Tremors are involuntary muscle contractions that cause body parts to tremble. Hand tremors are common and are often due to stress or tiredness. They may also indicate several health conditions.
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.
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,
- the head
- the arms
- the legs
- the torso
- the 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 are contracted 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 when a person needs to rely on fine muscle coordination for their work or other activities.
- 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):
About 75%of people with PD have tremors, whether resting, action, or mixed. Tremors usually begin on one side of the body, and may spread to the opposite side. Shaking may become more pronounced during periods of stress or strong emotion.
- Stroke: After a stroke, a person
can showa variety of tremors depending on the area affected. 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 studyfound that PTT happens as a result of damage to specific brain areas responsible for movement. These tremors are uncommon.
- Dystonia: A 2021 study stated that dystonia and tremor are closely linked. Tremors occurring in people with dystonia are either jerky and irregular, regular and wave-like, or mixed. Mixed types commonly affect the hands.
Other health conditions
The following health conditions
- alcohol misuse or withdrawal
- mercury poisoning
- liver or kidney failure
- stress, anxiety, or fatigue
- psychiatric conditions, such as post-traumatic stress disorder
- inherited degenerative disorders, such as
hereditary ataxia or fragile X syndrome
Certain drugs can also cause hand tremors. Examples
- some asthma medications
- drugs for psychiatric conditions, such as certain antidepressants and mood stabilizers
- seizure medications, such as valproate (Depakene) and valproic acid (Depakote)
- anti-arrhythmic drugs, such as procainamide
- cancer medications
- medications that suppress the immune system, such as cyclosporine
- certain antiviral drugs
- specific antibiotics
It is normal to have shaky hands. This is especially true if a person is feeling stressed or anxious or has had insufficient sleep.
Mild hand tremors that do not affect a person’s daily life are not usually a cause for concern. However, if a person experiences severe or persistent hand tremors that interfere with their daily activities, they should see a doctor to help determine the 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
- avoiding excess alcohol consumption
- avoiding stimulants, such as caffeine and amphetamines
- Treating underlying conditions: Hand tremors that occur due to an underlying condition, such as hyperthyroidism 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
- Occupational therapy: An occupational therapist can help people living with tremors to continue to engage in their usual daily activities.
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.
Most types of tremors are incurable. However,
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 is a neurotoxin that causes localized paralysis. Botox injections may be beneficial in treating voice and head tremors. However, botox injections for hand tremors can lead to weakness in the fingers.
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, which is the part of the brain that coordinates and controls 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.
Below are some frequently asked questions about hand tremors.
Are hand tremors always Parkinson’s?
Hand tremors don’t always mean a person has Parkinson’s disease (PD). Essential tremors are one of the
When should I be concerned about hand tremors?
It’s normal to have a slight tremor. However, a person should talk with a healthcare professional if their hand tremor gets worse over time or starts to affect their daily activities.
What deficiency causes shaky hands?
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.