Hand Tremors
Tremors may affect your hands, arms, head, face, voice, trunk, and legs.

Tremors mean shakiness. They are unintentional, rhythmic movements of a body part. Though they are not life-threatening, they can cause severe disability and worry.

Tremors may affect your hands, arms, head, face, voice, trunk, and legs. Most people have hand tremors making it difficult to carry out daily activities, such as writing, drinking, eating, shaving, or dressing. Tremors of voice may cause a shaky voice.

What conditions can give you tremor?

You may experience tremors without a cause. These are called essential tremors. Conditions that may give you tremors include:

What are the types of tremors?

The common types of body tremors include:

  • Rest tremor
    • Commonly found in Parkinson’s disease.
    • It gets worse when you are stressed or anxious.
    • Tremors occur when limbs are not moving and disappear with movement.
  • Action tremor (occurs when the limb or body part is moving).
  • Postural tremor (while maintaining a position, such as outstretching your arm).
  • Kinetic tremor (occurs when you move a body part).
  • Intention tremor (worsens when the limb is guided to move towards a particular body part).
  • Task-specific tremor (occurs only while performing a specific task or activity like writing).
  • Idiopathic (unknown cause) dystonic tremor
    • Accompanied by dystonia (muscle spasm) and affects multiple body parts, such as hands, head, and occasionally, voice.
  • Essential tremors are chronic, slow-progressive tremors that are 8-10 times more prevalent than Parkinson’s disease and mostly run in families (inherited). These tremors affect your hands and arms and disappear during sleep.
  • Orthostatic (posture-related) tremors affect one or more parts of your body while standing, walking, or other movements causing exhaustion and pain.
  • Dystonia (muscle spasm): Research states that the brain sends faulty signals to muscles causing painful muscle spasms and forces the body into twisting, repetitive movement, or abnormal postures.

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How will your tremors be diagnosed?

Your doctor/neurologist may examine you, evaluate your condition, and may order for

  • Brain scans, such as magnetic resonance imaging (MRI) and computed tomography (CT), to eliminate any other condition.
  • Blood samples to rule out thyroid or copper levels.
  • DAT scans to distinguish between essential tremor and Parkinson’s tremor.

What are the treatment options?

Treatment includes:
  • Lifestyle changes: Avoiding substances that may cause tremors, such as caffeine, alcohol, and Amphetamines, may help to reduce shaking.
  • Physical therapy: Physical exercises may help to improve muscle control, functioning, and strength and eventually may improve your living.
  • Psychological therapy: Relaxation techniques, such as breathing exercises, may help you to combat panic and anxiety attacks.
  • Symptomatic medical treatment:
  • Alcohol may suppress your essential tremor temporarily for about 4 hours. However, it often worsens the next day.
  • Brain surgery: Your neurologist may suggest brain surgery called deep brain stimulation for essential tremors if you have severe disabling tremors and intolerance or are not responding to medications. Successful surgery may maintain tremor control for up to 6 years. Deep brain stimulation may improve your thought processes, mood state, and quality of life.

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Medically Reviewed on 12/1/2020
References
Medscape. Essential tremor treatment & management. https://emedicine.medscape.com/article/1150290-treatment

WebMD. The brain and essential tremor. https://www.webmd.com/brain/essential-tremor-basics#1

NHS. Tremor or shaking hands. https://www.nhs.uk/conditions/tremor-or-shaking-hands/

NIH. Tremor Fact Sheet. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Tremor-Fact-Sheet

American Parkinson Disease Association. A tremor doesn’t always mean it’s Parkinson’s. https://www.apdaparkinson.org/article/other-causes-of-tremor/

National Organization of Rare Disorder. Essential tremor. https://rarediseases.org/rare-diseases/essential-tremor/

National Tremor Foundation. https://tremor.org.uk/

Parkinson’s foundation. Tremor. https://www.parkinson.org/Understanding-Parkinsons/Symptoms/Movement-Symptoms/Tremor

Mayoclinic. Essential tremor. https://www.mayoclinic.org/diseases-conditions/essential-tremor/symptoms-causes/syc-20350534

Bhatia KP, Bain P, Bajaj N, et al. Consensus Statement on the Classification of Tremors. From the Task Force on Tremor of the International Parkinson and Movement Disorder Society. Mov Disord. 2018 January; 33(1): 75-87. doi:10.1002/mds.27121