Hand tremors, whether mild or severe, can occur in various situations. It can be an early warning of some neurological and degenerative conditions; here, we will explore profoundly what causes hands to shake.
In the very first place, if you experience any persistent hand tremors, consult your doctor, as any healthcare professional can determine the underlying cause and recommend some management options or appropriate treatment.
For some individuals, shaky hands come up with minor inconveniences, and the symptoms may lead to difficulty using their hands daily. We will guide you with what causes hand tremors and symptoms and treatment of shaky hands. In addition, some tips on how to stop the hands from shaking and available treatment options.
Tremors are involuntary muscle contractions that make body parts tremble. Shaking hands is common and could be due to stress, tiredness, or several health conditions. Continue reading to know what can cause shaky hands, primary symptoms, and treatments.
Table of Contents
What are tremors?
Tremors are rhythmic involuntary muscle contractions that cause shaking movements in any part of the body or hands. Tremors can lead someone to shake hands, legs, head, and even voice.
Different diseases, such as Parkinson can cause hand tremor due to some damaged parts of the brain that controls movement. The other reasons may include an overactive thyroid, anxiety, or chronic alcohol use.
One may notice hand tremors while holding objects, a change in handwriting, or visible shaking movements. Tremors can differ depending on the causing conditions and symptoms, which may help diagnose the specific condition’s cause.
Shaky hands are more common than you think and may vary in causes and outcomes. Medication is the most common treatment to deal with tremors, but there is also the option of injections and surgeries, which may help. However, most people do not need treatment.
There are more than twenty types of tremors, but we categorize them into two following groups:
Resting tremors
Such tremors occur when the muscles relax, primarily when the hands rest in the lap.
Action tremors
Most tremors lie under this category which occur with contracted muscles with some voluntary movements.
What causes trembling hands and their symptoms?
In handshaking diseases, tremors may occur due to activity; when you start doing some exercise, it may disappear. Hand tremors arise when an action happens, and we can describe them on the bases of appearance time:
- Intention tremor starts when someone affected reaches for a target. For instance, arriving at a keyhole as you try to unblock your door.
- Postural tremor occurs when your hands are outstretched, but gravity pulls them down. During this outstretching position, you can not keep your hands thoroughly.
- The task-specific tremor happens while performing an activity, especially when you are writing.
Physiologic tremors
People with a slight tremor when moving or maintaining any specific posture, which is a physiologic tremor. Physiologic tremors are small and not noticeable enough. Hand tremors may be more pronounced when someone holds their hands, or they are stressed or undergoing some anxiety.
Enhanced physiologic tremor
What can cause shaky hands is enhanced physiologic tremor (EPT), an improved form of physiologic tremor which usually affects the hands and fingers on both sides of the body. It may not be noticeable most of the time, but sometimes it is visible and pronounced. The following things may cause enhanced physiologic tremor in some people:
- Stress
- Fatigue
- Anxiety
- Vigorous exercise
- Lack of sleep
- Overactive thyroid
- Excessive caffeine intake
- Alcohol withdrawal
An enhanced physiologic tremor is not a neurological disease; it results from muscle movement and blood flow. Moreover, EPT does not require medical treatment unless it interrupts work and other activities, and you need fine muscle coordination.
To diagnose some physiological tremors, the doctor will ask you about the pattern and various other risk factors. After getting to the root cause, they suggest you fix the underlying issues accordingly.
Essential tremors
The most common type of tremor disorder is essential tremor which may start in your hands and move to your arms, head, voice, and other body parts. A very different type of tremor as it affects your hands when they are already moving.
Other forms of tremors take place when the individual is still. It could result from a mutation or gene, which means that your parents already had the disease and you got it from them. Environmental toxins can cause such conditions, but we must dig deeper to understand the connections.
After environmental toxins, age is another risk factor. Essential tremors can happen anytime at any age, but chances increase in people over 40. Odds increase as we age so it may get severe over time.
This common tremor is a nerve disorder as your coffee cup won’t stay still in your hands. Such trembling kicks in when you start working or want to accomplish something, but this condition disappears when you are not doing anything.
If the symptoms are mild, there is no need for specific treatment. However, if the symptoms interfere with everyday tasks or your job, you may need medicines, occupational therapy, or surgery.
Eventually, one may undergo a condition that is even hard to treat. There are certain medications to treat the things which may not work consistently. Surgery is another option, also known as deep brain stimulation; doctors implant a device in your brain to control the tremors during the treatment.
Symptoms of essential tremor
- Shaking voice
- Shaky hands get worse with movement or any activity.
- Head shaking
- Worsen with movement.
- It occurs in the hands first, affecting one or both hands.
- It can include a “yes-yes” or “no-no” motion of the head.
- Begin gradually and become noticeable on one side of the body.
- Emotional stress, fatigue, temperature extremes, and caffeine intake may exacerbate it.
What causes essential tremors?
About half of the people suffering from essential tremors have an altered gene, a familial tremor. The people who do not have familial tremors have an unknown complication that causes ET in them.
A tremor may cause involuntary shaking in various body parts, including hands, head, and voice box. A person with essential tremors may have a postural hand tremor or an intentional hand tremor.
Essential tremor is the most basic neurological cause of any tremor. People with ET in their hands need help completing tasks such as writing, holding a cup, pouring water, or playing any instrument.
ET affects your hands when moving, whereas other tremors happen when you are still. Although it is not life-threatening, stress, fatigue, and overused caffeine can worsen. If we never cope with things in time, it could be challenging, even eating, drinking, writing, or performing minor daily tasks.
Essential tremors may include the following risk factors:
Altered gene
The inherited variety of essential tremors, familial tremors, is an autosomal dominant disorder. An altered gene from one parent passes on the condition. If anyone has any parent with an altered gene for essential tremor, they have a 50% chance of getting the situation.
Age
Essential tremor is more common in people who are forty and older.
Complications by essential tremor
Essential tremor is not life-threatening but could worsen by passing time. There are the following symptoms if the tremors become worse:
- Shaking while eating.
- Shaky hands while putting on makeup or shaving.
- A problem in holding a cup or glass without spilling.
- Talking issues such as voice box or tongue got affected.
- Writing issues.
Treating essential tremor
The symptoms of ET may fluctuate with time, usually mild when someone is in resting mode, and get severe when triggered. Some individuals have very mild symptoms that do not affect their day-to-day activities, so they do not take it much seriously or need any treatment.
On the other hand, if the tremor appears problematic and refrains you from performing daily chores, then you need treatment. One may start with adaptive technology such as weighted utensils and willpower testing.
Various other treatments for essential tremors may start from oral medications to
Injections that may paralyze muscles to stop them from shaking.
Overactive thyroid
The disturbance in thyroid hormone levels, such as shaky hands, could be due to hyperthyroidism. Nonetheless, your thyroid gland is working too hard, increasing your heart rate.
If someone goes through hyperthyroidism, they will lose weight without effort, get a faster heartbeat, and have a sleeping disorder. To diagnose the symptoms, you need to undergo a simple blood test.
Neurological conditions for tremors
When your hands sometimes tremble, they can interfere with daily chores. Such involuntary hand movements or movement disorders occur daily in middle and older age, and people face difficulty feeding themselves, driving, dressing, or doing anything with their hands.
What causes trembling hands, which is due to the problem in the deep parts of the brain which control movement.
Multiple Sclerosis
Multiple Sclerosis is a degenerative disease that damages a myelin coating on your nerves. What can cause shaky hands in Multiple Sclerosis is that it may target your immune system, brain, nerves, and spinal cord, making it difficult to relay messages.
When MS disease happens, you may get symptoms of shaking hands and other body parts. There are more chances that you may tremble in your hand or foot. This disease may cause a variety of tremors.
It usually happens when disease prevails in pathways of the central nervous system. Medicine could be the most common way to treat it, and any occupational therapist may help you learn how to manage the symptoms.
Parkinson’s disease
The tremor could be an early sign of Parkinson’s disease as hands shake because brain cells which tell your muscles to move, get damaged. According to the results of a study, Parkinson affected 10 million people worldwide, and 60,000 of them are in the United States.
Parkinson’s is a neurological disorder causing significant problems with the motor system as the problem occurs with a brain chemical called dopamine which may worsen over time.
The shaking in Parkinson’s usually starts on one hand but spreads to the other over time. It may also cause trouble with balance and make you move slowly, possibly due to stiffening up your arms and legs.
Not everyone having Parkinson’s disease gets shaky, but most people in the early stages have slight movement in the hand, foot, or even fingers. Typically, the tremor affects one side of your body. We also call it a resting tremor; it happens when you relax your muscles.
When someone stops moving, they can cope with shaking; even a little flex in your fingers may help. Simultaneously like other types of tremors, stress and anxiety can make it worse. If you do not treat it timely, the disease may penetrate your body and go from one side to another.
About 75 percent of those with Parkinson’s have tremors, whether action, resting, or mixed. The treatment of Parkinson’s is medication, and you may need surgery for better muscle control.
Symptoms of Parkinson’s
- Tremor
- Instability
- Falls
- Rigidity or stiffness
- Slow movements
- Memory problems
- Change in behavior
- Hallucinations
Unlike essential tremors, which appear when someone is resting, people with Parkinson’s have stiff, slow movements, a risk of falls,s and balance issues. These tremors may also affect the legs so we will recommend timely treatment.
Moreover, Parkinson’s may include mood disorders such as depression, psychosis, hallucination, and dementia.
Treatment for Parkinson’s
The well-known medicine for Parkinson’s is levodopa, which may increase the dopamine in the brain. In addition, physical therapy is helpful to improve mobility and balance.
The concerned doctor may recommend adaptive technology, such as gloves or weighted utensils. You may also need medication to treat other symptoms, such as stool softeners for constipation and tranquilizers for depression.
Finally, surgery that will work for deep stimulation can reduce the apparent symptoms of Parkinson’s.
Essential tremor vs. Parkinson’s disease
Many people associate tremors with Parkison’s disease, but there are some significant differences in various ways.
- Timings of tremors
- Associated conditions
- Affected parts of the body
Timing of tremors
Essential tremors happen when using hands. In comparison, Parkinson’s tremors occur when the hands are at the side of your body or even resting in the lap.
Associated conditions
Essential tremors do not cause other health problems, but Parkinson’s disease is associated with stooped posture, slow-down movement, and dragging feet while walking. At the same time, people with essential tremors develop some neurological symptoms like uneven walking.
Affected parts of the body
Essential tremors involve the head, hands, and voice. Parkinson’s tremors start in the hands and can affect the legs and other body parts.
Stroke
A person may show a variety of tremors after a stroke, depending on the affected area. Resting tremors appear due to damage in the basal ganglia, whereas intentional tremors appear due to wear in the cerebellum.
Symptoms of stroke
- Tremors primarily
- Sudden or severe headache
- Facial weakness
- Slurred speech
- Weakness on one side of the body
Rubral tremor
A stroke may cause a specific type of tremor, a rural tumor that may happen during or even persist after the stroke. Rubral tremors cause irregular movements and jerky situations in arms and legs. All these things get worse with activity.
Various other types of tremors in stroke
Stroke may also cause numerous tremors, including cerebellar tremor, which occurs when the brain coordinates a specific movement, especially when reaching an object. All this happens as the cerebellum (part of the brain) controls coordination which is damaged.
Treatment for the stroke
If someone is undergoing stroke symptoms, they will come up with a sudden tremor named 9-1-1. Treatments may include medications to deal with the effects of stroke and medications such as aspirin or other blood thinners to prevent different strokes.
There could be a combination of medications to treat the tremors caused by a stroke. The combination of medicines is usually levodopa (used for Parkinson’s’) and some anti-seizure medications. You may need surgery, such as deep brain stimulation.
What other causes your hands to shake?
Shaky hands do not always mean you are going through any illness; sometimes, tremors are your body’s response to something.
These are some other possible conditions that may cause shaky hands.
- Metabolic disorders
- Brain tumors
- Wilson’s disease
Traumatic brain injury
Tremors that appear after a traumatic brain injury are post-traumatic tremors (PTT). This disease is uncommon as it damages the specific brain areas responsible for movement.
Dystonia
It is a movement disorder where involuntary muscle contractions are a reason for some movements and postures. This condition happens due to improper functioning of the basal ganglia in the brain.
Dystonia and tremors have close connections; hence, tremors in people with dystonia will occur with irregular or wave-like, or mixed effects in the hands.
Caffeine intake
If you are taking coffee all the time, day long, you need to cut yourself off. Caffeine is a stimulant that will trigger the natural chemicals that help you wake up. Nonetheless, caffeine will be a potential cause of shaky hands.
We can not blame coffee only, as we can find caffeine in some medicines, chocolates, and carbohydrate drinks.
Alcohol withdrawal
If anyone has an alcohol addiction, they can have the symptoms of shaky hands when they try to quit. If someone is alcoholic, their hands start shaking 10 hours after their last drink, and trembling may last for a few weeks.
Some detox programs, along with some medication, will help you to manage withdrawal symptoms.
Lack of sleep
We need energy, and sleep deprivation can make your brain not send messages to all the right places. When you do not sleep enough, your brain mistakenly tells your hands to shake. You may sleep your way back to steady hands.
Low blood sugar
Blood sugar ensures power to your nerves and muscles; your hands will shake if insufficient. Low blood sugar can be caused by diabetes, too much alcohol, particular medications, and food deprivation.
A doctor may narrow down the reasons why these things happen and the trigger cause behind the symptoms.
Stress
When something stresses you out in routine, your nerves become overstressed. Your hands tremble, and your heart starts beating fast. The shaky situation goes away when the stress vanishes.
Some stress relief techniques will help you, including deep breathing and meditation.
What drugs cause shaking hands?
Shaking hands could be a side effect of different types of prescription drugs. Mainly, these drugs are related to mood, migraine, asthma, or neuropathy, affecting your trembling hands. Even some antihistamines can also cause handshaking problems.
We will guide you with some drugs that may cause handshaking.
- Asthma medications
- Anti-arrhythmic drugs, such as procainamide
- Seizure medications, such as Depakene and Depakote
- Prescriptions for psychiatric conditions, such as certain antidepressants and mood stabilizers.
- Cancer medications such as thalidomide
- Corticosteroids
- certain drugs which may suppress the immune system, such as cyclosporine.
- Certain antiviral drugs
- Specific antibiotics
- Caffeine
- Amphetamine
Smoking
Most people smoke as they feel it will ease stress and may cause anxiety. The addictive drug in tobacco is nicotine which gets into the bloodstream and increases the heartbeat.
Smoking may make you feel anxious and become the reason for trembling hands. One must consult their doctor to get ideas for quitting tobacco.
Lack of Vitamin B12
B12 is such a critical vitamin to keep your nervous system healthy. If you will not include meat, eggs, or milk in your diet or take certain medications, you have a chance of a lower amount of this vitamin.
A deficiency of vitamin B12 can cause your hands to shake or numb your arms and legs. Your doctor will recommend it if you need some supplements to deal with this disease.
Pheochromocytoma
A kind of rare tumor that grows in the adrenal gland, which makes your blood pressure high. As a result, you may be shaking, with heavy sweating, shortness of breath, and severe headache.
Pheochromocytoma tumors can also lead to heart disease and stroke, so we recommend surgery to remove them.
Liver disorders
What causes my hands to shake could be due to liver disorders like Wilson’s disease. This condition could be genetic as copper buildup in your body, damaging your liver and brain.
After getting liver damage, you may feel tired or even get jaundice (a yellow tint in your eyes and skin).
Brain disorders
If anybody went through a stroke or a traumatic injury, the muscles in their hands might lose their control. To deal with this situation, ask your doctor about medication and some occupational therapy to manage shaky hands. Excessive caffeine or nicotine can exacerbate the symptoms even in this situation.
Diagnosis for trembling hands
Diagnosis of shaky hands or tremors requires a physical exam and a careful medical history examination. The examiner will analyze it as they want to know what it looks like and how the associated features will work.
Doctors will examine whether there is balance impairment, slowness of movements, and stiffness in Parkinson’s disease, possibly due to a stroke or a brain lesion. Is the next person taking a certain kind of medication?
They will analyze whether the individual consumes a lot of caffeine or has any underlying conditions. They will also figure out whether it is necessary to order lab work to check the thyroid or any image of the brain to check for any brain stroke.
How do you stop shaking hands?
After knowing what causes your hands to shake and what causes hand tremors, we will guide you with some methods to stop your hands from shaking.
Treating underlying conditions
Hand tremors usually occur due to underlying conditions, such as hyperthyroidism or alcohol withdrawal, and one must follow the proper treatment to deal with these conditions.
Lifestyle changes
Specific lifestyle changes may help reduce hand tremors in people with enhanced physiologic tremors, which may include:
- Avoiding vigorous exercise.
- Cut-down excess alcohol consumption
- Avoiding stimulants such as caffeine.
Switching medications
Tremors can be a side effect of certain medications. If you experience such symptoms while taking medication, report them to your doctor. Your doctor can then adjust the dosage or switch to an alternative medicine.
Psychological techniques
People who experience tremors due to panic attacks or anxiety can improve by practicing relaxation techniques, including mindfulness and breathing exercises.
Physical therapy
A physical therapist can teach people to improve the following things:
- Balance
- Coordination
- Muscle control
- Functioning
- Strength
Occupational therapy
Any occupational therapist can help people living with shaking hands while making them engage in their usual daily activities.
What would be possible treatment options for shaky hands?
Most types of tremors are incurable if suitable treatment options are available, which will help any affectee to manage the symptoms.
Medication
Doctors come up with some prescribed medicines which may help you to reduce the severity of tremors with the possible treatment options:
- Anxiety medications.
- Anti-seizure medications (primidone)
- Beta-blockers (propranolol)
Doctors usually recommend disease-specific drugs for people with tremors, which may relate to specific conditions. If the doctors determine the cause of tremors, they can prescribe tranquilizers to relax involuntary muscular movements.
Botox
Botox is a neurotoxin that may cause localized paralysis, which may be beneficial in treating voice and head tremors. Nevertheless, botox injections for hand tremors can lead to weakness in the fingers.
Surgery
Medicines do not impact the people who undergo severe tremors, which may affect their daily life. Then doctors usually recommend surgical interventions such as deep brain stimulations (DBS).
While performing DBS surgery, doctors usually place a small generator under the skin of the chest, which sends electrical signals to electrodes implanted in the thalamus, which may coordinate and control some involuntary movements.
Frequently asked questions (FAQs)
Is it normal to have trembling hands?
It is normal to have shaky hands when feeling stressed, anxious, or deprived of sleep. Mild tremors do not affect a person’s routine life and are not a matter of concern. In comparison, if a person suffers from persistent hand tremors, which may interfere with daily activities, one must seek a doctor’s help to determine the cause and fix it.
When to see a doctor with shaky hands disease?
Anyone suddenly getting a tremor in their hands or other body parts should visit their doctor for a diagnosis. A doctor will come up with more severe causes, some of which may require prompt medical treatment.
People with existing handshaking issues could see the doctor if the situation worsens and interferes with their daily lifestyle.
Conclusion
Handshaking starts gradually, possibly due to some stress, anger, or primarily illness, and worsens over time. Everyone feels a slight tremor in the hands or body when moving or getting into a particular posture which is normal and known as a physiologic tremor.
What can cause shaky hands? Whatever the reason, everyone’s hands shake here and there as the tiny muscle fibers in your hands constantly contract and relax at random. It may appear due to an imbalance between muscle groups which disturbs the contraction timings.
What causes my hands to shake? If you come to know if there are some persistent tremors, there could be some underlying medical conditions or a side effect of a particular medication. At the same time, sudden tremors need a sudden doctor consultation for a better possible diagnosis.
What causes essential tremors, a neurological condition that may cause involuntary and rhythmic shaking, affecting every part of your body, especially your hands? Although it is not dangerous, it still worsens over time in some people.
What causes hand tremors and treatments vary widely in terms of tremors; hence it is better to talk to your doctor about the history and symptoms.
