Hand Tremor

Considerations:
A tremor is a symptom that may be present in otherwise healthy people, as well as in people with medical disorders.

Tremor or shaking can be associated with fatigue , stress , anxiety , anger, or rage. However, constant tremor that is not associated with altered emotional states may be a sign of disease or abnormal condition and should be evaluated. Tremor that is associated with involuntary movement of other parts of the body, such as the tongue and head, is always abnormal and should be evaluated.

Essential tremor , which is usually hereditary, is common (prevalence is 15%) in people older than 70 years. Essential tremor is rarely present when the hands are not being used and becomes most apparent when trying to do something like reaching for an object or writing. It is not caused by an underlying disease.

Essential tremor is commonly suppressed by alcohol consumption , an important fact in making the diagnosis, but alcohol is NOT a desirable treatment.

Common Causes:

Note: There may be other causes of a hand tremor. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for a hand tremor, occurring alone or in combination with other problems.

Home Care:
Severe tremors may interfere with ability to perform daily activities. Assistance with these activities, as necessary, is recommended and precaution should be taken to avoid injury during activities such as walking or eating.

For hand tremor caused by stress , try to relax.

For hand tremor caused by reaction to drugs, consult with the doctor about discontinuing, reducing the dosage, or switching medications. DO NOT CHANGE MEDICATIONS WITHOUT CONSULTING YOUR HEALTH CARE PROVIDER.

For hand tremor caused by essential tremor , try to relax, and avoid dependence on alcohol.

For hand tremor caused by alcohol abuse , avoid alcohol.

For hand tremor caused by other conditions, see the doctor.

Call Your Healthcare Provider If:

  • the shakes are worst at rest and least intensive when reaching for something.
  • there are prolonged and severe tremors that interfere with lifestyle.
  • the tremors are associated with other symptoms.



What to Expect:
The medical history will be obtained and a physical examination performed.

Medical history questions documenting hand tremor in detail may include:

  • type
    • Is the tremor regular or irregular?
    • Are the movements small (fine) or large (coarse)?

  • distribution
    • Are both hands affected?
    • Is it the same on both sides?

  • quality
    • Does the tremor impair the ability to use the hands?
    • Is it a rapid and rhythmic tremor?

  • aggravating factors
    • Is it worse after emotional stress ?
    • Does excitement make it worse?
    • Is it worse when you try to use your hand (action tremor)?
    • Do specific postures (e.g., holding arms extended horizontally) make the tremor worse?

+ + Which postures?

  • relieving factors
    • Is the tremor better after you rest?
    • Is the tremor better after you sleep?
    • Does drinking an alcoholic beverage make the tremor less?
    • Does L-DOPA (levodopa medication) make the tremor less?

  • other
    • What other symptoms are present?

Diagnostic tests that may be performed include:

Once a cause of the tremor has been determined, the appropriate treatment for the disease will be prescribed.

After seeing your health care provider:
If a diagnosis was made by your health care provider related to a hand tremor, you may want to note that diagnosis in your personal medical record.