Tremor is a neurological symptom that can be physiological, functional, or pathological. Finger tremors are most common, followed by tremors of the eyelids, corners of the mouth, tongue, and less commonly, the head, lower limbs, and trunk. Clinically, common tremors include functional anxiety tremors and pathological types like cerebellar tremors and Parkinson's disease tremors. The former two are most evident during intentional actions (like grasping or eating) and are categorized as “intention tremors.” Intention tremors, accompanied by ataxia and reduced muscle tone, are indicative of cerebellar signs. In contrast, Parkinson's disease tremors occur during rest and are suppressed during voluntary movements, thus classified as “resting tremors.” Besides trembling, Parkinson's disease also presents with increased muscle tone and reduced movement. All types of tremors typically intensify under stress or emotional excitement and disappear during sleep.
Acupuncture treatment primarily stimulates distal central reflex zones in the affected limbs, supplemented by local central reflex zones on the spine and head.
Acupuncture shows efficacy in treating anxiety tremors and cerebellar tremors. Early-stage, short-duration, and mild tremors respond better than late-stage, long-duration, and severe tremors. In tremors caused by anxiety or hyperthyroidism, there is often increased sympathetic nerve activity and adrenaline secretion, which can heighten muscle spindle sensitivity. Thus, the mechanism of acupuncture in treating anxiety tremors may relate to its overall relaxation effect, including reducing sympathetic nerve tension.
The effectiveness of acupuncture in Parkinson's disease varies with clinical type, showing better results in cases with predominant muscle rigidity than those with predominant tremors. If effective, improvements are usually seen in the first treatment course. Massage and acupuncture therapy can alleviate tremors, rigidity, and movement difficulties in Parkinson's disease, regardless of the disease stage. It can also improve balance, circulatory functions, and reduce the need for conventional medication.
The therapeutic effect of acupuncture on muscle rigidity suggests its potential in reducing muscle tension. Thus, acupuncture is hypothesized to delay the progression of Parkinson's disease and is more effective in early-stage patients with mild symptoms.
Moxibustion on the shenzhu point has shown efficacy in treating tremors. Some patients experience immediate reduction in upper limb tremors post-treatment.
However, acupuncture is less effective for tremors accompanied by increased muscle tone in Parkinson's disease. It shows better results in conditions primarily characterized by neuromuscular paralysis or reduced muscle tone, indicating that acupuncture stimulation may have a greater excitatory than inhibitory effect on neuromuscular excitability.
In conclusion, while acupuncture and moxibustion can be beneficial in the management of various tremor types, their effectiveness is contingent on the nature and stage of the condition. Particularly in Parkinson's disease, the treatment may be more suited for symptoms like muscle rigidity rather than tremors per se. As with any therapeutic intervention, patient response to acupuncture can vary, but it should be considered as part of a comprehensive treatment plan.