Some of the main causes of hand tremors include Parkinson’s disease, essential tremor, stress and anxiety, multiple sclerosis, and alcohol withdrawal.
Depending on the underlying cause, hand tremors may also be accompanied by other symptoms such as imbalance, voice tremors, dizziness, chills, mental confusion, or fainting.
If hand tremors are intense, persistent, or occur alongside other symptoms like loss of consciousness, excessive sweating, or difficulty speaking, it is recommended to consult a primary care physician for a full evaluation and appropriate treatment.
1. Parkinson’s disease
Parkinson’s disease is a degenerative brain condition that affects movement. It can cause hand tremors, as well as tremors in the arms, legs, or chin, along with muscle stiffness, slow movement, and balance problems.
Read more about the signs and symptoms of Parkinson's disease and how they can present.
What to do: Treatment focuses on relieving symptoms and is managed by a neurologist. Medications such as levodopa, carbidopa, and amantadine may be prescribed. Other supportive therapies may include physical exercises to strengthen muscles, therapeutic massage, occupational therapy, and speech therapy.
2. Essential tremor
Essential tremor is a nervous system disorder that mainly causes hand and arm tremors during movement. It can also affect the head, voice, or legs.
What to do: Treatment may include relaxation techniques, physical therapy, and biofeedback. Avoiding stimulants like caffeine can help reduce symptoms. Medications such as beta-blockers, anti-seizure drugs, and anti-anxiety medications may be recommended. Botox injections can also be used in cases where medication and stress control are not enough to manage the tremors.
3. Medication side effects
Certain medications, including antidepressants, anticonvulsants, antihistamines, and asthma treatments, can cause hand tremors as a side effect.
What to do: Speak with the prescribing doctor to evaluate the possibility of adjusting the dosage or switching to a different medication.
4. Hypoglycemia
Low blood sugar, or hypoglycemia, occurs when blood glucose levels drop below normal. This can trigger symptoms such as hand tremors, dizziness, chills, mental confusion, heart palpitations, and even fainting.
Also recommended: 17 Symptoms of Hypoglycemia (and What to Do) tuasaude.com/en/symptoms-of-hypoglycemiaWhat to do: Treatment depends on the severity of the condition. If the person is conscious, they should consume foods or drinks high in simple sugars to quickly restore blood sugar levels. In severe cases, where blood sugar drops below 55 mg/dL, a glucagon injection may be necessary if available. If symptoms persist, emergency medical services should be contacted.
5. Stress and anxiety
Stress and anxiety can cause tremors in the hands, legs, and voice due to the release of cortisol and adrenaline. These hormones increase alertness, muscle tension, nervous system activity, and heart rate.
Read about the difference between stress and anxiety and how these can present.
What to do: Treatment should be guided by a psychologist or psychiatrist and may involve psychotherapy and relaxation techniques, such as regular physical activity, sleeping 7 to 9 hours per night, and maintaining a healthy diet. In some cases, treatment may include natural remedies like passionflower (passiflora) or prescription medications such as antidepressants, anti-anxiety drugs, or antipsychotics.
6. Excessive caffeine intake
Too much caffeine, found in coffee, chocolate, and green tea, can lead to hand tremors. Caffeine stimulates the nervous system and may trigger or worsen muscle tremors.
What to do: Reducing or eliminating caffeine intake is often enough to relieve the symptoms. In cases of caffeine overdose, treatment may involve activated charcoal, IV fluids, or medications like beta-blockers to manage symptoms. These interventions should be guided by a healthcare provider.
7. Hyperthyroidism
Hand tremors can occur due to hyperthyroidism, a condition in which the thyroid gland produces too much thyroid hormone. This increases cellular energy production and overstimulates the nervous system.
Check-out the symptoms of hyperthyroidism which may signal an overproduction of thyroid hormone.
What to do: Treatment should follow guidance from a primary care physician or endocrinologist and may include medications like methimazole or propylthiouracil, radioactive iodine therapy, or thyroid surgery.
8. Multiple sclerosis
Multiple sclerosis (MS) is a neurological and autoimmune disease that causes permanent damage to the nerves. It can lead to symptoms like hand tremors, loss of motor control, and muscle weakness.
What to do: Treatment includes medications such as methylprednisolone, interferon, and prednisone to manage symptoms, prevent flare-ups, or slow disease progression. Regular physical activity, acupuncture, occupational therapy, and physical therapy can also help manage symptoms.
9. Alcohol withdrawal
Alcohol withdrawal can cause tremors in the hands or other body parts because regular alcohol use alters how neurotransmitters work in the brain. When alcohol is stopped, imbalances in neurotransmitters like GABA and glutamate can cause withdrawal symptoms such as tremors, anxiety, irritability, nightmares, headaches, and loss of appetite.
What to do: Treatment usually involves keeping the person in a calm and controlled environment, such as a hospital or rehab facility, to minimize the risk of complications. Intravenous fluids, vitamin supplements like folate and thiamine, and medications such as benzodiazepines, chlordiazepoxide, oxazepam, antipsychotics, or anticonvulsants like carbamazepine and valproic acid may also be used.
When to see a doctor
It is important to seek medical attention if hand tremors are intense, persistent, or interfere with daily activities. A doctor should also be consulted if other symptoms occur, such as changes in consciousness, balance problems, excessive sweating, or difficulty speaking.