Guide To The Causes Of Hand Tremors

November 28, 2023

Hand tremors occur when the hands shake involuntarily and rhythmically. They often happen in episodes. Tremors may make it difficult for patients to carry out daily tasks such as eating, writing, using the computer, dressing, and cooking. Hand tremors are often benign. However, it is important to have a doctor investigate them. This is because they can be early indicators of a neurological condition. Doctors will begin by asking the patient about their health history and current medications. They will also conduct a physical examination. This exam includes checks of the patient's reflexes, sensation, strength, gait, and coordination. Doctors may also evaluate the tremors by asking the patient to drink from a glass, write, or hold their arms outstretched.

Hand tremors treatment largely depends on the underlying cause. However, there are some standard options. Hand tremors medication ranges from anxiety medication to medicine for Parkinson's disease. There are also many home remedies for hand tremors, including relaxation techniques such as meditation and mindfulness. Of course, as mentioned, patients must understand the cause of their hand tremors first.

Panic Or Anxiety

Hand tremors sometimes occur as a result of panic or anxiety. For example, individuals experiencing a panic attack may report shaky hands. In these cases, hand tremors are likely the result of mental health issues and not an indication of a physical underlying medical condition. However, patients experiencing hand tremors and anxiety or panic should still see their primary doctor. This is to ensure that this symptom is not due to an undiagnosed neurological condition.

If the tremors are the result of anxiety or panic, doctors may prescribe anti-anxiety medication. Individuals who choose to take benzodiazepines may require frequent follow-up visits since some of these medications can be habit-forming. In addition to medication, patients may want to consider seeing a counselor or psychiatrist to learn behavioral techniques that could reduce panic attacks and anxiety symptoms.

Certain Medications

Patients who take certain medications are at an increased risk of experiencing hand tremors. This is because they are a common side effect. Inhaled asthma medications increase stress hormones, which can result in tremors. Examples of such asthma medications are albuterol and formoterol. Amiodarone, a drug used to treat heart rhythm irregularities, is known to cause hand tremors in at least one-third of the patients who take it. Selective serotonin reuptake inhibitors are associated with hand tremors in roughly twenty percent of patients who use them. Lithium and tricyclic antidepressants may also cause tremors.

Hand tremors caused by medications differ from those caused by neurological conditions. The tremors that stem from medication occur with voluntary movements. Examples include when individuals are reaching for something or performing a specific task. Unlike other tremors, medication-induced tremors tend to affect both hands. In addition, they do not worsen over time. They tend to resolve if the dose is lowered as well. Patients also see their tremors disappear if they discontinue or switch their medication.


A stroke develops when normal blood flow to the brain is interrupted or reduced. This results in a lack of oxygen to the brain, causing brain cells to die. Strokes are considered medical emergencies. Stroke symptoms include weakness in one limb or side of the body, walking difficulties, trouble seeing, as well as trouble speaking and understanding speech. A sudden, severe headache often occurs as well. Patients who have even one of these symptoms should be examined in the emergency room. Doctors can give the patient a medication that dissolves blood clots and helps restore blood flow as a stroke treatment. However, this medication only works if it is administered within a few hours of the stroke.

Even with treatment, patients who have had a stroke may have complications. These complications include speech and walking difficulties. Hand tremors could develop due to a loss of muscle control. When they are the result of a stroke, tremors usually affect one hand. Physical therapy is typically recommended for individuals recovering from a stroke. This helps patients regain some strength and function in the affected area.

Multiple Sclerosis

Multiple sclerosis is a condition that affects the central nervous system. Patients with this condition may experience hand tremors (usually in one hand). They may also have weakness and numbness in the affected limb. Symptoms may be intermittent in cases of relapsing-remitting multiple sclerosis. However, roughly seventy percent of patients will eventually develop secondary-progressive multiple sclerosis. In this form of the disease, symptoms get progressively worse, and symptom progression continues even if there are still periods of remission. Doctors diagnose multiple sclerosis by performing a neurological examination and conducting tests such as blood tests, MRI scans, evoked potential tests, and lumbar punctures.

Patients with the relapsing-remitting form may get some symptom relief through certain injections. Examples of such injections include beta interferons and glatiramer acetate. Patients may also want to consider oral medications such as fingolimod. These medications can help reduce their relapse rate. Infusion treatments can help patients with some forms of progressive multiple sclerosis, and physical therapy may be beneficial.

Parkinson's Disease

Parkinson's disease is a progressive condition that impairs movement. It often starts with a barely noticeable tremor in one hand that occurs at rest. As the disease worsens, patients may also experience stiffness and slowing of movements. Their writing and speech may be altered. Doctors diagnose Parkinson's disease with neurological examinations and imaging studies. Patients may need to have repeated tests to confirm the diagnosis.

Treatments for Parkinson's disease include medications such as carbidopa-levodopa and dopamine agonists. These medications can help reduce tremors and make it easier for patients to move and write. If medication is ineffective, doctors may consider a surgical procedure known as deep brain stimulation. This procedure may temporarily halt tremors and other involuntary movements, and it also reduces muscle rigidity.

Essential Tremor

Essential tremor is a neurological condition. Thankfully, it is often harmless. Patients with this disorder experience significant involuntary shaking. This shaking is rhythmic for many patients. Although this disorder can affect any part of an individual's body, it is the most common in the hands. Thus, some patients have hand tremors because they have essential tremor. Reports indicate that patients deal with this condition the most during activities such as tying their shoes or writing.

It is vital to note that other conditions do not cause essential tremor. However, many patients often mistake essential tremor for Parkinson's disease. Many patients do not need medical treatment for essential tremor, since it is often mild. In serious cases, patients have a variety of medication options.


Stress is a major cause of hand tremors for many individuals. It is also vital to note that stress also makes tremors caused by other factors worse. Stress due to frustration triggering hand tremors is quite common. Typically, it is because an individual is attempting to contain their stress and frustration. However, it means that they cannot keep a hand tremor under control. Stress from fear is another cause of hand tremors. Patients with anxiety are the most at risk of hand tremors due to stress. Thankfully, stress-induced hand tremors have a variety of treatment options. Most individuals need to start with incorporating more stress management into their routines. This includes practicing mindfulness, meditation, and deep breathing.


Hyperthyroidism is a condition in which a patient's thyroid is overactive. In it, the thyroid gland produces thyroid hormones excessively. Symptoms of this condition include weight loss, rapid and irregular heartbeat, increased appetite, sweating, and trouble sleeping. Overall, hyperthyroidism makes an individual's body work at a much faster rate than necessary. For instance, patients will lose weight because their metabolism dramatically increases due to this condition.

Of course, hand tremors are quite common in hyperthyroidism as well. The intensity of hand tremors varies based on the severity of a patient's hyperthyroidism. In other words, they are more intense when their condition is more severe. Patients need prompt treatment for hyperthyroidism. This will help stop their hand tremors. Options include a variety of medications, such as beta-blockers and anti-thyroid medication, and thyroid removal surgery.

Vitamin B12 Deficiency

Vitamin B12 is an essential vitamin for every individual. This is because vitamin B12 helps an individual's nervous system work efficiently. A lack of vitamin B12 means that their nervous system cannot regulate itself properly and their nerve cells are no longer healthy. This often triggers hand tremors. A vitamin B12 deficiency refers to levels that are two hundred nanograms per milliliter (ng/mL) or less.

Low vitamin B12 has more connections than causing the hand tremors alone. Reports indicate that low vitamin B12 has been linked to worsened tremors from Parkinson's disease and essential tremor. Ultimately, patients need to consume more vitamin B12 to correct this issue. A severe deficiency often requires vitamin B12 injections or supplements. However, individuals can also consume more vitamin B12 through their diet. Good sources include milk, eggs, nutritional yeast, fish, and chicken.

Consuming Too Much Caffeine

Caffeine is a stimulant for the nervous system. It is incredibly common. Sources of caffeine include coffee, black tea, energy drinks, and even chocolate. There are also caffeine supplements available with other vitamin supplements at pharmacies. Experts indicate that most healthy adults can consume up to four hundred milligrams of caffeine safely each day. This is roughly equal to four cups of regular coffee. However, the source matters, since energy drinks contain much more caffeine than coffee. Espresso also has more caffeine than regular coffee.

Unfortunately, many individuals drink too much caffeine. When this happens, their nervous system is overstimulated, which is what triggers hand tremors. Thankfully, the treatment for this is simple. Individuals who drink significant amounts of caffeine and deal with hand tremors must reduce their consumption. Doing so gradually is the best course of action to avoid withdrawal symptoms.

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