Shaking; Tremor - hand; Hand tremor; Tremor - arms; Kinetic tremor; Intention tremor; Postural tremor; Essential tremor
Tremor may be caused by:
Tremors can happen at any age. They are more common in older people. Everyone has some tremor when they move their hands. Stress, fatigue, anger, fear, caffeine, and smoking may make this type of tremor worse.
A tremor that does not go away over time may be a sign of a medical problem and should be checked by your health care provider.
Essential tremor is the most common tremor. The shaking most often involves small, rapid movements. It usually occurs when you are trying to do something, such as reaching for an object or writing. This type of tremor may also run in families.
A tremor is a type of shaking movement. A tremor is most often noticed in the hands and arms. It may affect any body part, including the head or vocal cords.
Your provider will likely suggest self-care measures to help with daily life.
For tremors caused by stress, try ways to relax, such as meditation or breathing exercises. For tremors of any cause, avoid caffeine and get enough sleep.
For tremors caused by a medicine, talk to your provider about stopping the drug, reducing the dosage, or switching to another medicine. Do not change or stop medicines on your own.
For tremors caused by alcohol use, seek treatment to help you stop drinking alcohol.
Severe tremors may make it hard to do daily activities. You may need help with these activities.
Devices that may help include:
Your doctor will perform a physical exam, including a detailed brain and nervous system (neurologic) examination. You may be asked questions to help your doctor find the cause of your tremors:
The following tests may be ordered:
Once a cause of the tremor has been determined, treatment will be prescribed.
You may not need treatment unless the tremor interferes with your daily activities or causes embarrassment.
Treatment depends on the cause. Tremor caused by a medical condition, such as hyperthyroidism, will likely get better when the condition is treated.
If the tremor is caused by a certain medicine, stopping the drug will usually help it go away. Never stop taking any medicine without first talking to your doctor.
You may be prescribed medicines to help relieve symptoms. How well medicines work depends on your overall health and the cause of the tremor.
In some cases, surgery is done to relieve the tremors.
Call your provider if your tremor:
Fasano A, Deuschl G. Therapeutic advances in tremor. Mov Disord. 2015;30:1557-1565. PMID: 26293405.
Jankovic J, Lang AE. Diagnosis and assessment of Parkinson disease and other movement disorders. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 23.
Raftery AT, Lim E, Ostor AJK. Tremor. In: Raftery AT, Lim E, Ostor AJK, eds. Churchill's Pocketbook of Differential Diagnosis. 4th ed. Philadelphia, PA: Elsevier; 2014:468-470.
Review Date: 4/30/2018
Reviewed By: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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