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Tremors: What Can They Mean?

Medically reviewed by Susan Kerrigan, MD and Marianne Madsen on February 3, 2023
Additions/comments by Neurologist Steve Schadendorf, MD

If you’ve reached middle age or beyond, you might have noticed that your hands start to shake every now and then. Maybe you disregard this when it happens and go about your day as usual. But many people who experience shaky hands – also called tremors – have a difficult time doing everyday things such as getting dressed, driving, or even lifting a cup of water to their mouth. What do tremors mean, and what can you do about them?


What causes tremors?


Tremors are not life-threatening, but they can be annoying. And if you’ve got one, you’ve surely wondered why. The fact is that tremors can be caused by a number of different factors, and many types of tremors can happen at random, seemingly without a cause at all. All tremors, though, originate somewhere in the brain, in the parts that control motor function and movement.


Tremors can be caused by neurological disorders, like Parkinson’s disease, stroke, multiple sclerosis (MS), and traumatic brain injury (TBI). In addition, tremors can be caused by certain drugs and medications: Stimulants, asthma medicines, antidepressants, heart medicines, alcohol, nicotine, blood pressure drugs, cancer medications, and immunosuppressants can all lead to tremors. Finally, certain medical conditions like anxiety or panic attacks, liver or kidney failure, and hyperthyroidism can also cause tremors.

Types of tremors


There are three main types of tremors:


  1. Essential tremors, also known as benign essential tremors, are the most common type of tremors. They usually affect your hands but can also affect other parts of your body including head, tongue, legs, and even your voice.
  2. Parkinsonian tremors are very common in those with Parkinson’s disease. About 70% of people with Parkinson’s experience tremors. They always start on one side of the body and usually affect both hands but can also affect the face and legs.
  3. Dystonic tremors occur in people with dystonia, a disorder that causes involuntary muscle contractions. Dystonia can affect any muscle in the body, causing tremors.

I have a tremor, but I don’t know why. What should I do?


Your doctor or healthcare provider will be able to determine what exactly is causing your tremor, and if your tremor is a symptom of a bigger problem. Your visit to your doctor may involve the following:


  • Your doctor will go over your medical history.
  • You’ll undergo a physical examination to determine the location of your tremor and how often it occurs.
  • You will undergo a neurological examination, to rule out any problems with balance, speech, or muscle stiffness.
  • Your doctor may also decide to do a blood or urine test, an imaging test, an electromyogram, or a test that measures your ability to perform daily tasks.


Treating tremors


Unfortunately, tremors cannot be cured, but they can be treated, either through medication, surgery (in severe cases), or physical and speech therapy. Many cases of tremors are mild and do not require treatment at all.


If you’ve been experiencing tremors and can’t figure out why, make an appointment with your doctor and see how he or she recommends that you proceed.

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