Intention tremors

[cyborg ninja pirate jesus]

I have a client whose arms begin to shake involuntarily every time he attempts to use dexterity. For example signing his name. It is similar to the beginning seforum.xxxes of parkinsons. His MD has ruled out parkinsons. But the signs are the same. Has anyone encountered a client with this problem? How did you treat it? I have been using an extremity rocking technique I use to work on clients with cerebral palsy along with stretching and stripping. But he doesn't seem to be getting any better. The chiro I work with believes it is a type of anxiety disorder, since the tremors cease when he focuses on contracting an unrelated muscle. If anyone has any techniques or suggestions please share.

 

[Lie Ryan]

Intention tremors

I don't think that the chiro is qualified to make a diagnosis of an anxiety disorder.

Without knowing the cause or underlying conditions that are are contributing then there is no way that you can really "treat" this directly.
I see no reason to expect that massage would improve the condition.
There are many benefits to massage that may indirectly benefit client's overall health.

BTW -The tremors isn't what he came in for is it?

I would treat whatever the client's main complaint is FIRST.

Then would use some Cranio-Sacral techniques and see what comes up. CST is helpful in improving many physical and neurological conditions and certainly would not hurt.

But I would never focus on an issue that the client did not ask specifically to be addressed.

 

[Patel]

Intention tremors

This is the kind of thing we are woefully unequipped to evaluate. There is a good chance that this client has some form of neurological condition, and the sooner diagnosed, the better chance he has of being able to manage it. Refer him to see a neurologist ASAP. He can continue receiving massage, but it's clear that the work you are doing isn't having an impact on that particular issue so don't treat "it", treat HIM.

 

[Warren]

Intention tremors

I don't think that the chiro is qualified to make a diagnosis of an anxiety disorder.

I must respectfully point out the fact that that is NOT true. I apologize if the following sounds a little indignant, but after the 8 years of schooling I went through and the toll it took on my body, mind, soul, and family, this does bear explanation.

This link should help... http://www.drgrisanti.com/mddc.htm

A DC is still a Doctor, which means that we CAN diagnose and treat conditions. Which conditions those are depends on the state and its laws on practice scope. I am a DC in TX and if I DON'T diagnose a condition (diabetes, high blood pressure, anxiety, depression, cancer, etc) we're responsible, and subject to liability. This is because our schooling specifically educates us on how to do physical exams, orthopedic and neurological exams, some psychological evaluations, lab testing, diagnostic imaging, etc. We are indeed portal-of-entry Primary Healthcare Providers.

I MUST diagnose the anxiety. It's my a$$ if I don't. I can't claim to "treat" it because I don't do psychiatric drugs. I MUST recommend psychological counseling. I may (and do) elect to address the underlying physiology that may be creating/contributing to their anxiety. I order routine blood testing and some specialty saliva testing and start with the fundamentals and work my way through adrenal and neurotransmitter balancing. Yes, it can be more effective than the anxiety drugs they'll be prescribed, because I work WITH the body's physiology. Even though I am a DC.

 

[infamous g]

Intention tremors

Sorry for the thread hijack. Back to the original dilemma...

Intention tremors are typically cerebellar in nature. This can be due to MS or stroke, but can also be ischemia, neuroma, cerebellar autoantibodies, etc etc. Anybody who presents with cerebellar issues and anxiety I also have to rule out gliadin hypersensitivity, as this can induce the genetically predisposed to make antibodies to their own cerebellum over time. It's a long shot but it's worth it, considering current research estimates that 81% carry the genetic predisposition.

I agree with Jason; neurologist ASAP. Focus on what we do best as MTs: be present, therapeutic, and supportive.

 

[carogator28]

Intention tremors

I stand by my statement and believe it is factually accurate in this instance -

This patient could have been referred to a Neurologist (which I am hoping he is already seeing).
OP gave no indication that any tests were done of a neurological nature.
IF DC could not make a diagnosis of any disorder by performing the myriad of tests available (neurological) then patient could have been referred to a psychiatrist.
In addition the MT has no advanced psychiatric medical training and the DC was pushing the line a bit by making this comment to the MT, as it was not pertinent to treatment. If the Dr. and patient had a private conversation about this then it should have stayed private.
FWIW
We have ALL been at the receiving end of doctor's saying it's all in the patient's head when they are unable to diagnose a condition.
I don't even have to ask for a show of hands of people even here that have fibromyalgia and have gone years with this kind of attitude (anxiety, depression, etc).
Just because there is no diagnosis does not mean that there's nothing going on physically.

 

[Unregistered]

They are called intion tremors or action tremors.