Why Hands Tremble: Causes and Treatment of Hand Tremors

Hand tremor, or tremulous hyperkinesis, manifests as repetitive muscle contractions in the hand. It can occur as a primary symptom independently or as a result of serious health issues, toxic damage, metabolic disorders, or nervous system problems.

A neurologist can diagnose tremors during an examination, and further tests may be recommended if symptoms warrant it. Treatment generally involves conservative medication therapy, though certain cases (like refractory tremors) may require surgical intervention.

Why Hands Tremble

There are numerous causes of hand tremors, and understanding the root cause is essential to address the issue.

Physiological Tremor

Physiological tremors are considered normal reactions and are not dangerous. Tremors can even occur in healthy individuals, presenting as a mild hand shake that typically resolves on its own and does not affect quality of life.

Common causes of physiological tremors include:

• Fatigue: Physical exhaustion can lead to hand shaking, which often occurs after long runs or strenuous workouts. The symptom may also affect the knees and lower legs.
• Emotional Strain: Extended periods of stress, intense anxiety, hysteria, or chronic stress can increase the excitability of the central nervous system, resulting in tremors. If the shaking resolves after the stress factor is removed, medical intervention is usually unnecessary.
• Adolescent Growth: During certain growth phases, tremors may appear suddenly, even in a relaxed state, and can affect the hands, head, or legs. Specific treatment is usually not required, though special medications may be prescribed to alleviate symptoms.

A comprehensive examination, lab tests, and specialized assessments can help pinpoint the exact cause of hand tremors.

Pathological Tremor

Pathological hand tremors, unlike physiological ones, often indicate an underlying condition that will not improve until the root cause is addressed. Pathological tremors are usually more pronounced and can interfere with daily life, often accompanied by other troubling symptoms.

Common causes of pathological tremors include:

• Prolonged medication use or abrupt cessation of certain drugs.
• Alcohol consumption or drug use, as well as sudden withdrawal.
• Serious systemic illnesses, such as Parkinson's disease.

In some cases, hand tremors can develop due to unusual illnesses, complicating the diagnostic process.

Endocrine System Disorders

Increased thyroid hormone production, low blood sugar, and adrenal gland dysfunction can all cause tremors, along with symptoms like a persistently elevated body temperature, rapid breathing, and an accelerated pulse.

Neurological Disorders

Hand tremors can be an early symptom of Parkinson’s disease, often accompanied by head tremors, balance issues, memory decline, and diminished cognitive function. Stress and tension tend to worsen the tremor symptoms.

Parkinson’s disease is sometimes mistaken for essential tremor, a central nervous system disorder with a hereditary component. Essential tremor is characterized by medium-intensity shaking that can progressively worsen over time. Symptoms often begin in middle age and become more intense with time.

Focal disruptions in the central nervous system (CNS) can also trigger tremors, often as a result of encephalitis, cancer progression, head trauma, or stroke. These conditions may impair movement coordination, speech clarity, and precision in actions.

Metabolic Issues

Metabolic disruptions, another reason for hand tremors and weakness, can lead to a condition known as asterixis or “flapping” tremor, which involves brief reductions in muscle tone.

Autoimmune Disorders

Multiple sclerosis, for example, often features frequent, involuntary tremors in the hands and other body parts. Comprehensive screening is necessary.

Musculoskeletal Disorders

Advanced cervical osteochondrosis can trigger involuntary hand spasms and numbness in the limbs.

Why Are My Hands Shaking? Where to Start?

Identify potential causes. For example, hand tremors often worsen gradually with alcohol abuse, a serious sign of dependency. Tremors may affect the hands, head, or other body parts, often intensifying in the morning. Similarly, hand tremors are a common side effect of certain medications. If tremors are severe and disrupt daily life, discontinuing the medication might resolve the issue.

Hormonal imbalances frequently lead to hand tremors by causing fluctuations in substances produced by the thyroid and other glands. These imbalances can also result in tongue tremors, issues with temperature regulation, psychological disturbances, hair loss, anxiety, or sweating. This varied clinical presentation can complicate diagnosis.

A broad tremor is sometimes caused by rhythmic myoclonus, with symptoms intensifying during physical activity or movement.

Only a qualified neurologist can accurately diagnose the root cause of hand tremors. If you suspect a stroke or recently experienced a head injury, it’s important not to delay medical assistance—contact emergency services immediately.

Types of Tremor

Hand tremors or muscle spasms can occur during rest or certain actions. Some types of tremors are hereditary, though most are acquired. Tremors can occur independently or with other neurological disorders, leading to isolated or combined pathology.

Severity Levels:

• Mild
• Moderate
• Pronounced
• Significant

Based on the Affected Area, Tremors May Be:

• Focal: limited to the hands
• Segmental: affecting the hands and head
• Generalized: extending to all limbs, the tongue, and other body parts
• Hemitremor: occurring on one side only

Consulting a doctor for diagnosis, determining the underlying cause, and pursuing comprehensive therapy is essential.

Diagnosis of Hand Tremors

To understand the cause of tremors, see a neurologist—a specialist in nervous system disorders. They may refer you to other relevant medical professionals if needed.

Diagnosis starts with analyzing and assessing symptoms, conducting a general examination, and performing neurological tests. The doctor will ask about the circumstances and frequency of the tremors, their nature, and associated symptoms. Family medical history, especially neurological conditions, will also be reviewed.

Treatment

Treatment for tremors depends on the underlying cause. Physiological tremors resolve once the external irritant is removed. For stress-related tremors, mild sedatives, alternating hot and cold showers, and a balanced diet may help.

Comprehensive therapy focuses on treating both the tremor and its root cause, as addressing symptoms alone may not yield lasting results. For endocrine issues, treatment aims to stabilize thyroid hormone and glucose levels. Neurological disorders may be managed with medications to control epileptic activity and seizures, or beta-blockers if needed.

If cervical osteochondrosis is causing the tremor, exercises and specialized massages are recommended. Note that hand tremors can signal critical conditions, such as a sudden drop in blood sugar, traumatic brain injury, a sharp blood pressure spike, or stroke. In these cases, immediate medical attention is advised.