Shivering: Causes, Treatment, And When To See A Doctor

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Medical News TodaySubscribeHow to stop shivering

Medically reviewed by Kelsey Nank, PA-C — Written by Claire Sissons — Updated on October 18, 2024

Causes
Treatments and seeing a doctor
Summary

People shiver for many reasons, such as fever, being cold, and more. Strategies to help stop shivering may depend on the cause, but can include deep breathing, using extra blankets, and medical treatment.

When people are cold, the muscles in their body will contract and relax rapidly to generate heat. This causes part or all of the body to shiver or shake. People can still shiver on a warm day if there is a cool breeze or they are sitting in the shade.

Shivering is an involuntary movement of the body, which means that it is uncontrolled. Hiccups and sneezing are other examples of involuntary movements.

What causes shivering?

Shivering occurs most commonly when a person is cold. When muscles move, they generate heat. Therefore, when a person is cold, their muscles begin to quickly tighten and loosen over and over again to produce heat. This is known as shivering. It is usually temporary and should stop once the individual warms up.

However, shivering can also be a symptom of physical or mental illness.

Below are potential causes of shivering:

1. Fever

Cold woman outdoors shivering — A fever may cause shivering.

Other than being cold, the most common cause of shivering is fever. The average body temperature is around 98.6° F. Doctors usually define a fever as a body temperature higher than 100.4°F.

Fever usually occurs as a result of infection, but inflammation or an allergic reaction can also increase body temperature. Some people with a fever may also have signs of flu, but others will have no additional symptoms.

Drinking plenty of fluids and taking nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen can help to reduce a temperature.

If a person has other symptoms, particularly a stiff neck, rapid heartbeat, or shallow breathing, they should seek medical advice urgently. If they have no other symptoms, they will only need to visit a doctor if the fever lasts for more than 3 days.

2. Psychogenic movement disorders

For some people, stress or mental health factors can cause shivering and other involuntary movements. This usually occurs due to a psychogenic movement disorder, which can affect any part of the body.

A doctor who specializes in medical conditions affecting the brain, called a neurologist, will usually diagnose psychogenic movement disorders. They may look for the following characteristics when making a diagnosis:

movements happening suddenly, without warning
memories of a traumatic event triggering movements
movements stopping if a person is distracted
underlying mental health issues, such as depression

There is often no underlying brain or nerve damage. Instead, shivering is the body’s response to stress.

Doctors will often treat psychogenic movement disorders with a combination of mental health therapy and physical therapy.

3. Postanesthetic shivering

A person may shiver when recovering from an anesthetic.

Shivering can occur when a person regains consciousness after a general anesthetic. This is known as postanestheric shivering.

A person’s temperature may drop during a surgical procedure, which can cause them to shiver when they wake up after the operation is over. Anesthetics can also affect the body’s ability to regulate temperature, which can make it difficult for the body to warm up quickly after an operation.

Doctors will usually check a person’s temperature and provide them with blankets or heaters if necessary.

4. Fear, excitement, or stress

Strong emotions can cause a person to shake or shiver. This is often due to a surge of adrenaline in the body. Adrenaline is a hormone that triggers the body’s fight-or-flight response.

Shivering should stop after the adrenaline leaves the body. For many people, this will happen very rarely, perhaps during a particularly exciting or frightening moment. For those who experience chronic stress, adrenaline surges and shaking can be more frequent.

5. Anxiety

Similarly, when a person experiences anxiety, it may present with physical symptoms, such as shaking. This is also due to a surge of adrenaline.

Treatment for anxiety may include therapy, medication, and lifestyle changes. Activities that might help a person to manage their anxiety include exercising, practicing mindfulness and meditation, and spending time with supportive friends and family.

6. Tremor

Involuntary trembling, shaking, or shivering can be due to a medical condition called essential tremor. Essential tremor is a neurological condition, meaning that it relates to the brain. Evidence suggests that essential tremor may affect up to 5% of the global population.

Tremors can also be a symptom of Parkinson’s disease. This is a disorder that affects an area of the brain and tends to develop gradually.

7. Low blood sugar

If a person has not had food for a long time, the level of glucose in their blood can drop. This low blood sugar can cause a person to shiver or feel shaky.

For people who have diabetes, this will be known as hypoglycemia, and it can be severe. People with diabetes should check their blood glucose regularly to prevent their levels from dropping too low.

8. Sepsis

Sepsis is an overwhelming response of the body to infection, and it often occurs in connection with lung, skin, gut, or urinary tract infections.

One of the symptoms of sepsis is shivering. Other symptoms may include confusion, fever, warm skin, lightheadedness, a rapid heartbeat, and a skin rash.

Sepsis is a medical emergency. People with sepsis will need prompt treatment with antibiotics in a hospital.

Treating shivering at home and when to see a doctor

Shivering is usually temporary. If it occurs due to a fever, low blood sugar, or a strong emotion, it should resolve once a person treats the underlying cause. They can:

treat a fever with fluids and NSAIDs
eat to restore blood sugar levels
sit down somewhere quiet and breathe slowly to calm strong emotions

Other causes of shivering may be due to an underlying medical condition. If a person is concerned, they should note any other symptoms and seek medical advice.

Takeaway

Shivering can be a more severe symptom for older adults or people with an underlying health condition. Older adults are often less able to regulate their body temperature so they may become cold more quickly. Keeping warm in cold weather is essential for good health.

Fever increases the heart rate and makes breathing faster. This can be serious if a person has a heart or lung condition.

Diabetes
Anxiety / Stress
Flu / Cold / SARS
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.

Agarwal S, et al. (2023). Essential tremor.https://www.ncbi.nlm.nih.gov/books/NBK499986
Blondin DP, et al. (2018). Chapter 10 - Shivering and nonshivering thermogenesis in skeletal muscles.https://www.sciencedirect.com/science/article/abs/pii/B9780444639127000102
Functional (psychogenic) movement disorders. (n.d.).https://www.bcm.edu/healthcare/specialties/neurology/parkinsons-disease-and-movement-disorders/psychogenic-movement-disorders
LeWine HE, et al. (2023). Fever in adults: When to worry.https://www.health.harvard.edu/diseases-and-conditions/treating-fever-in-adults
Overview: Fever in children. (2022).https://www.ncbi.nlm.nih.gov/books/NBK279455
Risks associated with your anaesthetic: Section 3: Shivering. (2019).https://www.rcoa.ac.uk/sites/default/files/documents/2019-11/03-Shiveringweb.pdf
Sepsis: Symptoms. (2022).https://www.nhs.uk/conditions/sepsis
What are the signs of low blood glucose (hypoglycemia)? (n.d.).https://diabetes.org/living-with-diabetes/hypoglycemia-low-blood-glucose/symptoms-treatment
What is adrenaline? (n.d.).https://mhanational.org/what-adrenaline

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Medically reviewed by Kelsey Nank, PA-C — Written by Claire Sissons — Updated on October 18, 2024

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Tag » Why Do I Shake When I'm Cold

Shivering: Causes, Treatment, And When To See A Doctor

What causes shivering?

1. Fever

2. Psychogenic movement disorders

3. Postanesthetic shivering

4. Fear, excitement, or stress

5. Anxiety

6. Tremor

7. Low blood sugar

8. Sepsis

Treating shivering at home and when to see a doctor

Takeaway

How we reviewed this article:

Latest news

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