Understanding Tremors (Hand Shaking) – Causes, Types & Treatment
Tremor is an involuntary, rhythmic muscle contraction leading to shaking movements in one or more parts of the body. Most often in the hands, tremors may also affect the head, voice, arms, or legs, making routine activities more challenging. For others, shaky hands are more than just nerves, they’re a daily struggle that affects quality of life. So, what causes hand tremors? Are they ever a sign of something serious? Most importantly, is there a cure for essential tremors? In this post we cover all these questions and more to demystify this condition.
What is Tremor? (Definition & Types)
Tremor is an involuntary shaking or trembling that can occur in any part of the body. It can be infrequent or persistent and can cause minimal discomfort or be disabling. Depending on when they appear, tremors are classified into various types.
There are two most common types:
- Resting Tremor: This occurs when the muscles are relaxed and resting, as if your hands are resting in your lap. Resting tremors, which are most commonly seen with neurological conditions such as Parkinson’s disease.
- Action Tremor: Action tremor happens when you move on purpose, like when you write, feed yourself, or pick up something. The most common form is essential tremor, which belongs to this group.
Other types include:
- Dystonic Tremor: This occurs in those affected with dystonia, which is when unusual muscle contractions lead to repetitive or twisted movements.
- Physiologic Tremor: A slight, usually transient shaking caused by stress, fatigue, or an overdose of caffeine. This is normal and if the control is kept strict, there is no harm.
Hand Tremors Causes
There are various causes of hand tremors and they can be broadly categorised as neurological, metabolic, those associated with lifestyle, and other causes.
Neurological Causes:
- Essential Tremor: This is the most common form of tremor and it commonly runs in families. It often occurs in the fingers or lower arms, and is most evident during movement. Although it is not life-threatening, it does tend to get worse over time.
- Parkinson’s Disease: Characterised by a resting tremor, Parkinson’s is a degenerative disease. In addition to hand tremors, it can lead to muscle rigidity, slowness of movement and balance problems.
- Multiple Sclerosis (MS): MS is an autoimmune disorder that partially destroys nerve sheaths, and may lead to action tremors among other motor control problems.
Metabolic & Lifestyle Causes:
- Hyperthyroidism: An overactive thyroid causes metabolism to rev up, leading to hand tremors, rapid heartbeat and weight loss.
- Substance abuse: Caffeine overdose or alcohol withdrawal can cause tremor. Chronic misuse of alcohol can also cause tremors that don’t go away.
- Medication Side Effects: Some medications, such as bronchodilators used to treat asthma, some antidepressants and antipsychotics, can induce tremors as a side effect.
Other Causes:
- Low Blood Sugar (Hypoglycaemia): This is a common ailment present in diabetics causing your hands to shake, be irritable and be confused.
- Anxiety and fatigue: Mental and physical stress can make tremors worse or bring them on.
Diseases That Cause Tremors in Hands
There are also medical conditions however, that are linked to hand shakes:
- Essential Tremor – The most frequent type, often hereditary.
- Parkinson’s Disease – With resting tremor and rigidity.
- Dystonia – Results in abnormal position and tremors from continual involuntary movements of muscles.
- Brain Injury / Stroke – May interfere with control centres in the brain.
Some tremors may be categorised as idiopathic, that is, without a known cause.
Diagnosis: How Doctors Identify Tremors
The cause of a tremor requires a careful medical history and consistent physical examination. An examination When you visit your GP or neurologist, they will probably start with a physical examination, in which they look to see when your tremor happens – when you are at rest, when you are moving, or when you are in certain positions.
Investigations may also be indicated for the following:
- Neurological Examination: An evaluation of coordination, reflexes, and muscle tone.
- Imaging: MRI or CT scans may be performed to exclude structural lesions in the brain.
- Blood Tests: to check thyroid issues, blood sugar issues or deficiency such as vitamin B12.
It is important to have an accurate diagnosis to ensure proper treatment.
Cure for Essential Tremors & Treatment Options
There is no cure for essential tremors, though several treatments can alleviate symptoms and help with daily activities.
Medical Treatments:
- Beta-Blockers (such as Propranolol): Used for treating heart problems, they can also help suppress tremors.
- Anti-Seizure Medications (e.g., Primidone): Helpful in diminishing the severity of the tremor, particularly when beta-blockers are contraindicated.
- Botulinum Toxin Injections: These are for people with more severe, or localised, tremors, such as the hands, or head.
- Deep Brain Stimulation (DBS): An operative technique primarily used in Parkinson’s and dystonia, DBS introduces electrodes into the brain which are able to control abnormal impulses.
Natural & Lifestyle Cures:
Lifestyle changes such as following have been successful in some patients:
- Minimising caffeine and alcohol: Both may exacerbate the tremor.
- Methods of Stress Management: Meditation, breathing exercises, yoga help in reducing intensity of tremor.
- Physical Therapy: with an organised programme, muscle coordination can be improved, tremor has less impact.
Experimental Therapies:
- Focused Ultrasound – A non-invasive treatment that directs focused sound waves at the part of the brain that causes tremors.
- Diet change: However, magnesium and vitamin B12 are believed to promote nerve health and reduce tremor intensity, according to some research.
Living with Tremors: Tips & Outlook
Many people who have the condition can manage tremors by adjusting their lifestyle slightly to function independently:
- Stabilise hand movements by using adapted equipment such as weighted pens or cutlery with large grips.
- Stay away from obvious triggers such as caffeine, lack of sleep or stress.
Prognosis: For most people with ET, the symptom frequency and intensity gradually progress and do not demand specific intervention, whereas the tremor severity in PD deteriorates with time and treatment.
Conclusion
Hand tremors can make a big impact on how confident and capable we feel. Knowing what causes them, from essential tremor to brain disorders, can help direct us to the right diagnosis and treatment. Weak or severe, help and treatment are available.
If shaky hands disrupt your life, consult a neurologist for expert advice and care.
