Living with chronic conditions like fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) can be a daily challenge, as individuals navigate a range of symptoms that affect their quality of life. Among these symptoms, internal tremors stand out as a unique and often misunderstood experience. In this post, we'll delve into what internal tremors are, why they occur, and how individuals can manage them.
What are Internal Tremors?
Internal tremors are sensations of shaking or trembling inside the body, typically without any visible or external signs. Unlike visible tremors, such as those seen in Parkinson's disease, internal tremors are felt rather than observed. They can vary in intensity and frequency, sometimes occurring sporadically and at other times persisting for longer periods.
Internal Tremors in Fibromyalgia and ME/CFS
While internal tremors can occur in various conditions, they are particularly prevalent in fibromyalgia and ME/CFS. Individuals with these conditions often describe feeling as though their body is vibrating or trembling from within. These tremors can affect different parts of the body, including the limbs, torso, or even the internal organs.
Causes and Mechanisms
The exact cause of internal tremors in fibromyalgia and ME/CFS remains unclear. However, researchers speculate that they may be related to dysfunction in the nervous system. Abnormalities in how the brain processes sensory information or regulates muscle activity could contribute to the experience of internal tremors. Additionally, factors such as heightened sensitivity to stimuli, stress, and fatigue may exacerbate these tremors.
One study published in the Journal of Rheumatology suggests that abnormalities in the central nervous system, including altered pain processing and sensory perception, may play a role in the development of internal tremors in fibromyalgia (Berglund, et al., 2011).
Understanding Internal Tremors in Fibromyalgia
Nature of Internal Tremors:
Internal tremors are sensations of shaking or vibrating felt inside the body without visible external movement.
They can affect various parts of the body and are often described as a feeling similar to shivering or trembling internally.
Possible Mechanisms:
Central Nervous System Dysregulation: Fibromyalgia is thought to involve abnormalities in the central nervous system (CNS), particularly in how pain signals are processed. This dysregulation might also affect motor control and lead to sensations of tremors.
Autonomic Nervous System (ANS) Dysfunction: The ANS controls involuntary bodily functions and is often dysregulated in fibromyalgia patients. This dysfunction could manifest as internal tremors.
Muscle and Nerve Hyperactivity: There is evidence of increased sensitivity and hyperactivity in the nerves and muscles of fibromyalgia patients, which could contribute to the feeling of internal shaking.
Related Conditions and Symptoms:
Restless Legs Syndrome (RLS): Many fibromyalgia patients also have RLS, which involves uncomfortable sensations in the legs and an uncontrollable urge to move them. This can sometimes be mistaken for or accompany internal tremors.
Anxiety and Stress: High levels of anxiety and stress are common in fibromyalgia and can exacerbate or trigger symptoms like internal tremors.
Diagnosis and Differentiation:
Diagnosing internal tremors in fibromyalgia involves a thorough clinical evaluation to rule out other conditions such as Parkinson's disease, essential tremor, or multiple sclerosis.
There are no specific tests for internal tremors; diagnosis is primarily based on patient history and symptom description.
Managing Internal Tremors
Managing internal tremors often involves a multi-faceted approach aimed at reducing overall symptoms and improving quality of life. Here are some strategies that individuals with fibromyalgia and ME/CFS may find helpful:
Medication:Â Certain medications, such as muscle relaxants or those targeting nerve pain, anticonvulsants (e.g., pregabalin, gabapentin) and antidepressants (e.g., duloxetine, amitriptyline), may help alleviate internal tremors. However, it's essential to work closely with a healthcare provider to determine the most suitable treatment approach.
Lifestyle Modifications:Â Making lifestyle adjustments can help minimize the impact of internal tremors. This may include prioritizing rest and relaxation, maintaining a balanced diet, and avoiding triggers that exacerbate symptoms.
Stress Management:Â Stress can exacerbate symptoms of fibromyalgia and ME/CFS, including internal tremors. Practicing stress-reduction techniques such as mindfulness, deep breathing exercises, or gentle yoga may help alleviate tension and improve overall well-being.
Physical Therapy:Â Engaging in gentle exercise or physical therapy under the guidance of a healthcare professional can help improve muscle strength, flexibility, and coordination. However, it's essential to start slowly and gradually increase activity levels to avoid exacerbating symptoms.
Support Network:Â Building a strong support network of friends, family, and healthcare providers can provide emotional support and practical assistance in managing symptoms.
A Personal Note on Managing Internal Tremors
My internal tremors always worsened with any physical activity. Just moving could intensify the symptoms, and even sneezing would trigger a cascade of electrical buzzing throughout my body. It wasn't just physical activity that exacerbated the tremors. Food and mental stress also played significant roles in making the symptoms worse. This combination made managing the condition incredibly confusing and difficult.
Getting your diet right is a crucial aspect of managing these tremors. Keeping a food diary can help identify specific foods that might trigger your symptoms. Additionally, it's important to manage physical activity carefully to avoid putting strain on your nervous system. Mental stress is another significant trigger, as any form of stress or stimuli can provoke a reaction in an overly sensitive nervous system.
I found that adopting a personalized low-carb diet, combined with carefully managing both physical and mental exertion, helped to calm my system. Additionally, L-Theanine, an amino acid found in green tea known for its calming effects on the nervous system, was particularly beneficial. Over time, this approach allowed me to handle more activity with less intense tremors.
Understanding L-Theanine - Read Post
Conclusion
Internal tremors are a challenging symptom for individuals with fibromyalgia and ME/CFS, impacting their daily functioning and quality of life. While the exact cause of these tremors remains elusive, research suggests they may be related to abnormalities in the central nervous system and heightened sensory perception
References
Bennett, R. M. (1999). Fibromyalgia and the disability dilemma: A new era in understanding a complex, multidimensional pain syndrome. Arthritis & Rheumatism, 42(9), 2000-2010.
Staud, R. (2011). Peripheral and central mechanisms of pain sensitization in chronic pain syndromes. Current Rheumatology Reports, 13(6), 569-575.
Sluka, K. A., & Clauw, D. J. (2016). Neurobiology of fibromyalgia and chronic widespread pain. Neuroscience, 338, 114-129.
Martinez-Lavin, M. (2007). Biology and therapy of fibromyalgia. Stress, the stress response system, and fibromyalgia. Arthritis Research & Therapy, 9(4), 216.
Clauw, D. J. (2014). Fibromyalgia: A clinical review. JAMA, 311(15), 1547-1555.
Wolfe, F., & Walitt, B. (2020). Culture, science and the changing nature of fibromyalgia. Nature Reviews Rheumatology, 16(9), 549-557.
Thieme, K., Turk, D. C., & Flor, H. (2004). Comorbid depression and anxiety in fibromyalgia syndrome: Relationship to somatic and psychosocial variables. Psychosomatic Medicine, 66(6), 837-844.
Arnold, L. M., Clauw, D. J., & McCarberg, B. H. (2011). Improving the recognition and diagnosis of fibromyalgia. Mayo Clinic Proceedings, 86(5), 457-464.
Häuser, W., Wolfe, F., Tölle, T., Uçeyler, N., & Sommer, C. (2012). The role of antidepressants in the management of fibromyalgia syndrome: A systematic review and meta-analysis. CNS Drugs, 26(4), 297-307.
Häuser, W., Petzke, F., Üçeyler, N., & Sommer, C. (2011). Comparative efficacy and harms of duloxetine, milnacipran, and pregabalin in fibromyalgia syndrome. The Journal of Pain, 12(5), 522-529.
Jones, K. D., Adams, D., Winters-Stone, K., Burckhardt, C. S., & Fuld, D. P. (2006). A comprehensive review of 46 exercise treatment studies in fibromyalgia (1988-2005). Health and Quality of Life Outcomes, 4, 67.
Busch, A. J., Barber, K. A., Overend, T. J., Peloso, P. M., & Schachter, C. L. (2007). Exercise for treating fibromyalgia syndrome. Cochrane Database of Systematic Reviews, (4), CD003786.
Bernardy, K., Fuber, N., Klose, P., & Hauser, W. (2010). Efficacy of cognitive-behavioral therapies in fibromyalgia syndrome - A systematic review and metaanalysis of randomized controlled trials. The Journal of Rheumatology, 37(10), 1991-2005.
Wolfe, F., & Rasker, J. J. (2014). The evolution of fibromyalgia – Past, present, and future. Scandinavian Journal of Pain, 5(1), 126-132.
Berglund, B., Harju, E. L., Kosek, E., & Lindblom, U. (2011). Quantitative and qualitative perceptual analysis of cold dysesthesia and hyperalgesia in fibromyalgia. The Journal of Rheumatology, 38(9), 2032–2040
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