Disclaimer: The following is based on my personal experience and research I have done on internal tremors, which I've suffered from for many years. I am not a doctor, and the following should not be taken as medical advice. Always consult a healthcare provider for an accurate diagnosis and treatment plan.
Internal tremors are something I’ve personally experienced, and I vividly remember trying to explain the sensation to my doctor—who had no idea what I was describing. No one seemed to understand. It felt like a deep, internal trembling or vibrations, almost like an electrical current buzzing through me or as if I were shaking from within.
They felt even worse at night. I felt so wired that I couldn’t sleep. Even when I did manage to drift off, I would fall into a nightmarish dream state and wake up shaking even more.
The tremors weren’t visible—there was no external movement—but the sensation was very real. What struck me most is that these symptoms, although not universally experienced, appear in different conditions like fibromyalgia, postural orthostatic tachycardia syndrome (POTS), functional neurological disorder (FND), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and more recently, Long COVID. It’s fascinating that individuals with seemingly distinct diagnoses can share this specific symptom, pointing toward a common underlying link.
In this post, we’ll explore why these tremors might occur, the possible connections between conditions, how they manifest, and strategies that may help manage them.
What are Internal Tremors?
Internal tremors are sensations of shaking or trembling inside the body, typically without any visible or external signs. Unlike visible tremors, such as those seen in Parkinson's disease, internal tremors are felt rather than observed. They can vary in intensity and frequency, sometimes occurring sporadically and at other times persisting for longer periods.
Interestingly, research shows that people with Long COVID who experience internal tremors tend to have worse overall health and more symptoms than those without tremors. This suggests tremors might indicate more severe nervous system involvement.
Among participants with long COVID, those who had internal tremors had worse health status and different associated symptoms and comorbidities than others who had long COVID and no internal tremors. The American Journal of Medicine.
A Shared Symptom Across Diagnoses
One of the most fascinating aspects of internal tremors is their presence across various seemingly distinct conditions. Fibromyalgia, ME/CFS, Long COVID, POTS, and functional neurological disorder (FND) have all been associated with this unsettling symptom. While these disorders differ in their primary causes and manifestations, the shared experience of internal tremors suggests a common underlying factor—nervous system dysfunction.
The Nervous System: The Core Link
The emergence of Long COVID has shone a spotlight on internal tremors, encouraging more research into their cause. What’s become clear is that the nervous system—particularly the central and autonomic systems—plays a big role. Here are some possible mechanisms:
Central Nervous System Dysregulation: Abnormalities in pain processing and sensory perception within the CNS can also affect motor control, leading to the sensation of internal tremors. This heightened sensitivity, known as central sensitization, is a hallmark of fibromyalgia and ME/CFS.
Autonomic Nervous System Dysfunction: The ANS, which governs involuntary functions like heart rate, blood pressure, and digestion, can become dysregulated, causing symptoms like internal shaking. Dysautonomia, a malfunction of the ANS, is commonly seen in conditions like fibromyalgia, Long COVID, and POTS. For example, individuals with POTS often experience a rapid heart rate upon standing and other autonomic symptoms, which may include tremors.
Small Fibre Neuropathy: Emerging research indicates that small fibre neuropathy—a condition affecting the nerves responsible for sensory and autonomic functions—might be a contributing factor. Nerve damage from this condition could lead to the sensations of buzzing, vibrating, or shaking that characterize internal tremors.
Recognizing the nervous system as the common thread among these conditions helps us understand how internal tremors may stem from shared mechanisms. It also highlights the potential for treatment approaches that focus on calming and rebalancing the nervous system.
Research Insights and Resources One preprint study published in MedRxiv (2021) explores the experiences of individuals with Long COVID who reported internal tremors and vibration symptoms. This study provides a qualitative analysis of patient accounts from the Survivor Corps Facebook group, detailing symptom onset, triggers, and their impact on daily life.
Descriptions of sensations, such as internal vibrations or tremors without visible movement, highlight the significant physical and emotional toll on patients. Importantly, the study calls for further research into underlying mechanisms and effective treatments.
You can read the full article here: Internal Tremors and Vibration Symptoms Among People with Post-Acute Sequelae of SARS-CoV-2.
Another study identified potential links between internal tremors in Long COVID and dysautonomia, a dysfunction of the autonomic nervous system, as well as small fibre neuropathy. Dysautonomia has also been observed in other chronic conditions, suggesting a common thread of nervous system involvement.
For more details, read about dysautonomia and Long COVID here: Dysautonomia and Long COVID.
Diagnosis and Differentiation
Diagnosing internal tremors involves a thorough clinical evaluation to rule out other conditions such as Parkinson's disease, essential tremor, or multiple sclerosis. There are no specific tests for internal tremors; diagnosis is primarily based on patient history and symptom description.
Managing Internal Tremors
Medications: Certain medications, such as muscle relaxants or those targeting nerve pain, anticonvulsants (e.g., pregabalin, gabapentin), and antidepressants (e.g., duloxetine, amitriptyline), may help alleviate internal tremors. However, it's essential to work closely with a healthcare provider to determine the most suitable treatment approach.
Lifestyle Strategies
While there’s no one-size-fits-all solution, here are some strategies that have helped me and might work for you:
Adjust Your Diet Diet plays a significant role in calming the nervous system. Through a food diary, I discovered certain foods exacerbated my symptoms. Transitioning to a low-carb, ketogenic-style diet stabilized my blood sugar levels, preventing spikes that overstimulate the nervous system. This dietary approach also promotes ketosis, which has neuroprotective effects, reducing inflammation and oxidative stress in the brain.
Support the Gut-Brain Axis The gut and brain communicate bidirectionally through the vagus nerve, meaning gut health directly impacts nervous system regulation. Incorporating probiotics, prebiotics, and anti-inflammatory foods can help calm your system from the inside out.
Be Mindful of Physical and Mental Exertion When your nervous system is hyper-reactive, both physical and mental activities can feel overwhelming. Gradual, controlled physical activity—like gentle stretching, breathing exercises, and mindfulness—can help. Similarly, managing mental exertion is crucial. Tasks that demand sustained focus or decision-making can worsen symptoms, so pacing yourself and scheduling breaks is key. Avoid overexertion, as it may exacerbate symptoms..
Explore Supplements Supplements like L-Theanine, an amino acid found in green tea, can promote relaxation by influencing neurotransmitters like GABA. I found it particularly helpful in reducing the constant buzzing sensation associated with internal tremors.
Manage Stress Stress reduction is crucial. Techniques like mindfulness, slow breathing and yoga can help. Choose meditative practices that involve gentle control of breathing and focus to avoid triggering the sympathetic nervous system.
Create a Calming Environment Your surroundings play a role in nervous system regulation. Reducing noise, minimizing clutter, and maintaining a comfortable temperature can help lower stress levels. Consider incorporating calming sensory inputs, like soft lighting, soothing music, or aromatherapy, to create a relaxing space.
The Bottom Line
I believe internal tremors are deeply rooted in nervous system dysfunction. These sensations are physiological—a response of the nervous system to chronic stress, illness, or trauma.
Whether they stem from fibromyalgia, ME/CFS, Long COVID, POTS, or FND, understanding their mechanisms and adopting a holistic approach can make a significant difference in managing symptoms.
Healing takes time, but with consistent effort and the right strategies, calming your nervous system and finding relief is achievable.
References
Dysautonomia in the Post-COVID Era: Understanding Its Impact on the Autonomic Nervous System. The American Journal of Medicine. Available at: https://www.amjmed.com/article/S0002-9343%2824%2900470-4/pdf
Dysautonomia and Small Fiber Neuropathy in Long COVID. MDPI Open Access Journals. Available at: https://www.mdpi.com/2035-8377/17/1/2
Internal Tremors and Vibration Symptoms Among People with Post-Acute Sequelae of SARS-CoV-2: A Narrative Review of Patient Reports. MedRxiv Preprint. Available at: https://www.medrxiv.org/content/10.1101/2021.12.03.21267146v1.full
Exploring the Pathophysiology of Internal Tremors in Chronic Illnesses. PubMed Central (PMC). Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC10689282/
The Link Between ME/CFS and Post-COVID Syndrome. PopSugar Health. Available at: https://www.popsugar.com/health/mecfs-post-covid-49344168
Comments