TremorShaking; Tremor - hand; Hand tremor; Tremor - arms; Kinetic tremor; Intention tremor; Postural tremor; Essential tremor
A tremor is a type of shaking movement. A tremor is most often noticed in the hands and arms. It may affect any body part, including the head or vocal cords.
Tremors can happen at any age. They are more common in older people. Everyone has some tremor when they move their hands. Stress, fatigue, anger, fear, caffeine, and smoking may make this type of tremor worse.
A tremor that does not go away over time may be a sign of a medical problem and should be checked by your health care provider.
Essential tremor is the most common tremor. The shaking most often involves small, rapid movements. It usually occurs when you are trying to do something, such as reaching for an object or writing. This type of tremor may also run in families.
Essential tremor (ET) is a type of involuntary shaking movement. It has no identified cause. Involuntary means you shake without trying to do so an...
Tremor may be caused by:
- Certain medicines
- Brain, nerve, or movement disorders, including uncontrolled muscle movements (dystonia)
- Brain tumor
- Alcohol use or alcohol withdrawal
Alcohol use disorder is when your drinking causes serious problems in your life, yet you keep drinking. You may also need more and more alcohol to f...
- Multiple sclerosis
- Muscle tiredness or weakness
- Normal aging
- Overactive thyroid
- Parkinson disease
- Stress, anxiety, or fatigue
- Too much coffee or other caffeinated drink
Your provider will likely suggest self-care measures to help with daily life.
Shaking - self-care; Essential tremor - self-care; Familial tremor - self-care
For tremors caused by stress, try ways to relax, such as meditation or breathing exercises. For tremors of any cause, avoid caffeine and get enough sleep.
For tremors caused by a medicine, talk to your provider about stopping the drug, reducing the dosage, or switching to another medicine. Do not change or stop medicines on your own.
For tremors caused by alcohol use, seek treatment to help you stop drinking alcohol.
Stop drinking alcohol
Alcohol use disorder - quitting drinking; Alcohol abuse - quitting drinking; Quitting drinking; Quitting alcohol; Alcoholism - deciding to quit...
Severe tremors may make it hard to do daily activities. You may need help with these activities.
Devices that may help include:
- Buying clothes with Velcro fasteners or using button hooks
- Cooking or eating with utensils that have a larger handle
- Using a sippy cup to drink
- Wearing slip-on shoes and using shoehorns
When to Contact a Medical Professional
Call your provider if your tremor:
- Is worse at rest and gets better with movement such as when you reach for something
- Is prolonged, severe, or interferes with your life
- Occurs with other symptoms, such as headache, weakness, abnormal tongue movements, muscle tightening, or other movements that you cannot control
What to Expect at Your Office Visit
Your doctor will perform a physical exam, including a detailed brain and nervous system (neurologic) examination. You may be asked questions to help your doctor find the cause of your tremors:
The following tests may be ordered:
- Blood tests such as CBC, blood differential, thyroid function tests, and glucose test
A complete blood count (CBC) test measures the following:The number of red blood cells (RBC count)The number of white blood cells (WBC count)The tota...
The blood differential test measures the percentage of each type of white blood cell (WBC) that you have in your blood. It also reveals if there are...
Thyroid function tests
Thyroid function tests are used to tell whether your thyroid is working normally. The most common thyroid function tests are:Total, or free T4 (the m...
- EMG or nerve conduction studies to check the functions of the muscles and nerves
Electromyography (EMG) is a test that checks the health of the muscles and the nerves that control the muscles.
- Head CT scan
- MRI of the head
- Urine tests
Once a cause of the tremor has been determined, treatment will be prescribed.
You may not need treatment unless the tremor interferes with your daily activities or causes embarrassment.
Treatment depends on the cause. Tremor caused by a medical condition, such as hyperthyroidism, will likely get better when the condition is treated.
If the tremor is caused by a certain medicine, stopping the drug will usually help it go away. Never stop taking any medicine without first talking to your doctor.
You may be prescribed medicines to help relieve symptoms. How well medicines work depends on your overall health and the cause of the tremor.
In some cases, surgery is done to relieve the tremors.
Fasano A, Deuschl G. Therapeutic advances in tremor. Mov Disord. 2015;30:1557-1565. PMID: 26293405. www.ncbi.nlm.nih.gov/pubmed/26293405.
Jankovic J, Lang AE. Diagnosis and assessment of Parkinson disease and other movement disorders. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 23.
Raftery AT, Lim E, Ostor AJK. Tremor. In: Raftery AT, Lim E, Ostor AJK, eds. Churchill's Pocketbook of Differential Diagnosis. 4th ed. Philadelphia, PA: Elsevier; 2014:468-470.
Muscular atrophy - illustration
Muscular atrophy is the decrease in size and wasting of muscle tissue. Muscles that lose their nerve supply can atrophy and simply waste away.
Review Date: 5/30/2016
Reviewed By: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.