Hand Tremors? When to See a Doctor

Most people, even children and young adults, will experience mild tremors in their hands at some point in their life. These involuntary movements are not usually something to worry about and can often be caused by anxiety, fatigue or too much caffeine.

“However, if hand tremors are severe or prolonged and begin to affect your daily life, it’s time to see a doctor,” says Camilla Kilbane, MD, a movement disorders specialist at University Hospitals. “In addition, if they occur with other symptoms such as stiffness, slowness, lack of coordination or other neurological symptoms, a complete evaluation is recommended.”

What Causes Shaky Hands?

Common causes of mild, temporary hand tremors include:

• Stress and anxiety. Anything that spikes your adrenaline can cause the muscles to tense and make you feel shaky temporarily.
• Medications. Many medications can cause or worsen tremors, including anti-depressants, inhalers for asthma, chemotherapy and steroids.
• Low blood sugar. When blood sugar levels drop too low, it can make you feel shaky.
• Vitamin deficiencies. Although rare, a deficiency of vitamins B1, B6 and B12 can cause tremors.
• Substance abuse or withdrawal. People going through withdrawal from alcohol or other substances often experience tremors.

Can Tremors Be a Sign of Neurological Disease?

In some cases, hand tremors can be an early symptom of a more serious condition, including:

Essential Tremor

Essential tremor is the most common trembling disorder and becomes more common with age. It’s often called familial tremor because it tends to run in families. With this condition, tremors occur when your hands are moving, such as writing, eating, shaving or putting on makeup. It tends to affect both hands equally and the tremors are often mild. However, for some people the condition can progress and impact their ability to carry out the activities of daily living.

Parkinson’s Disease (PD)

Hand tremors associated with Parkinson’s disease often affect one side of the body more than the other. In addition, unlike essential tremors, Parkinson’s tremors tend to happen when the body is at rest. Other symptoms may include stiffness, slow movements and gait changes. People with Parkinson’s may also have non-motor symptoms, such as loss of smell and constipation.

Multiple Sclerosis

Tremors from multiple sclerosis may include involuntary shaking, jerking or twitching movements, which can occur when at rest and during activities such as holding a glass or cup.

When to See a Doctor

“There are many medical conditions that can cause muscle jerking,” says Dr. Kilbane. “These include thyroid disorders, liver and kidney disorders, stroke and diabetes. Because there are so many potential causes, it is important to seek medical evaluation if tremors are impacting your quality of life or if they’re accompanied by other symptoms.”

“To determine the cause of tremors, we start with a comprehensive medical history and physical exam. Based on the symptoms reported by a patient, we may order blood tests for thyroid and vitamin levels and, if the tremors occur on just one side of the body, we may order brain imaging,” says Dr. Kilbane.

Treatment depends on the cause and severity of the tremors and may include medication, lifestyle modifications and, in some cases, interventional treatments or surgery. For some people, if the tremors are mild and not a symptom of more serious disease, treatment may not be necessary.

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The experts at UH Neurological Institute offer advanced diagnostics and treatment for a wide range of neurological conditions including movement disorders.