My head keeps shaking. Could it be Parkinson’s disease?

“My head keeps shaking even when I’m sitting still.”

“I hadn’t really noticed, but people around me said my head was shaking.”

“Could it be something like Parkinson’s disease?”

Repeated, involuntary shaking of the head is commonly called head tremor, or chaemeori in Korean.

When their head starts shaking, many people first worry about Parkinson’s disease.

However, head shaking alone does not mean that someone has Parkinson’s disease.

Head tremor can occur with essential tremor, or it may be associated with cervical dystonia, in which the muscles around the neck become abnormally tense.

During a consultation, we therefore look not only at how much the head shakes, but also at whether other parts of the body tremble, the posture and movement of the neck, and when symptoms become worse.

Essential tremor can also affect the head

When people hear “essential tremor,” they often think first of shaking hands.

However, essential tremor can affect the head or voice as well as the hands.

It is also helpful to check whether the hands shake when holding a cup or writing, and whether family members have a similar tremor.

The head may shake from side to side or up and down.

Still, not every head tremor is essential tremor.

In particular, if head tremor is accompanied by changes in neck posture or movement, the neck also needs to be assessed.

Does your neck turn to one side or feel very stiff?

When we see people with head tremor, we sometimes hear comments like these.

“One side of my neck always feels tight.”

“My head seems to keep turning to one side.”

“One shoulder is much tighter than the other.”

“It seems to shake more when I turn my head in a certain direction.”

In such cases, head tremor associated with cervical dystonia may also be considered.

The head may actually be slightly turned or tilted to one side, and pain or stiffness in the neck and shoulders may occur as well.

During the consultation, we therefore assess

which direction the head shakes,

whether the neck is usually turned or tilted to one side,

whether turning the head to the left or right is restricted,

which side of the neck and shoulders is particularly tense,

and whether pain or stiffness is also present.

In other words, we assess the head tremor and the condition of the neck together.

It may become worse when you are tired or tense

Head tremor does not always have the same intensity.

“It gets worse when I speak in front of people.”

“My head shakes a lot the day after I haven’t slept well.”

“It seems worse when I’m tired or under a lot of stress.”

Some people describe their symptoms this way.

We therefore ask not only when the tremor began, but also about sleep, fatigue, stress, caffeine intake and any medicines currently being taken.

If the shaking gets worse when you are tense, that does not mean it is simply a psychological problem.

An existing tremor may become more noticeable because of fatigue or tension.

Does head tremor mean Parkinson’s disease?

Tremor can occur in Parkinson’s disease.

However, head tremor alone is not a reason to immediately assume Parkinson’s disease.

Instead, in addition to head tremor, we look for

• Shaking of one hand while at rest
• Movements that have become noticeably slower than before
• Stiffness in the body, arms or legs
• Reduced swinging of one arm when walking
• Changes in the way you walk

and assess whether these changes occur together.

If these symptoms are also present, the possibility of Parkinson’s disease or another neurological condition needs to be assessed.

Conversely, if only the head trembles, other possibilities, including essential tremor and tremor associated with cervical dystonia, should also be considered.

How is it treated?

Not everyone with head tremor receives the same treatment.

We consider whether the pattern resembles essential tremor,

whether there is also tension in the neck and shoulders or a change in posture,

and whether symptoms vary greatly with lack of sleep, fatigue or tension before deciding on the treatment approach.

If it is essential tremor

Research into Korean medicine treatments, including acupuncture, for essential tremor is ongoing.

Studies that bring together the findings of several clinical trials have also reported positive results, with a reduction in tremor severity after acupuncture.

In Korea, reports have also described improvement after herbal medicine treatment or a combination of acupuncture and herbal medicine in people with essential tremor.

Although further research is needed, positive research findings and treatment reports continue to accumulate, so acupuncture or herbal medicine may be considered according to the patient’s condition.

In clinical practice, we assess not only the tremor itself but also sleep, fatigue, tension and other accompanying symptoms when choosing a treatment.

If neck tension or abnormal posture is also present

If the head trembles while turning or tilting to one side, with marked tension in the neck and shoulders, we assess the neck as well.

Acupuncture, pharmacopuncture and cupping may be used for tense neck and shoulder muscles.

If turning the neck is difficult, or movement around the neck, thoracic spine and shoulders is also restricted, Chuna manual therapy may be used alongside other treatment, depending on the condition.

In Korea, case reports have described improvements in neck movement and posture, pain and difficulties with daily activities after a combination of acupuncture, moxibustion, Chuna and herbal medicine in patients with cervical dystonia.

There are also Korean case reports of reduced tremor after acupuncture and manual therapy in patients whose main symptom was head tremor.

More research is still needed in this area. However, in view of these positive treatment reports, excessive neck tension or abnormal posture accompanying head tremor may also be addressed as part of treatment.

Not all head tremors are the same

Although the head may appear to shake in a similar way, the underlying cause can differ from person to person.

Head tremor may occur with essential tremor,

or with abnormal tension in the muscles around the neck,

and in some cases other neurological symptoms need to be assessed as well.

So, rather than deciding on a diagnosis simply because the head is shaking, it is helpful to review

• When the shaking began
• Whether the hands or voice also tremble
• The posture and movement of the neck
• Whether there is tension or pain in the neck or shoulders
• Whether other changes in movement are present

step by step.

If head tremor persists for a long time, even meeting other people can become a source of worry, and it may cause considerable stress in daily life.

Rather than dismissing it as “just getting older,” it may be helpful to have the type of tremor properly assessed and begin treatment suited to your condition.