Key takeaways

  • Tremors are involuntary muscle contractions that cause body parts to tremble. Hand tremors are common and are often due to stress or tiredness.
  • Hand tremors may also indicate health conditions, such as multiple sclerosis, Parkinson’s disease, or alcohol use disorder.
  • Mild tremors may not be a cause for concern. If tremors worsen or interfere with daily activities, it is important to talk with a healthcare professional.

For some people, shaky hands may be a minor inconvenience. For others, the symptom may lead to difficulty using the hands for everyday tasks.

This article describes what tremors are, outlines some potential causes of shaky hands, and asks whether it is common. We also provide tips on how to stop the hands from shaking and discuss some of the treatment options available.

Tremors are involuntary, rhythmic muscle contractions that make a body part appear to be shaking or trembling. Everyone has a slight tremor when moving or maintaining a particular posture. These are called physiologic tremors.

They are often so small that a person does not see or notice them. Hand tremors may be more noticeable when a person holds their hands out straight in front of the body or when they are stressed or anxious.

Tremors mostly affect the hands. However, it can also occur in other body parts, such as the:

  • head
  • arms
  • legs
  • torso
  • voice box (larynx), which may cause a shaky voice

There are several types of tremors. However, most fall into two categories:

  • Resting tremors: These occur when the muscles are relaxed, including when the hands are resting on the lap.
  • Action tremors: These occur when the muscles contract due to voluntary movement. The majority of tremors are action tremors.

Sometimes, tremors can indicate an underlying health issue, especially if they are persistent or very pronounced.

Tremors can be normal or could result from neurological conditions, other health problems, or medication use. Below are some potential causes of hand tremors.

Enhanced physiologic tremor

Enhanced physiologic tremor (EPT) is perhaps the most commonly observed postural tremor. It usually affects the hands and fingers on both sides of the body.

The following may worsen EPT in some people:

Enhanced physiological tremor does not require medical treatment, except potentially when a person needs to rely on fine muscle coordination for their work or other activities.

Essential tremor

An essential tremor is one of the most common types of tremor. It can start at any age, but usually first appears during teenage years or between 40 and 50 years.

Essential tremors are typically harmless. However, some people may experience embarrassment, and others may find that the tremors interfere with their ability to carry out daily tasks.

Neurological conditions

Pathological tremors are generally due to an issue in the deep parts of the brain that control movement. Some neurological conditions that can cause shaky hands include:

  • Multiple sclerosis (MS): Many people with MS experience some degree of tremor. This often develops when the disease damages areas in the pathways of the central nervous system that control movement.
  • Parkinson’s disease (PD): Up to 75% of people with PD have tremors, whether resting, action, or mixed. Resting tremors are the most common. Tremors usually begin on one side of the body and may spread to the other side. Shaking may become more pronounced during periods of stress or strong emotion.
  • Stroke: A tremor after a stroke is uncommon but can occur. Damage to the basal ganglia causes a person to have resting tremors, while damage to the cerebellum causes intention tremors.
  • Traumatic brain injury (TBI): Tremor as a consequence of TBI is called post-traumatic tremor (PTT). A 2020 study found that PTT results from damage to specific brain areas responsible for movement. These tremors are uncommon.
  • Dystonia: Dystonia is a condition involving abnormal, involuntary muscular contractions. Tremors occurring in people with dystonia are either jerky and irregular, regular and wave-like, or mixed. People may see a pattern of movement in the hands or other body parts.

Other health conditions

The following health conditions can also cause shaky hands:

Medications

Certain drugs can also cause hand tremors. According to a 2022 review, tremor is most common with the use of the following drugs:

It can be normal to have shaky hands. This is especially true if a person is feeling stressed or anxious or needs more sleep.

Mild hand tremors that do not affect a person’s daily life are not usually a cause for concern. However, if someone experiences severe or persistent hand tremors that interfere with their daily activities, it is a good idea to see a doctor to help determine the cause.

The treatment for shaking hands may depend on the underlying cause. Below are some methods people may be able to use to help stop their hands from shaking.

  • Lifestyle changes: The following lifestyle changes may help to reduce hand tremors in people with enhanced physiologic tremor:
    • avoiding vigorous exercise
    • limiting alcohol consumption
    • avoiding stimulants, such as caffeine and amphetamines
  • Treating underlying conditions: Hand tremors that occur due to an underlying condition, such as MS or alcohol withdrawal, typically improve following appropriate treatment.
  • Psychological techniques: People who experience tremors due to anxiety or panic attacks may benefit from practicing relaxation techniques, such as mindfulness and breathing exercises.
  • Switching medications: A person who experiences tremors while taking a medication should report the side effect to their doctor. The doctor may be able to adjust the medication dosage or switch the person to a different drug.
  • Physical therapy: A physical therapist can teach people exercises to improve the following:
    • muscle control, functioning, and strength
    • coordination
    • balance
  • Occupational therapy: An occupational therapist can help people living with tremors to continue to engage in their usual daily activities.

Medications

Doctors may prescribe medications to help reduce the frequency and severity of tremors. Possible treatment options include:

Doctors may also prescribe disease-specific drugs for people with tremors related to specific conditions such as PD and MS. If doctors are unable to determine the cause of tremors, they may prescribe tranquilizers to help relax the involuntary muscle movements.

Botox injections may also be beneficial for hand tremors. Botox is a neurotoxin that causes localized paralysis.

Medical procedures

In severe cases where medication and other treatments are ineffective, a doctor may recommend procedures like deep brain stimulation (DBS) or radiofrequency ablation.

DBS surgery sees a doctor place a small generator under the skin in the upper chest. The generator sends electrical signals to electrodes implanted in the thalamus or basal ganglia, parts of the brain that coordinate and control some involuntary movements.

Radiofrequency ablation involves using an electric current to heat nerve tissue in order to disrupt its ability to relay signals for several months.

Anyone who suddenly develops tremors in their hands or other parts of their body should see their doctor for a diagnosis. A doctor will need to rule out more serious causes, some of which may require prompt medical treatment.

People with existing tremors should see a doctor if the tremors worsen or begin to interfere with their daily lives.

Hand tremors can be a symptom of Parkinson’s disease, multiple sclerosis, or dystonia. They can also occur following a stroke or traumatic brain injury.

However, essential tremors are one of the most common causes of hand tremors and can occur without any other neurological signs.

It is normal to have a slight tremor occasionally. However, a person should talk with a healthcare professional if their hand tremor worsens over time or starts to affect their daily activities.

Researchers have found that a vitamin B-12 deficiency in children can cause tremors. However, it is important to speak with a healthcare professional before taking supplements to treat tremors.

It is normal for most people to experience a slight tremor in their hands or other body parts when moving or maintaining a particular posture.

Certain factors can make the tremor more noticeable, including stress or anxiety, caffeine consumption, and lack of sleep.

In some cases, severe or persistent tremors may indicate an underlying medical condition or a side effect of a particular medication. Anyone who suddenly develops tremors should see their doctor as soon as possible for a diagnosis.