Hand tremor is a problem often met in daily life, whether holding a cup of coffee, writing, or using a mobile phone. Many people feel anxious when they notice their hand shaking abnormally. In truth, hand tremor comes at many levels and from many causes, from the minor to diseases that need serious treatment. This article will take you through hand tremor, its real causes, and the appropriate way to treat it, so that you can look after your health correctly.

Finger tremor

The kinds of hand tremor worth noticing

Before we come to causes and treatment, we should understand that hand tremor has several patterns, and each may point to a different cause. Noticing the character of the tremor helps the doctor to diagnose it more precisely.

Tremor at rest

Tremor at rest (resting tremor) usually appears when the hand or arm is resting on a surface or lying still without moving. This pattern is often found in patients with Parkinson's disease, and it typically has the characteristic "coin counting" or "pill rolling" quality, in which the hand shakes as though rolling something between the thumb and the index finger.

Tremor on movement or activity

Tremor on movement (action tremor) appears when the hand is used for an activity, such as lifting a glass of water, writing, or using a spoon to eat. This pattern is often found in essential tremor, and it usually worsens with tasks that demand precision, such as threading a needle or writing small letters.

Other patterns of tremor found

Besides these two main types, there are other patterns of tremor: rhythmic or irregular shaking, tremor only when excited or under stress, or tremor appearing only at certain times of day. These patterns may point to different causes.

A checklist of the 9 main causes of hand tremor you may never have known

Hand tremor does not come from a single cause. Several factors may produce it, and understanding the cause will help you know how to manage it appropriately.

Parkinson's disease

Parkinson's disease is a neurological disease whose important symptom is tremor at rest. It usually begins on one side of the body — one hand shaking first, then spreading to the other. Other symptoms come with it, such as slowed movement, muscle rigidity, and poor balance.

Essential tremor

This is the most commonly found neurological disorder. Its distinguishing feature is a hand tremor on movement, usually affecting both hands, and usually worse with activities that demand precision. Sometimes the symptoms improve temporarily after a small amount of alcohol. The condition may run in the family, and it usually begins to show in middle to older age.

Side effects of some medicines

Several medicines may cause hand tremor as a side effect, such as asthma medicines, some blood-pressure medicines, antidepressants, anticonvulsants, and cholesterol-lowering medicines. If you suspect that a medicine you are taking may be the cause, you should consult your doctor and not stop the medicine yourself.

Abnormal thyroid function

An overactive thyroid (hyperthyroidism), in which the body produces too much thyroid hormone, may cause tremor together with other symptoms such as heavy sweating, palpitations, weight loss, and feeling abnormally hot.

Low blood sugar

Low blood sugar (hypoglycaemia) is another cause of hand tremor, particularly in patients with diabetes who use insulin or blood-sugar-lowering medicines. Other symptoms that may come with it include heavy sweating, a fast heartbeat, hunger, fatigue, and confusion.

Too much alcohol and caffeine

Consuming caffeine in quantity (coffee, tea, soft drinks, energy drinks) may stimulate the nervous system and cause tremor. In the same way, people who drink alcohol heavily over a long period may have tremor when they stop or reduce the amount (alcohol withdrawal).

Stress and anxiety

Emotional states such as stress, worry, or excitement can trigger a temporary hand tremor. It usually disappears once you feel relaxed, but if it happens often you should find an effective way to manage the stress.

Lack of necessary vitamins and minerals

A lack of vitamin B12, magnesium, or vitamin E may result in hand tremor. Eating a complete and varied diet will help the body receive all the nutrients it needs.

Other diseases of the brain and nervous system

Other diseases such as stroke, brain tumour, dementia, or disorders of the cerebellum may also cause hand tremor.

Diagnosing and finding the cause of hand tremor

When hand tremor is worrying, seeing a doctor to diagnose the real cause is important. The doctor will take a detailed history, including family history, regular medication, and triggering factors. There will also be a physical examination focused on the nervous system, and further tests may be ordered, such as:

  • Blood tests for thyroid function, sugar levels, and nutrients
  • Brain imaging with MRI or CT scan
  • Special neurological investigations such as EMG (electromyography)

Approaches to treating hand tremor

Treatment for hand tremor depends on the cause and the severity of the symptoms. The doctor will consider which method is most suitable for each person.

Treating the underlying cause

The best approach is to treat the cause. If the tremor arises from an overactive thyroid, treating the thyroid disease will reduce the tremor. If it comes from a medicine, the medicine may have to be changed or the dose adjusted.

At PYONG Rehabilitation Clinic we have specialist physicians in both rehabilitation medicine and neurology, with expertise in diagnosing and treating conditions relating to the nervous system in particular, so that the real cause of a hand tremor can be found precisely.

Using medicine to control the tremor

Where necessary, the doctor may consider medicine to control the tremor, such as:

  • Beta-blockers such as propranolol, often used in essential tremor
  • Anticonvulsants such as primidone or topiramate
  • Benzodiazepines, used where anxiety is the cause
  • Parkinson's medicines such as levodopa, in cases of Parkinson's disease

Physiotherapy and occupational therapy

Physiotherapy training may help improve movement and muscle control. An occupational therapist can advise on techniques and assistive equipment that make daily activities easier.

At PYONG Rehabilitation Clinic we emphasise whole-person treatment, bringing modern technology together with traditional treatment for the greatest effect. For hand tremor we offer treatment with:

In addition, our occupational therapists train the movement of the muscles of the arm and hand in particular, to increase precision in using the hand in daily life and reduce the tremor, supported by modern technology such as:

Where spasticity comes with the tremor, we treat with botulinum toxin injection under ultrasound guidance for the highest precision, helping to reduce the muscle tightening that produces tremor in the long run. And for those who also have difficulty swallowing, we offer swallowing training with special techniques from our occupational therapists, together with electrical stimulation of swallowing.

Surgery (where necessary)

Where the symptoms are severe and do not respond to medication, surgical methods may be considered, such as:

  • Deep brain stimulation
  • Destroying part of the brain tissue (thalamotomy)

Surgery is usually a last option and has to be considered carefully.

5 ways to look after yourself and ease hand tremor

Besides medical treatment, changes in lifestyle and self-care have an important part in easing hand tremor.

1. Manage stress and rest enough

Stress is a factor that may make hand tremor worse. Finding ways to relieve stress — meditation, deep breathing, yoga, or enough rest — may help ease the symptoms.

2. Avoid stimulant drinks

Reduce or stop drinks high in caffeine, such as coffee, tea, soft drinks, and energy drinks, as well as alcohol, which may trigger tremor.

3. Eat well, across all 5 food groups

Eating food with complete nutritional value, especially food rich in B vitamins, magnesium, and vitamin E, will help the nervous system work better.

4. Exercise regularly

Light but regular exercise, such as walking, swimming, or yoga, helps increase muscle strength, improve balance, and reduce stress.

5. Use assistive equipment in daily life

There are several kinds of equipment designed to help people with hand tremor, such as weighted cups, weighted cutlery, or pens with tremor damping, which can make daily activities easier.

Is hand tremor dangerous? The warning signs that need a doctor quickly

Although hand tremor is not serious in many cases, some signs indicate that you should see a doctor soon:

  • Tremor that appears suddenly and severely
  • Tremor that worsens quickly
  • Other symptoms with it, such as confusion, weakness, slurred speech, poor balance, or severe headache
  • Tremor that greatly disturbs daily life
  • Tremor that begins after starting a new medicine

If you have these symptoms you should consult a doctor to find the cause and the appropriate treatment.

Frequently asked questions (FAQ)

Many people have questions about hand tremor. Here are the questions most often asked, with answers that may be useful.

What causes a hand tremor only when hungry?

Hand tremor when hungry usually arises from low blood sugar. When the body lacks glucose, its main source of energy, adrenaline is released, which can produce tremor. Eating small meals more often, and choosing food with a low glycaemic index, will help prevent this.

Can young people have hand tremor?

Although hand tremor is more often found in older adults, young people can have it too, particularly with risk factors such as genetics, stress, certain medicines, or too much caffeine. In some cases, tremor in a young person may be a sign of a neurological disease that needs appropriate diagnosis and treatment.

Can hand tremor be cured completely?

Whether it can be cured completely depends on the cause. If it arises from a factor that can be corrected, such as a medicine side effect, a nutritional deficiency, or stress, correcting that cause may resolve the symptoms. But if it arises from a neurological disease such as Parkinson's disease or essential tremor, it may not be curable, though the symptoms can be controlled and improved with appropriate treatment.

Summary

Hand tremor is a commonly found condition with a variety of causes, from ordinary matters such as stress or caffeine to neurological disease. Noticing the character of the symptoms, the triggering factors, and any accompanying symptoms will help the doctor diagnose the cause more precisely.

Appropriate treatment depends on the cause of the symptoms, whether treatment with medicine, a change of lifestyle, or physiotherapy. At PYONG Rehabilitation Clinic we have a team of specialist physicians in rehabilitation medicine and neurology with experience in caring for people with pain and disorders of the nervous system, so that hand tremor can be diagnosed and planned for comprehensively and precisely, both in finding the neurological cause and in restoring the working of muscle and nerve.

If you have a hand tremor that worries you or disturbs your daily life, you should consult a doctor for diagnosis and appropriate treatment, because early treatment helps prevent the symptoms from worsening and helps you to a better quality of life.