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What causes shaky hands?

Shaky hands are commonly referred to as a hand tremor. A hand tremor in itself 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.

Many people associate shaky hands with Parkinson’s disease. But according to the Cleveland Clinic, the most common cause of shaking hands is actually essential tremor.

Essential tremor most commonly affects adults, but it’s not well understood. It’s thought to be caused by a disruption in the normal functioning in parts of the central nervous system, such as the cerebellum. This type of tremor runs in families for some.

Researchers aren’t entirely sure what causes the neurological interruption nor how to stop it. They’re also unclear about whether it’s a degenerative process.

People with essential tremor experience frequent shaking that tends to be worse when in motion. The shaking can’t be controlled and most often occurs in the hands, arms, head, and vocal cords.

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:

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.

Commonly prescribed medications

According to the National Tremor Foundation, the most commonly prescribed medications for treating shaky hands of an essential tremor are:

Propranolol is a beta-blocker designed to treat arrhythmia, fast heart rate, and hypertension, while primidone is an antiseizure medication.

If these don’t work for you, your doctor may recommend other medications.

Which treatment has helped your shaky hands?

Other beta-blockers

Metoprolol (Lopressor) and atenolol (Tenormin) are also beta-blockers that may be used to treat essential tremor. Your doctor may prescribe one of these medications if other medications don’t help your tremor, but it may not work as well as propranolol.

Other antiseizure medications

Gabapentin (Neurontin) and topiramate (Topamax) are other medications primarily used to treat neurological or psychiatric conditions, such as seizures or neuropathic pain. They may be helpful for people with essential tremor.

Anti-anxiety medication

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 significant 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 3 months. Subsequent injections may be needed.

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)

Deep brain stimulation (DBS) is a surgical procedure used to treat a tremor. During a DBS procedure, a surgeon will place electronic devices called electrodes in your brain that receive an electronic signal that interferes with the brain activity responsible for the tremor.

The signal is transmitted from a device that’s implanted under the skin of the upper chest. DBS is currently only recommended for people with advanced or severe limb tremor.


Thalamotomy is another surgical option.

During this procedure, your surgeon will use radiofrequency sound waves to make a permanent lesion in a very minute area of your brain’s thalamus. (MRI is used to guide where the waves are aimed.) This interrupts the brain’s normal electrical activity and reduces or stops the tremor.

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

  • 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. For example, there are many adaptive utensil options available on Amazon.
  • Wear wrist weights. The extra weight on your arm may make control easier. Find a great selection of wrist weights here.

Treatment options will be determined by the cause of your hand tremor, though there’s 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 them 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’s no cure. The problem, which often begins in adolescence or in the 40s, may worsen as you age.

Treatments may offer some symptom relief. The types of treatment you use will depend on how severe the shaking is and the potential side effects of each treatment option. You and your doctor can weigh your options.

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. 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.

The most common cause of shaky hands is essential tremor. This neurological disorder causes frequent, uncontrolled shaking, especially during movement. Other causes of shaky hands include anxiety and seizures.

While there’s no cure for most hand tremors, prescription medications and lifestyle changes may provide relief, depending on the cause.