Shaking Hands (hand Tremors): 14 Causes And Treatments

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Medical News TodaySubscribeWhy are my hands shaking? Causes, is it normal, and remedies

Medically reviewed by Nancy Hammond, M.D. — Written by Amanda Barrell — Updated on December 21, 2023

What are tremors?
Causes
Are shaky hands normal?
How to stop hands shaking
Contacting a doctor
Treatments
FAQ
Summary

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.

What are tremors?

A person with their hands on their lap. — Francesca Lagonika/EyeEm/Getty Images

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, such as:

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.

What are the causes of shaky hands?

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:

stress
anxiety
fatigue
lack of sleep
excessive caffeine intake
vigorous exercise
overactive thyroid

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.

Neurological conditions

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): 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 show a 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 study found 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 can also cause shaky hands:

alcohol misuse or withdrawal
mercury poisoning
hyperthyroidism
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

Medications

Certain drugs can also cause hand tremors. Examples include:

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
corticosteroids
certain antiviral drugs
specific antibiotics
amphetamine

Is it normal to have shaky hands?

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.

How do you stop the hands from shaking?

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
- coordination
- balance
Occupational therapy: An occupational therapist can help people living with tremors to continue to engage in their usual daily activities.

When to see a doctor

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.

How can a person stop their hands from shaking?

Most types of tremors are incurable. However, treatment options are available to help a person manage the symptoms.

Medications

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

beta-blockers, such as propranolol
anxiety medications
anti-seizure medications, such as primidone

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

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.

Surgery

In severe cases where medication and other treatments are ineffective, surgical options like deep brain stimulation (DBS) or radiofrequency ablation may be recommended.

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.

Frequently asked questions

Below are some frequently asked questions about hand tremors.

What are shaking hands a symptom of?

Hand tremors can be a symptom of Parkinson’s disease (PD), multiple sclerosis (MS), 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.

Should a person be worried about shaky hands?

It’s 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.

What deficiency causes shaky hands?

Researchers have found that a vitamin B-12 deficiency in adolescents can cause hand tremors or shaky hands.

Summary

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.

Multiple Sclerosis
Parkinson's Disease
Anxiety / Stress
Neurology / Neuroscience

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Gironell, A., et al. (2018). Tremor types in Parkinson disease: A descriptive study using a new classification.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6186312/
Downey, L. A., et al. (2017). Psychomotor tremor and proprioceptive control problems in current and former stimulant drug users: An accelerometer study of heavy users of amphetamine, MDMA, and other recreational stimulants.https://pubmed.ncbi.nlm.nih.gov/28425095/
Essential tremor. (2023).https://rarediseases.info.nih.gov/diseases/5910/essential-tremor
Jang, S., et al. (2020). Injury of the dentatorubrothalamic tract in patients with post-traumatic tremor following mild traumatic brain injury: a case-control study.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7716042/
Morgan, J. C., et al. (2017). Insights into pathophysiology from medication-induced tremor. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5712675/
Muacevic, A., et al. (2020). Doxycycline-induced hand tremors: Case report and review of antibiotic-associated tremors.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7606173/
Serin, H. P., et al. (2019). Neurological symptoms of vitamin B12 deficiency: analysis of pediatric patients.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6884369/
Shaikh, A., et al. (2021). Dystonia and tremor: A cross-sectional study of the dystonia coalition cohort.https://n.neurology.org/content/96/4/e563.abstract#sec-15
Siniscalchi, A., et al. (2012). Post-stroke movement disorders: Clinical manifestations and pharmacological management.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3468879/
Tremor. (2023).https://www.ninds.nih.gov/health-information/disorders/tremor
Tremor. (n.d.).https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Tremor
Tremor or shaking hands. (2020).https://www.nhs.uk/conditions/tremor-or-shaking-hands/
Tremor syndromes: An updated review. (2021).https://www.frontiersin.org/articles/10.3389/fneur.2021.684835/full
What are the symptoms of Fragile X-Associated tremor and Ataxia syndrome (FXTAS)? (2021).https://www.nichd.nih.gov/health/topics/fxtas/conditioninfo/symptoms
What is MS? (n.d.).https://www.nationalmssociety.org/What-is-MS
What is posttraumatic stress disorder (PTSD)? (2022).https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd
White, R., et al. (2019). Population-scale hand tremor analysis via anonymized mouse cursor signals.https://www.nature.com/articles/s41746-019-0171-4

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Medically reviewed by Nancy Hammond, M.D. — Written by Amanda Barrell — Updated on December 21, 2023

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What are tremors?

What are the causes of shaky hands?

Enhanced physiologic tremor

Neurological conditions

Other health conditions

Medications

Is it normal to have shaky hands?

How do you stop the hands from shaking?

When to see a doctor

How can a person stop their hands from shaking?

Medications

Botox

Surgery

Frequently asked questions

What are shaking hands a symptom of?

Should a person be worried about shaky hands?

What deficiency causes shaky hands?

Summary

How we reviewed this article:

Latest news

Related Coverage

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