For those who have already developed tremors, treatment may include the following.
Occupational or physical therapy: These treatments can help manage tremors that interfere with daily life. Therapy may include the use of braces, weighted devices, wrist rests, and exercises to increase control and balance, Serra says.
Deep brain stimulation: Often used as a therapy to treat Parkinson’s disease, it may also be helpful for cases of severe MS tremors. Electrodes are implanted in the brain, Serra explains, to block involuntary muscle movement. A study on the long-term effects of deep brain stimulation reported that 64 percent of the participants with MS saw an improvement in their tremors three months after surgery. And a review found that MS-related tremors improved after deep brain stimulation.
“Deep brain stimulation shows promise, but the improvements are not always dramatic enough to justify the risks,” Serra says. Those include infection and bleeding in the brain. But deep brain stimulation is not widely available and not especially common for MS.
Botox: Approved to treat MS-related spasticity in the upper and lower limbs, as well as overactive bladder, this treatment may also help MS-related limb tremors. In one study, participants with MS showed improvement in handwriting tremors and overall tremor severity after Botox shots. And a review found that Botox significantly reduced the severity of tremors in the hands after 6 weeks of treatment, especially when used alongside electromyography, which measures the health of muscles and motor neurons (the nerve cells that control muscles). The review authors noted that there was strong evidence supporting the use of Botox for MS tremors, and that the main side effect, hand muscle weakness, was tolerable.
When injected into a muscle, Botox blocks nerve signals that cause tightening and movements of the muscle. Its effects last approximately 3 months, according to the review.
Focused ultrasound: There is some evidence that this treatment, which involves using targeted sound waves to treat areas in the brain, may be safe and effective for certain MS tremors. It’s a promising treatment but not yet common.
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