes to involuntary movements, including Tremor. Since your case isn't textbook, it would be wise to see a neurologist who specializes specifically in movement disorders.

Maria Fisher46 said:George Thompson63, your symptoms are quite unusual. That mention of a one-sided Tremor really stands out—it’s not typical for physiological or psychological tremors, nor is it standard for essential tremor, though it can start on one side before eventually spreading to the other hand. Usually, that kind of tremor is bilateral, even if the intensity varies between hands. Given your age, you definitely need more testing to rule out other culprits like thyroid issues, Wilson's disease, or metabolic imbalances...

Tell me, if you don't mind, did you get checked out at Mayo Clinic? They are essentially the gold standard when it comes to involuntary movements, including Tremor. Since your case isn't textbook, it would probably be wise to have a neurologist who specializes specifically in movement disorders take a look.

Thanks for the reply. Yes, I actually saw a neurologist at the Mayo Clinic who examined me and ordered an EMG and EKG, both of which came back normal.

As for my thyroid, I had those hormone levels tested along with a full blood count, or so my doctor told me. Everything there was normal too... Blood sugar is fine, blood pressure is fine...

redranger2 said:You mentioned things get worse when you're feeling anxious, which is why I’m suggesting that antidepressants and Misar might actually help. We need to figure out if this is a specific issue localized to your hand, or if the tremors just become more noticeable when your anxiety spikes. From what I can gather, the neurologist gave you a clean bill of health, though you still haven't had that MRI done.

Once those results come back clear, you should definitely take all your findings to a psychiatrist and start some treatment. You've mentioned struggling with depression, anxiety, and now even a phobia regarding public speaking. Don't be so afraid of medication; they exist to help us live a normal life, not to make us suffer. :-)

The Rivotril instructions say: if you happen to feel suicidal, contact your primary care physician immediately xD

George Thompson63 said:The warnings on the Rivotril label are almost comical; they basically tell you that if you happen to experience suicidal ideation, you should probably reach out to your primary care physician right away. xD

That kind of disclaimer is standard for just about any medication in this class, mostly because the manufacturer
is just trying to insulate themselves from potential lawsuits.

So, I just got my brain MRI results back. Everything looks fine, except for this one part that I can't make head or tail of:

"Displacement of the arachnoid space from the suprasellar to the intrastellar region, indicating insufficiency of the diaphragma sellae."

I'm not sure if this has anything to do with my pituitary gland, or if there's some kind of connection to my postural tremors.

There's also this:

"Slight thickening of the mucosa in the alveolar recess of the right maxillary sinus" and "Bulbous middle turbinates are visible, more pronounced on the left, along with a mild nasal septal deviation."

That's everything. 🙂