Shaky Hands

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Introduction

What are shaky hands?

Shaky hands are a common symptom that can even occur in healthy people. Although there are many causes of shaky hands, in some people there is no known cause. The most common cause is an essential tremor, which often is inherited and considered benign. Shaky hands may occur with conditions that affect only the hands or with conditions that affect the other parts of the body, such as generalized diseases of the neuromuscular system or central nervous system. Diseases that commonly cause shaky hands include Parkinson’s disease, overactive thyroid (hyperthyroidism), and multiple sclerosis.

Shaky hands may occur after ingesting or withdrawing from certain drugs or substances, such as alcohol and caffeine. Shaky hands can also result from emotions stimulated by the nervous system, such as anxiety, anger or fear, and from the aging process and its effects on the nervous system. Low blood sugar is also a common cause of this symptom.

Seek immediate medical care (call 911) if you experience sudden shaking of the hands accompanied by numbness or weakness of the arm or fingers on one side of your body; a change in level of consciousness or alertness, such as passing out or unresponsiveness; or the worst headache of your life, as these can be signs of stroke.

Seek prompt medical care if your shaky hands are persistent or cause you concern.

Symptoms

What other symptoms might occur with shaky hands?

Shaky hands may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Symptoms that frequently affect the digestive tract may also involve other body systems and parts, including the hands.

Drug symptoms that may occur with shaky hands

Shaky hands may accompany other symptoms related to taking or withdrawing from a drug including:

  • Anxiety
  • Convulsions
  • Fatigue
  • Fever
  • Hallucinations
  • Headache
  • Irritability
  • Loss of appetite
  • Rapid heart rate (tachycardia)
  • Seizure
  • Unusual sweating

Tremor symptoms that may occur with shaky hands

Shaky hands may accompany symptoms related to tremors including:

  • Difficulty eating

  • Impairment of fine-motor movement in the hands such as difficulty writing

  • Worsening of the shaking when you are tired, stressed or excited

Other symptoms that may occur with shaky hands

Shaky hands may accompany symptoms related to other body systems including:

  • Balance problems, difficulty walking, and falls

  • Difficulty starting or continuing a movement

  • Fatigue

  • Headache

  • Increased appetite

  • Involuntary movement of legs, lips or chin

  • Numbness

  • Restlessness

  • Weakness (loss of strength), which can be general or felt in one part of your body

  • Unexplained weight loss

Serious symptoms that might indicate a life-threatening condition

In some cases, shaky hands may be a symptom of a life-threatening condition that should be evaluated immediately in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Change in level of consciousness or alertness, such as passing out or unresponsiveness

  • Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations and delusions

  • High fever (higher than 101 degrees Fahrenheit)

  • Respiratory or breathing problems, such as shortness of breath, difficulty breathing or inability to breathe, labored breathing, wheezing, or choking

  • Seizure

  • Severe headache

Causes

What causes shaky hands?

Shaky hands may result from many factors. The most common cause is a tremor related to familial (inherited) traits. Other causes are diseases and conditions that affect the neuromuscular, endocrine or central nervous systems.

Some substances, such as caffeine and tobacco, commonly cause shaky hands because they stimulate the nervous system. Withdrawal from sedating drugs can also result in shaky hands, as the nervous system reacts to removing the sedating influence of the drugs by increasing sensitivity. Shaky hands are common symptoms of strong emotions, such as anxiety, fear and anger. In addition, the normal aging process is associated with shaky hands, most likely due to decline in neuromuscular function.

Tremor-related causes of shaky hands

Shaky hands may be caused by tremors including:

  • Dystonic tremor
  • Essential tremor
  • Intention tremor
  • Postural tremor
  • Resting tremor
  • Senile tremor

Drug-related causes of shaky hands

Taking or withdrawing from certain drugs can also cause shaky hands. Examples include:

  • Use of beta agonists

  • Withdrawal from certain medications, including some anti-anxiety drugs

  • Withdrawal from, or excessive consumption of, alcohol, caffeine or tobacco

Other causes of shaky hands

Certain diseases or conditions can also cause shaky hands including:

  • Brain tumor

  • Emotions, such as anger, anxiety and fear

  • Fatigue

  • Low blood sugar (hypoglycemia)

  • Multiple sclerosis (disease that affects the brain and spinal cord causing weakness, coordination, balance difficulties, and other problems)

  • Normal aging process

  • Parkinson’s disease (brain disorder that impairs movement and coordination)

  • Stroke

  • Thyroid diseases and disorders such as hyperthyroidism (overactive thyroid)

Serious or life-threatening causes of shaky hands

In some cases, shaky hands may be a symptom of a serious or life-threatening condition that should be evaluated immediately in an emergency setting. These include:

  • Brain tumor
  • Delirium tremens from severe alcohol withdrawal
  • Stroke

Questions for diagnosing the cause of shaky hands

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your shaky hands including:

  • How long have you experienced shaky hands?
  • When do you feel your hands shake?
  • Do you have any other symptoms?
  • What medications are you taking?

What are the potential complications of shaky hands?

Because shaky hands can be caused by serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

  • Brain damage
  • Inability to perform daily tasks
  • Paralysis
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Dec 28
  1. Tremor. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003192.htm.
  2. NINDS tremor information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/tremor/tremor.htm
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