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, tongue, 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 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 (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 Article
Tremor may be caused by:
- Certain medicines
- Brain, nerve, or movement disorders, including uncontrolled muscle movements (dystonia)
- Brain tumor
- Alcohol use or alcohol withdrawal
- 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.
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 Article
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
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 Article
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
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 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 white blood cells (WBC count)The number of red blood cells (RBC count)The numb...Read Article Now Book Mark Article
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 Article
Thyroid function tests
Thyroid function tests are used to check whether your thyroid is working normally. The most common thyroid function tests are:Free T4 (the main thyro...Read Article Now Book Mark Article
- 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.Read Article Now Book Mark Article
- 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 pubmed.ncbi.nlm.nih.gov/26293405/.
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.
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: 5/2/2022
Reviewed By: Amit M. Shelat, DO, FACP, FAAN, Attending Neurologist and Assistant Professor of Clinical Neurology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY. 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.