Shaky hands is usually not a life-threatening issue, though it can affect daily life and may cause concern. This shakiness is known medically as a tremor and could have various possible causes. Some tremors are harmless, while others are the result of an underlying issue and require treatment.

Physiologic Tremor

Nearly every person experiences physiologic tremors. These tremors are usually unnoticeable and manifest as a fine shaking of the hands and fingers. Physiologic tremors result from triggers like anxiety, fatigue, stress, and exercise. Enhanced physiologic tremors have different causes, and the shaking is more visible. An overactive thyroid, stimulants like caffeine, and hypoglycemia can all lead to enhanced physiologic tremors.

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Essential Tremor

Essential tremors are among the most widespread types of tremors, and many experts consider them the most common movement disorder. People over the age of 65 are most likely to develop an essential tremor, though they can affect anyone. The tremors are rhythmic and usually become less noticeable when a person is resting. Other signs of essential tremor include uncontrollable head-nodding, a quivering voice, and a change in gait. Essential tremor appears to be inheritable, though the cause is unknown.

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Psychogenic Tremor

Functional tremors or psychogenic tremors often start abruptly and seemingly without cause. While they may affect all body parts, they are most common in the hands and feet. Stress and similar stimuli can worsen a psychogenic tremor, but it may improve when the person is calm and relaxed. Many people with psychogenic tremors have an underlying condition, such as post-traumatic stress disorder or depression.

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Medication or Drug-Induced Tremor

Many medications list tremors or shaking as potential side effects. While these tremors often fall into other classifications, medical experts find it helpful to also view them as a unique category. Drugs for conditions like asthma often increase stress hormone levels, which can trigger a tremor. Antidepressants that stimulate serotonin receptors can also be responsible. A tremor is probably a side-effect of medication if it stays consistent, looks the same on both sides, or only occurs after changing dosages.

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Dystonic Tremor

People who have dystonia usually experience dystonic tremors. Dystonia is a movement disorder where muscles contract involuntarily, causing them to twist or shake repeatedly. Dystonic tremors are similar to essential tremors but have a few key differences. For example, touching the affected area may reduce the severity of the tremor. Additionally, dystonic tremor movements are irregular or jerky in comparison to an essential tremor’s more rhythmic shaking.

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Parkinson’s Disease

While not every person with Parkinson’s disease develops a Parkinsonian tremor, it is one of the condition’s most common symptoms. Usually, the tremor manifests as shaking in the hands while the individual is at rest, though the symptom may also affect the legs and face. Stress or strong emotions can worsen it. If the tremor begins on one side of the body, it may spread to other areas as the disease progresses.

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Cerebellar Tremor

Diseases or conditions that damage the cerebellum can cause cerebellar tremors. Strokes, tumors, and conditions like multiple sclerosis may cause this type of tremor. Unlike other tremors, cerebellar tremors are slow, easily visible, and usually occur at the end of a purposeful movement. Most people notice a cerebellar tremor after pressing a button or performing a similar action.

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Neuropathic Tremor

Damage to the peripheral nerves can develop from a physical injury or a disease like diabetes. Nerve damage may cause tremors and can also affect movement, sensation, and organ function. Developing a neuropathic tremor is a common side effect of peripheral nerve damage. In addition to the tremor, some people are unable to control their muscles. Experts sometimes mistake these neuropathic tremors for essential tremors.

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Asterixis is a neurological issue that causes a loss of motor control. Experts consider the resulting tremor unique; it is characterized by irregular, involuntary jerking movements, and the exact cause remains unknown. Asterixis has links to both excessive alcohol consumption and alcohol withdrawal. Damage to the cerebellum and metabolic encephalopathies that affect brain function may also be responsible. Some people describe the motion as resembling a bird flapping its wings, giving it the common name “flapping tremor.”

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When to See a Doctor

Because tremors are associated with Parkinson’s disease and multiple sclerosis, they are worrying to many people. It can be difficult to know when a tremor is harmless and when professional care is necessary. If a tremor persists or recurs frequently, it is unlikely to be physiologic and may require medical attention. Additional symptoms, such as tremors affecting other body parts or a loss of muscle control, may also signify a serious underlying issue.

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