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

The most common cause of shaking hands in adults is essential tremor, a condition doctors do not fully understand. Learn more about it in the causes section below.

If you experience hand tremors, speak with your doctor.

Read on to learn more about the treatments for shaking hands, as well as the various causes of this symptom.

Not everyone with shaky hands will need treatment. But if your doctor decides you’re a good candidate, they may prescribe medication first.

Commonly prescribed medications

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

Propranolol is a beta-blocker designed to treat:

Primidone is an antiseizure medication.

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

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 (which can cause shaking hands) and panic disorders, but early research indicated that it may be an effective treatment for essential tremor. This drug should be taken with caution because it’s known to be habit-forming.


Botulinum toxin type A (Botox) shows promise as a treatment for essential tremor affecting the hands. This medicine may cause significant muscle weakness where injected, so be sure to speak 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.

A doctor may recommend one or more strategies to help ease the symptoms of essential tremor. Suggestions may include:

  • Using 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.
  • Using specially designed utensils and tools. Gripping and controlling items like pens, pencils, garden tools, and kitchen utensils may be difficult if you have shaky hands. You might consider looking for versions of these items that are designed for people with grip and control challenges.
  • Wearing wrist weights. The extra weight on your arm may make control easier.

A 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

Deep brain stimulation (DBS) is a surgical procedure used to treat tremors. During a DBS procedure, a surgeon places 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 your 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 small area of your brain’s thalamus. An MRI is used to guide where the waves are aimed. This interrupts the brain’s typical electrical activity and reduces or stops the tremor.

A tremor, or shaking hands, is not always the result of an illness or disease. It can be a reaction to something like medication or stress.

Tremors range in severity. They can occur randomly, or they can be constant.

Understanding the underlying condition or issue can often help you and your doctor find a treatment that’s helpful.

Essential tremor

The most common cause of shaking hands is essential tremor, which affects adults most often. Essential tremor is not well understood. It’s thought to be caused by a disruption in the normal functioning in parts of your central nervous system, such as your cerebellum.

This type of tremor runs in families sometimes. In fact, about 50 percent of cases of essential tremor are thought to be genetic, according to the National Institute of Neurological Disorders and Stroke.

Researchers aren’t entirely sure what causes the neurological interruption or 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 your hands, arms, head, and vocal cords. The shaking may be more pronounced in your dominant hand, but it can affect both sides of your body.

Parkinson’s disease

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. This is called resting tremors.

But about one quarter of people with Parkinson’s disease also have an action tremor, or a tremor that occurs when the muscles are in use.

Tremor is typically an early sign of Parkinson’s disease. Most people will experience the shaking on one side of their body, but it may spread with time. Stress, anxiety, or excitement can make the shaking worse.


An ischemic stroke occurs when a blood clot blocks an artery that supplies blood to your brain. This prevents blood and oxygen from reaching your brain.

Long-term, lasting damage can occur if the stroke is not immediately treated. Any lasting damage can affect the neurological pathways in your brain and cause tremors in your hands.

Overactive thyroid

The thyroid is a gland in your neck that sits just above your collarbone. It produces the hormones that help supply your body with energy, and it uses those hormones to regulate your metabolism.

If you produce too much of the hormones, you may have a metabolic condition known as overactive thyroid, or hyperthyroidism. An overactive thyroid makes your body more active than it needs to be. This can cause issues like:

  • increased heart rate
  • trouble sleeping
  • shaking hands

Cerebellar disorders

Cerebellar disorders are a group of disorders that affect your brain’s cerebellum, the area of your brain that controls balance and coordination. Damage to this part of your brain can interrupt the intricate pathways that control movement and coordination.

Disorders like fragile X syndrome impact the cerebellum. They commonly cause tremors, in addition to balance and walking issues.

Other conditions can damage the cerebellum and lead to shaking hands. These potential causes include strokes, seizures, or tumors. The damage to someone’s brain may make smooth, controlled movement difficult.

Huntington’s disease

Huntington’s disease is a condition that causes the progressive breakdown of nerve cells in your brain. A shaking or jerking hand is one of the most common signs of Huntington’s disease. Over time, the condition will greatly impair your cognitive and emotional capabilities, as well as your physical ones.

Traumatic brain injury

A physical injury to your brain can impair your brain’s typical functioning. The damage to your brain may impact physical movement.

Hand tremors or shaking may occur when the injury affects certain areas of your brain, like the cerebellum, or the nerves that control hand movement.

A brain injury may occur in an accident, such as a car collision or a fall. It can even result from activities like sports.

Medication side effects

Shaking hands can be the result of medication side effects, including certain:

One reason these drug-induced tremors occur is because some of these medications block a brain chemical called dopamine. This chemical moves information from one part of your brain to another. When the dopamine can’t reach the parts of your brain that it should, movement issues like shaking hands can develop.

If you stop the medication, the tremors will likely go away. However, be sure to weigh the medication’s benefits against the side effects or ask your doctor about a different medication that may be less likely to cause shaking hands.

Caffeine overdose

If you’ve ever had a cup of coffee or tea on an empty stomach, you might know the impact caffeine may have on your hands. Too much caffeine can lead to shaking hands. That’s because caffeine stimulates your body’s muscles, causing them to move out of sequence.

Other symptoms of a caffeine overdose include:

  • rapid heartbeat
  • confusion
  • headache
  • insomnia
  • irritability

Alcohol overuse or withdrawal

People whose bodies are physically dependent on alcohol may experience a number of withdrawal symptoms if they try to stop drinking. Shaking hands, or “the shakes,” is one of the most common signs of alcohol withdrawal. Other symptoms include:

  • sweating
  • hallucinations
  • nausea
  • vomiting

The shaking or tremors may last a few days, but if your body has been physically dependent on alcohol for a long period of time, this symptom, as well as others, can last many months.


Stress and anxiety are a reality of everyday living for many people.

When you experience stress and anxiety, your body responds by releasing a surge of adrenaline, a hormone that helps control your body’s energy.

Stress also activates your natural “fight of flight response.” This sudden rush of adrenaline can lead to a faster heartbeat and an increase in blood flow to your brain. It may also cause shaking hands.

Stress can also worsen an existing tremor.

Low blood sugar

Low blood sugar, or hypoglycemia, occurs when your body doesn’t have enough energy, or glucose, to fuel your activities. Skipping meals, taking too much medication, exercising too much, or eating too little can lead to a drop in your blood glucose levels.

When your blood sugar levels drop too low, your body triggers its own stress response. This can make you feel shaky and jittery. Other symptoms of low blood sugar include:

  • sudden nervousness
  • rapid heartbeat
  • trouble thinking
  • sweating
  • dizziness

For people with diabetes, low blood sugar can be dangerous. If left untreated, it can lead to loss of consciousness, seizure, or coma.

Multiple sclerosis

Multiple sclerosis (MS) is a progressive disease that occurs when your body’s immune system attacks your brain, nerves, and spinal cord. This leads to issues like inflammation and lesions in your central nervous system and brain.

As the damage worsens, symptoms like shaking hands may appear. In fact, MS can cause a number of tremors.

Other symptoms of MS include:

  • changes to speech
  • difficulty swallowing or chewing
  • issues with bladder control

Though there’s no cure for most tremors, there are available treatments options. These treatments are determined by the cause of your hand tremor. 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, but there are ways to manage it. The condition, which often begins in adolescence or in your 40s, may worsen as you get older.

However, 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 discuss your options.

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

Once a diagnosis is 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. You can 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.

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