What Can Cause Hand Tremors?

Hand tremors occur when the hands shake involuntarily and rhythmically. Hand tremors tend to occur in episodes, and certain medical conditions could cause them to worsen or increase in frequency over time. Hand tremors may make it difficult for patients to carry out daily tasks such as eating, writing, using the computer, dressing, and cooking. Although hand tremors might be benign, it is important to have them investigated by a physician as they can sometimes be early indicators of a neurological condition. Doctors will begin by asking the patient about their health history and current medications, and they will also conduct a physical examination, which will include checks of the patient's reflexes, sensation, strength, gait, and coordination, and doctors may also evaluate the tremors by asking the patient to drink from a glass, write, or hold their arms outstretched. Treatments for hand tremors depend on the underlying cause, and options such as beta-blockers, anticonvulsants, physical therapy, and surgery may be considered.

The primary causes of hand tremors are discussed below.

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, though patients experiencing hand tremors and anxiety or panic should still see their primary care provider just to ensure this symptom is not due to an undiagnosed neurological condition. If the tremors do stem from anxiety or panic alone, the patient's healthcare provider might offer a prescription for anti-anxiety medication such as beta-blockers or tranquilizers. Individuals who choose to take tranquilizers may require frequent follow-up visits since some of these medicines can be habit-forming. In addition to medication, patients might want to consider seeing a counselor or psychiatrist to learn behavioral techniques that could reduce panic attacks and anxiety symptoms.

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Certain Medications

Patients who take certain medications are at an increased risk of experiencing hand tremors as a side effect. Inhaled asthma medications such as albuterol, salmeterol, and formoterol increase levels of stress hormones in the body, and this might result in tremors. 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, and lithium and tricyclic antidepressants might 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 such as when reaching for something or when performing a specific task. Unlike other kinds of tremors, medication-induced tremors tend to affect both hands, and they don't get worse over time. Tremors caused by medication tend to resolve if the dose is lowered or if the medication is switched or discontinued.

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Stroke

A stroke develops when normal blood flow to the brain is interrupted or reduced. This results in a lack of oxygen to the brain, and brain cells start to die. Strokes are considered medical emergencies, and patients having a stroke might suddenly display symptoms such as 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. To treat strokes, doctors can give the patient a medication that dissolves blood clots and helps restore blood flow. 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, including speech and walking difficulties. Hand tremors could develop due to a loss of muscle control, and these usually affect one hand. Physical therapy is typically recommended for individuals recovering from a stroke, and the therapy helps the patient regain some strength and function in the affected area.

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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), and they may also have weakness and numbness in the affected limb. While symptoms may be intermittent in cases of relapsing-remitting multiple sclerosis, 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 relapsing-remitting multiple sclerosis may get some relief from their symptoms through injections of beta interferons or glatiramer acetate, and oral medications such as fingolimod could help reduce the patient's relapse rate. Infusion treatments can help patients with some forms of progressive multiple sclerosis, and physical therapy may be beneficial.

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Parkinson's Disease

Parkinson's disease is a progressive condition that impairs movement. The condition 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, and writing and speech may be altered. Doctors diagnose Parkinson's disease with neurological examinations and imaging studies, and patients may need to have repeated examinations 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.