A pill rolling tremor is an early symptom of Parkinson’s disease. You will want to consult a doctor, because early diagnosis and treatment can help control your Parkinson’s symptoms and reduce complications.

If you have a pill rolling tremor, it looks like you are trying to roll a pill or another small object between your thumb and index finger. It’s a resting tremor, meaning that it is most likely to happen when your body is relaxed rather than when you’re using your hands.

A pill rolling tremor is one of the most common tremors associated with Parkinson’s disease. It’s usually one of the earliest symptoms.

Tremors are caused by problems in the parts of the brain that control movement, including the cerebellum and basal ganglia.

Some types of tremors can be inherited. Others are caused by factors such as:

  • neurological disorders, such as multiple sclerosis (MS) and stroke
  • excessive caffeine consumption
  • an overactive thyroid
  • liver or kidney failure
  • anxiety, stress, and fatigue

Tremors in general are one of the major symptoms of Parkinson’s disease, occurring in approximately 75% of all cases.

In Parkinson’s disease, nerve cells in a part of the brain called the basal ganglia degenerate and produce less of a neurotransmitter called dopamine. The basal ganglia use dopamine to form connections and communicate between neurons. When there’s less dopamine, there aren’t proper connections and communication.

The basal ganglia are responsible for making sure your body movements are smooth. When there aren’t as many connections in this area of the brain, they can’t do their job as well, leading to tremors and the other movement symptoms of Parkinson’s disease.

The conditions that can cause pill rolling tremors are all serious conditions, so if you have developed a pill rolling tremor, it’s important to see your doctor as soon as possible.

Because a pill rolling tremor is usually caused by Parkinson’s disease, the biggest risk factors for this type of tremor are the same as the risk factors for Parkinson’s.

While the causes of Parkinson’s disease are unknown, risk factors include:

  • Age. The risk of developing Parkinson’s disease usually increases around age 70 or older.
  • Sex. Men are slightly more likely than women to develop Parkinson’s disease.
  • Family history. Several genetic causes of PD exist, including variants of genes such as LRRK2, SNCA, PINK1, and PRKN.
  • Environmental factors. Some studies show that ongoing exposure to certain pesticides and other chemicals can slightly increase your risk of Parkinson’s disease.

In most cases, tremors can’t be cured. However, you can help reduce your tremor symptoms by treating the underlying cause of the tremor.

A pill rolling tremor caused by Parkinson’s disease can be eased with medication for Parkinson’s, such as levodopa.

In some cases of advanced Parkinson’s where other medications haven’t worked, deep brain stimulation can be used. In this treatment, electrodes are placed in the basal ganglia. They send small amounts of electricity into the brain, which helps reduce tremors.

In addition to DBS, focused ultrasound can also be used to treat PD tremors. Focused ultrasound involves sound waves being emitted into the brain. This destroys the specific area in the brain connected to the tremors.

In many cases, stress or other strong emotions can make tremors worse, regardless of the underlying condition. Finding ways to relax, such as focusing on a hobby, attending therapy, or taking up a mindfulness practice, can help reduce your pill rolling tremor.

Regular exercise can also help manage Parkinson’s symptoms. Before starting a new exercise regimen, consult with your primary care provider or physical therapist.

Assistive devices

If your pill rolling tremor interferes with daily activities, such as eating, assistive devices may be able to help. Learn more about utensils for individuals with Parkinson’s disease here.

There isn’t any conclusive, evidence-backed way to prevent Parkinson’s disease or the tremors associated with it. But early diagnosis and treatment of Parkinson’s can help control your symptoms and reduce complications.

Because pill rolling tremor may be an early symptom of Parkinson’s disease, you should see a doctor if you start having this symptom.