Tremors and Spinal Cord Compression

Tremors are extremely rare, but they can result from spinal compression and not necessarily a brain condition like Parkinson’s disease. Tremors are abnormal, involuntary body movements with various causes, most of which are connected to the brain and not the spine. A study reports that more than 75% of individuals with Parkinson’s experienced a resting tremor, and about 60% experience tremors while moving. Sometimes the spine is the contributor caused by compression of the spinal cord.

Spinal Compression Study

A 90-year-old man was hospitalized after having tremors, with Parkinson’s being the initial diagnosis. The tremors progressed to the point where the man could not feed himself or walk without support. The case became the focus of a medical report published by physicians in the Department of Orthopaedic Surgery, Division of the Spine, Singapore Tan Tock Seng Hospital. Along with the tremors, symptoms progressed to:

• Difficulty with fine motor skills like buttoning a shirt.
• However, it was ruled out because the patient was not presenting with other Parkinson’s symptoms.
• What was found from the symptoms was cervical spondylotic myelopathy, which is a spinal cord compression in the neck.
• The compression was caused by a herniated disc impinging the spinal canal and compressing the spinal cord causing spinal stenosis.
• The compression was resolved by having an ACDF surgical procedure.
• An anterior cervical discectomy and fusion or ACDF procedure can help manage the condition.
• An ACDF treats spinal cord compression by removing a degenerative or herniated disc in the neck.

Cervical Myelopathy

Causes of cervical spondylotic myelopathy include:

• Trauma
• Infections
• Inflammatory diseases like rheumatoid arthritis.
• Spinal stenosis

Common symptoms include:

• Balance problems
• Coordination problems
• Tingling in the hands
• Numbness
• Weakness
• Impairment of fine motor skills

Tremors as a symptom are rare.

Cervical Myelopathy vs. Parkinson’s Disease

There are cases where cervical spondylotic myelopathy and Parkinson’s disease symptoms can overlap. Studies have shown difficulties between the two diagnoses, as well as, individuals with Parkinson’s may exhibit symptoms similar to cervical spondylotic myelopathy that can include:

• Weakness
• Lack of coordination
• Bowel dysfunction
• Bladder dysfunction

Treatment Cervical Myelopathy Tremors

For individuals with cervical spondylotic myelopathy tremors, surgery can be used to help the condition. However, with cervical myelopathy, there is often some permanent damage. Individuals have shown that post-surgery and decompression, symptoms still present, maybe not as much, but there will be a need for a symptom management plan.

Prevention

The best way to prevent tremors associated with cervical spondylotic myelopathy is to minimize the strain on the spine that can lead to herniated discs and/or other spinal injuries. The discs in the spine degenerate, dry out and start cracking with age, increasing the risk of rupture. If a tremor develops, contact a doctor, spine specialist, or chiropractor to help diagnose the condition. These doctors can perform physical and neurological tests to determine the cause and treatment options.

Body Composition

Aging Health

Steady weight gain throughout life can lead to adult-onset diabetes. This is partly caused by having more body fat and progressive muscle loss. Loss of skeletal muscle mass is linked to insulin resistance that involves:

• The less muscle is available, the less insulin sensitive the body becomes.
• As insulin sensitivity decreases, the body becomes more resistant, increasing risk factors for type II diabetes.
• This can lead to osteoporosis, where the old bone is reabsorbed more and less new bone is created.

Both men and women can experience decreased muscle mass that can lead to:

• Thinner bones
• Weaker bones
• Increased risk of osteoporosis and severe injury from falls.

To help prevent these issues, it is recommended to:

• Eat sufficient protein throughout the day.
• It is recommended to space out protein intake across meals rather than consuming it all at once. This helps to ensure the proper amount is acquired.
• Monitoring body composition regularly can help minimize muscle mass loss and fat mass gain as the body ages.
• A regular strength training routine will help strengthen bones muscles and maintain optimal circulation.

References

Heusinkveld, Lauren E et al. “Impact of Tremor on Patients With Early Stage Parkinson’s Disease.” Frontiers in neurology vol. 9 628. 3 Aug. 2018, doi:10.3389/fneur.2018.00628

Jancso, Z et al. “Differences in weight gain in hypertensive and diabetic elderly patients primary care study.” The Journal of nutrition, health & aging vol. 16,6 (2012): 592-6. doi:10.1007/s12603-011-0360-6

Srikanthan, Preethi, and Arun S Karlamangla. “Relative muscle mass is inversely associated with insulin resistance and prediabetes. Findings from the third National Health and Nutrition Examination Survey.” The Journal of clinical endocrinology and metabolism vol. 96,9 (2011): 2898-903. doi:10.1210/jc.2011-0435

Tapia Perez, Jorge Humberto et al. “Treatment of Spinal Myoclonus Due to Degenerative Compression Myelopathy with Cervical Spinal Cord Stimulation: A Report of 2 Cases.” World neurosurgery vol. 136 (2020): 44-48. doi:10.1016/j.wneu.2019.12.170