A tremor is one of the common symptoms of multiple sclerosis (MS). Some people with MS experience vibration sensations without physical movements like a twitching eye or leg. “Before I was diagnosed with MS, I felt like I was sitting on a pager that was under my couch cushions,” one MyMSTeam member shared.
In medical conversations, vibration is often referred to as internal tremor or IT. Scientists define internal tremor as feelings of tremors, shaking, or vibrations in the body that are not caused by actual movements.
The vibrating sensation people with MS feel generally isn’t painful, but it can be annoying or confusing. “It's like throbbing vibrations,” one MyMSTeam member described. “It's not too bad, but I could really do without it.”
You may feel the vibrating sensation in different parts of your body, although people with MS usually have tremors in their feet and legs. “I feel it a lot at night or when I'm lying around for a while,” one MyMSTeam member explained. “I can feel the lower half of my body vibrating like I'm lying on a vibrating bed.”
Other members experience their internal tremor as a “slapping” sensation inside the chest, abdomen, back, or limbs. “I had a constant slapping feeling that started in my hands and feet that eventually moved to my lower legs and arms,” one member wrote. “I have those symptoms too, especially in my lower back area,” another said.
A 2015 study of people with several chronic conditions found that over a third of respondents with MS (36 percent) experienced internal tremor — a significantly higher rate than the 6 percent rate found in the general population. The vast majority of respondents (88 percent) said the internal tremor began a year or more after their other symptoms began.
The frequency of internal tremor can vary between people. For example, almost 32 percent of respondents in the above study said that they felt the vibrating sensation once per day, while 29 percent said it occurred two to three times per week, and 39 percent experienced it four to seven times a week.
MS is an autoimmune disease that occurs when the immune system attacks the myelin in the central nervous system, which includes the brain and spinal cord, causing damaged areas (lesions). Once a person with MS develops lesions in the areas that control movement, they may start experiencing dysfunctions such as tremor, speech problems, and eye twitches.
More work is needed to clarify how and why people with multiple sclerosis experience internal tremors. That said, doctors believe internal tremors may have the same root cause as visible tremor: damage to the parts of the brain that control movement (the cerebellum and thalamus) and to the nerve fibers within the spinal cord. Research also indicates that people who experience visible tremor (between 25 percent and 58 percent of MS cases) are significantly more likely to feel a vibrating sensation.
It’s important to note that vibrating sensations are also seen in other chronic health conditions, including Parkinson’s disease and essential tremor disorder. If you experience any unusual sensations, talk to your health care provider or a neurologist. They will be able to identify the cause of these sensations and work with you to find the best way of managing them. To figure out which condition is causing internal tremor, doctors might review your other symptoms.
In MS, these symptoms generally include motor and sensory symptoms, such as:
Vibrating sensations can be distracting and annoying, but they may not necessarily be painful. You may not need any immediate relief from internal tremors. However, the symptom may indicate damage to your central nervous system and should be taken seriously. If you’re experiencing vibrating, prickling, or tingling sensations (also called paresthesia) that align with the neurological symptoms of MS, you may want to ask your doctor or neurology expert for medical advice.
One study found that participants with MS and internal tremor reported significantly higher anxiety levels than those with MS without internal tremor. As one MyMSTeam member shared of this sensation, “I get it at night … usually at the end of the day, when I've done way too much.”
Stress is also a frequent cause of MS pseudo-exacerbations (a temporary period of worsening symptoms). These pseudo-exacerbations can look and feel like relapsing. However, they aren’t generally associated with an increase in disease activity, inflammation, or nerve damage. Instead, these exacerbations briefly worsen MS symptoms after periods of stress, illness, or excessive heat.
Managing stress through techniques such as yoga, exercise, medication, or therapy is an important part of keeping MS symptoms under control.
Currently, there are no medications approved by the U.S. Food and Drug Administration to manage MS tremor, though some drugs have been found to have a positive side effect on the symptom. For example, hydroxyzine (Atarax) may help alleviate stress-exacerbated tremor, while clonazepam (Klonopin) can lessen anxiety as a risk factor.
Other treatment options for tremor include physical therapy, neurosurgery, and electrode implants. However, these approaches may be too extreme for someone with MS who is only experiencing a vibrating sensation. Talk to your health care provider about what you can do to safely manage your symptoms, slow the progression of your MS, and improve your quality of life.
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