Tremor
Shaking; Tremor - hand; Hand tremor; Tremor - arms; Kinetic tremor; Intention tremor; Postural tremor; Essential tremorA 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, tongue, or vocal cords.
Considerations
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 type of 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
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...
Read Article Now Book Mark ArticleCauses
A tremor may be caused by:
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Certain medicines
Certain medicines
Drug-induced tremor is involuntary shaking due to the use of medicines. Involuntary means you shake without trying to do so and can't stop when you ...
Read Article Now Book Mark Article - Brain, nerve, or movement disorders (such as Parkinson disease), including uncontrolled muscle movements (dystonia)
Parkinson disease
Parkinson disease results from certain brain cells dying. These cells help control movement and coordination. The disease leads to shaking (tremors...
Read Article Now Book Mark ArticleDystonia
Uncontrolled or slow movement is a problem with muscle tone, usually in the large muscle groups. The problem leads to slow, uncontrollable jerky mov...
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- Alcohol use or alcohol withdrawal
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Multiple sclerosis
Multiple sclerosis
Multiple sclerosis (MS) is an autoimmune disease that affects the brain and spinal cord (central nervous system).
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- Normal aging
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Overactive thyroid
Overactive thyroid
Hyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often called overactive thyroid.
Read Article Now Book Mark Article - Stress, anxiety, or fatigue
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Stroke
Stroke
A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...
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Home Care
Your provider will likely suggest self-care measures to help with daily life.
Self-care measures
A tremor is a type of shaking in your body. Most tremors are in the hands and arms. However, they may affect any body part, even your head or voice...
Read Article Now Book Mark ArticleFor 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 medicine, 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
This article describes how to determine if you have a problem with alcohol use and offers advice on how to decide to quit drinking.
Read Article Now Book Mark ArticleSevere tremors may make it hard to do daily activities. You may need help with these activities.
Devices that may help include:
- Buy clothes with Velcro fasteners instead of buttons or hooks.
- Cook or eat with utensils that have larger handles that are easier to grip.
- Drink from half-filled cups or use sippy cups to avoid spilling.
- Use straws to drink so you do not have to pick up your glass.
- Wear slip-on shoes and use shoehorns.
- Wear a heavier bracelet or watch. It may reduce a hand or arm tremor.
When to Contact a Medical Professional
Contact 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 provider will perform a physical exam, including a detailed brain and nervous system (neurologic) exam. You may be asked questions to help your provider 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
CBC
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
Read Article Now Book Mark ArticleBlood differential
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...
Read Article Now Book Mark ArticleThyroid function tests
Thyroid function tests are used to check whether your thyroid is working normally. The most common thyroid function tests are:Free T4 (free thyroxine...
Read Article Now Book Mark ArticleGlucose test
A blood sugar test measures the amount of a sugar called glucose in a sample of your blood. Glucose is a major source of energy for most cells of the...
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Electromyography (EMG) or nerve conduction studies to check the functions of the muscles and nerves
Electromyography
Electromyography (EMG) is a test that checks the health of the muscles and the nerves that control the muscles.
Read Article Now Book Mark ArticleNerve conduction studies
Nerve conduction velocity (NCV) is a test to see how fast electrical signals move through a nerve. This test is done along with electromyography (EM...
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Head CT scan
Head CT scan
A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.
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MRI of the head
MRI of the head
A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...
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Once a cause of the tremor has been determined, treatment may be recommended.
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.
Hyperthyroidism
Hyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often called overactive thyroid.
Read Article Now Book Mark ArticleIf the tremor is caused by a certain medicine, stopping or changing the medicine will usually help it go away. Never stop taking any medicine without first talking to your provider.
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.
References
Haq IU, Liebenow B, Okun MS. Clinical overview of movement disorders. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 105.
Jankovic J, Lang AE. Diagnosis and assessment of Parkinson disease and other movement disorders. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 24.
Okun MS, Ostrem JL. Other movement disorders. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 379.
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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.
Muscular atrophy
illustration
Review Date: 6/13/2024
Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.