Shaky Hands: Possible Causes and What to Do

Many people have experienced times when their hands shake or tremble. This movement is involuntary, and you cannot control it. Shaky hands, or tremor, may be harmless. However, it can also be a symptom of various medical conditions, some of which require medical care. Although there are many possible causes of shaky hands, sometimes there is no known cause. Shaky hands may occur with conditions that affect only the hands or those that involve other parts of the body. The most common cause of shaking hands is a neurological condition called essential tremor. Other causes may involve the endocrine or central nervous systems.

Shaky hands may come on gradually or abruptly, depending on the cause. It may occur when you are still or when you are actively using your hands. You may also notice other symptoms, such as a change in how you move.

The characteristics of the hand movements and other symptoms are clues to help identify a possible cause. Seek prompt medical care if shaky hands is persistent or causes you concern.

This article discusses the possible causes of shaky hands, when to contact a doctor for diagnosis and treatment, and symptoms that may accompany shaking hands.

Many types of tremor can involve the hands, but essential tremor is the most common one. It causes tremor in both hands (and arms). It occurs when you are still and when you are taking action, such as picking up your phone. Shaking hands from essential tremor is typically mild and worsens slowly with increasing age.

Essential tremor can occur at any time but most often appears during the teenage years or in the 40s or 50s.

Other tremor symptoms may include head tremor and a trembling voice if tremor affects the voice box. Essential tremor does not harm your physical health, but it can be bothersome. Some medications can help reduce the shakiness.

Learn about hand tremor here.

Parkinson’s disease is a chronic movement disorder. Damage to certain nerve cells and a loss of dopamine in the brain cause the symptoms, which commonly include tremor but not always.

Parkinsonian tremor can involve one hand at first and progress to both hands with time. This type of tremor occurs at rest. You may also notice trembling of the lips, chin, and legs with parkinsonian tremor. Learn about other symptoms here.

Medications may help reduce tremor. Occupational therapy can also be beneficial.

Multiple sclerosis (MS) is a chronic condition caused by damage to the myelin sheath that protects nerve fibers in the brain and spinal cord.

Many types of symptoms are possible with MS and may begin in early to middle adulthood. Symptoms can include tremor, muscle weakness, and balance problems. Learn more about symptoms here.

Like Parkinson’s disease, medications and different forms of therapy may be part of the treatment plan for MS.

Some substances, such as caffeine and tobacco, cause shaky hands because they stimulate the nervous system. Taking or withdrawing from certain drugs can also cause shaky hands. Examples include:

• withdrawal from certain medications, including sedatives for anxiety
• withdrawal from or excessive consumption of alcohol or tobacco
• use of asthma drugs and corticosteroids

Also known as hyperthyroidism, an overactive thyroid speeds up your metabolism. Symptoms include trembling, anxiety, increased appetite, and more. Learn about symptoms here.

Shaky hands from an overactive thyroid is an enhanced physiologic tremor. It should go away after reducing your thyroid hormone levels.

Low blood sugar, or hypoglycemia, is a treatable but potentially dangerous cause of shaky hands. Other symptoms can include hunger and sweating. If your blood sugar (glucose) falls very low, you may experience confusion and changes in the level of alertness.

If you have diabetes and are taking insulin or glucose-lowering drugs, seek prompt medical attention for shaky hands.

A deficiency in vitamin B12 (cobalamin) can cause some neurological symptoms, including involuntary movements such as tremor, parkinsonism, and chorea, according to an older publication from 2014 Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source . However, involuntary movements are a “rare manifestation” of this vitamin deficiency.

Eating a well-rounded diet prevents vitamin B12 deficiency. In people who are deficient in vitamin B12, supplements are essential Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source to prevent permanent neurological damage and other effects.

Wilson disease is a genetic condition that causes copper to accumulate in the body. Symptoms may include tremor when copper builds up in the nervous system. Wilson disease can also damage the liver.

Learn about Wilson disease here.

Shaky hands can also result from:

• anxiety, anger, or fear
• regular aging
• damage to the cerebellum from a brain tumor or stroke, for example
• delirium tremens from severe alcohol withdrawal

Consider contacting a medical professional if your hands are shaking for no apparent reason.

Contact a doctor right away if the problem persists for more than a few days, affects your ability to perform daily tasks, or is accompanied by other symptoms. Also, seek medical care for shakiness or trembling in an infant.

Some causes of shaky hands are serious and potentially life threatening. Seek immediate medical care (call 911) for the following symptoms:

• a change in the level of consciousness or alertness, such as passing out or being unresponsive
• a change in mental status or sudden behavior changes, such as confusion, delirium, hallucinations, or delusions
• high fever
• respiratory problems, such as shortness of breath or difficulty breathing
• convulsions or seizures
• a severe headache
• sudden numbness or weakness

Treatment options for shaky hands depend on the cause and the impact that shakiness has on your daily life.

You may be able to stop shaky hands due to a substance by removing or reducing the substance causing it, such as caffeine. If it is a physiologic condition, such as overactive thyroid or hypoglycemia, addressing the underlying condition may resolve shaking hands and other symptoms.

Treating shaky hands from a neurological condition such as Parkinson’s disease is more involved. Hand shakiness may worsen and make daily tasks quite difficult. Beyond medications, other potential treatments for severe tremor may include focused ultrasound and surgery on the part of the brain causing the tremor.

Lifestyle modifications and certain types of therapy may also help.

Shaky hands may accompany other symptoms, depending on the underlying cause. Symptoms may include:

• balance problems, difficulty walking, and falls
• difficulty starting or continuing a movement
• muscle stiffness
• numbness, weakness, or both in the hands or other parts of the body
• physiologic symptoms, which may include:
  • headache, fever, and fatigue
  • anxiety, irritability, or restlessness
  • irritability
  • unusual sweating
  • a loss of appetite
  • increased appetite but unexpected weight loss
  • a rapid heart rate (tachycardia)
• hallucinations
• convulsions or seizures

To identify a possible cause of shaky hands, a medical professional will perform a physical exam and ask you questions about your symptoms and lifestyle. They may ask you to write, hold a cup, or perform other tasks that involve fine motor skills. Depending on the outcome, they may refer you to a neurologist for additional tests.

Your doctor may ask you the following questions:

• 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?
• Do you smoke? If so, how much per day?
• Do you drink alcohol? If so, how much per week?
• How does shaking interfere with your daily activities?

Below are some other questions that people tend to ask about shaky hands.

A vitamin B12 deficiency can cause involuntary movements such as tremor.

Some evidence suggests that exercise may reduce tremor associated with Parkinson’s disease. Exercise may also reduce shaky hands in people with essential tremor. A 2016 study Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source suggested that reduced physical activity correlated with more tremor and balance symptoms.

Shaky hands is an involuntary movement with many potential causes. Sometimes, shaky hands is from temporary conditions such as consuming too much caffeine or having low blood sugar. It can also be due to essential tremor and other neurological conditions.

Contact a medical professional if you have shaky hands for no apparent reason.