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Shaking Hands: What Are My Treatment Options?

Understanding shaky hands

Key points

  1. Shaking hands are usually caused by an essential tremor.
  2. Essential tremor can worsen with age.
  3. Your treatment plan will vary depending on the severity of your shaking.

Shaky hands are commonly referred to as a hand tremor. A hand tremor isn’t life-threatening, but it can make daily tasks difficult. It can also be an early warning sign of some neurological and degenerative conditions. You should speak with your doctor if you experience hand tremors.

What causes shaky hands?

Causes

Many people associate shaky hands with Parkinson’s disease, but the most common cause of shaking hands is actually essential tremor.

Essential tremor is the most common neurologic disorder affecting adults, but it’s not well-understood. It’s likely caused by a disruption in normal brain function of the cerebellum. Researchers aren’t entirely sure what causes the interruption, if it is a degenerative process, or how it can be stopped.

People with essential tremor often experience frequent shaking. The shaking is most common in the hands, arms, head, and vocal cords, and cannot be controlled. This shaking is most obvious when you try to use a muscle. When the muscle is relaxed, the shaking will likely not occur or it will become more mild.

By comparison, people with Parkinson’s disease typically experience a hand tremor when their muscles are at rest and see a reduction in the tremor when their muscles are in use.

Shaky hands can also be caused by:

  • seizure
  • overactive thyroid
  • cerebellar disease
  • Huntington’s disease
  • medication side effects
  • caffeine overdose
  • alcohol abuse or addiction
  • anxiety
  • low blood sugar

Learn more: Early-onset Parkinson’s »

Is there a cure for shaky hands?

Question

Treatment options will be determined by the cause of your hand tremor, though there is no cure for most tremors. If your tremor is caused by an underlying condition, treating that condition may reduce or eliminate the tremor. If caffeine, alcohol, or other stimulants affect your tremor, consider removing these from your diet. If your tremor is a side effect of medication, speak with your doctor about your options.

If your shaky hands are caused by essential tremor, there is no cure. The problem, which often begins in early adulthood, will likely worsen as you age. Treatments may offer some relief of your symptoms. The types of treatment you use will depend on how severe the shaking is and the possible side effects that treatment may cause. You and your doctor can weigh your options.

What medications treat shaky hands?

Pills

Not everyone with shaky hands will need treatment, but if your doctor decides you’re a good candidate, you may first begin by taking prescription medication.

The most commonly prescribed medications for shaky hands are:

If these do not work for you, your doctor may recommend other medications.

Sotalol (Betapace) and atenolol (Tenormin) are beta-blockers designed to treat arrhythmia and hypertension, but they may be used to treat essential tremor. Your doctor may prescribe one of these medications if other medications do not help your tremor.

Gabapentin (Neurontin) and topiramate (Topamax) are medications primarily used to treat seizures. They may be helpful for people with essential tremor.

Alprazolam (Xanax) is used to treat anxiety and panic disorders, but research indicates that it may be an effective treatment for essential tremor. This drug should be taken with great caution because it’s known to be habit-forming.

Botulinum toxin type A (Botox) shows promise as a treatment for essential tremor in the hands. This medicine may cause permanent muscle weakness where injected, so be sure to talk with your doctor about the potential risks and benefits. The benefits from a successful injection can last up to three months. Subsequent injections may be needed.

What surgeries treat shaky hands?

Treatment

Your doctor is unlikely to recommend surgery as your first treatment option. Surgical treatments are typically reserved for people who have a severely disabling tremor. Surgery may become an option as you age or if the tremor worsens.

Deep brain stimulation (DBS)

DBS is a surgical procedure used to treat a tremor. During a DBS procedure, a surgeon will place an electronic device called an electrode in your brain. Once in your brain, the device emits an electronic signal that interferes with the brain activity responsible for the tremor. DBS is currently only recommended for people with advanced or severe limb tremor.

Thalamotomy

Thalamotomy is another surgical option. During this procedure, your surgeon will cut a small lesion in your brain’s thalamus. This interrupts the brain’s normal electrical activity and reduces or stops the tremor.

What therapies treat shaky hands?

Physical Therapy

Your doctor may suggest one or more lifestyle changes as a way to possibly help ease the symptoms of essential tremor.

Your doctor may recommend the following lifestyle changes:

  • Use heavier objects. You may need to replace lightweight or delicate objects, such as glasses, silverware, or plates, with heavier versions. The extra weight may make the item easier to handle.
  • Use specially designed utensils and tools. Gripping and controlling pens, pencils, garden tools, and kitchen utensils may be difficult if you have shaky hands. You may need to seek out versions of these items that are designed for individuals with grip and control issues.
  • Wear wrist weights. The extra weight on your arm may make control easier.

Talk to your doctor about treatments

when to see a doctor

If you’ve experienced shaky hands or symptoms of essential tremor, make an appointment to speak with your doctor. Your doctor will likely request several medical and physical tests to rule out other possibilities before a diagnosis can be made.

Once a diagnosis has been made, you can begin to discuss treatment options with your doctor. Treatment may not be necessary if the tremor is mild and doesn’t interfere with day-to-day activities. If the shaking becomes too difficult to manage, you can revisit the treatment options. Finding one that works well with minimal side effects may take time. Work with your doctor and any therapists or specialists you visit to find a plan that best suits your needs.

Keep reading: Essential tremor »

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