It’s easy to take standing steady for granted – until it becomes difficul
Eine skizzierte Person steht auf einem Brett und versucht zu balancieren, was nicht einfach erscheint. Das Logo ist rund und beigen Farbtönen gehalten.

Orthostatic Tremor (OT)

Understanding Orthostatic Tremor

Orthostatic tremor (OT) is a rare neurological movement disorder characterized by rapid muscle contractions at a high frequency (13-18 Hz) in the legs and sometimes the torso when standing.

In fact, the muscle’s activity resembles the sound of a helicopter, a typical sign of Orthostatic Tremor.

People with OT may not see or sense that their legs are having rapid muscle contractions; it may just feel like unsteadiness, or a loss of balance. The tremors typically aren’t painful while they’re happening, but affected individuals may develop leg muscle pain and stiffness over time.

Going from standing to sitting, walking, or leaning against a wall usually stops or greatly reduces the tremors.

What can you do if you suspect that you might have OT?

  • Ask your physician to place a stethoscope just a little to the outside of the thigh or slightly on the outer side of the calf. In case of OT you can hear the helicopter sound.

  • Another way to identify the tremor is with smartphone apps using the accelerometer feature.

  • The diagnosis can be confirmed by assessing the electrical activity in the leg muscles with a surface electromyography (EMG) while standing.

You may have to advocate for yourself, but getting the right diagnosis is worth it!

More information

In the global Orthostatic Tremor Support Network Group on Facebook, tips and experiences are share. There are also local support groups.

Selection of research articles and papers:
Aug 2025: “Orthostatic Tremor is evoked by muscle load without need for orthostatic position” by Karolina af Edholm MDGonzalo Uribarri PhDMathias Sundgren MD, PhDAnders Svenningsson MD, PhDErik Fransén PhD

PhD thesis, 2023: “The gait disorder in patients with orthostatic tremor – Manifestation, modulation, and strategies for therapy” by Ken Moehwald

PhD thesis, 2021: “Orthostatischer Tremor:
Epidemiologie, Langzeitverlauf und Diagnostik” by Flavia Guri

 

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