Hand Tremor

Alternative names:

shaking of the hands; tremor - of the arms or hands

Home care:

Severe tremors may interfere with ability to perform daily activities. Assistance with these activities, as necessary, is recommended and precaution should be taken to avoid injury during activities such as walking or eating.

For hand tremor caused by stress, try to relax.

For hand tremor caused by reaction to drugs, consult with the doctor about discontinuing, reducing the dosage, or switching medications. DO NOT CHANGE MEDICATIONS WITHOUT CONSULTING YOUR HEALTH CARE PROVIDER.

For hand tremor caused by essential tremor, try to relax, and avoid dependence on alcohol.

For hand tremor caused by alcohol abuse, avoid alcohol.

For hand tremor caused by other conditions, see the doctor.

Call your health care provider if:

• the shakes are worst at rest and least intensive when reaching for something.
• there are prolonged and severe tremors that interfere with lifestyle.
• the tremors are associated with other symptoms.

What to expect at your health care provider's office:

The medical history will be obtained and a physical examination performed.

Medical history questions documenting hand tremor in detail may include:

• type
  • Is the tremor regular or irregular?
  • Are the movements small (fine) or large (coarse)?

• distribution
  • Are both hands affected?
  • Is it the same on both sides?

• quality
  • Does the tremor impair the ability to use the hands?
  • Is it a rapid and rhythmic tremor?

• aggravating factors
  • Is it worse after emotional stress?
  • Does excitement make it worse?
  • Is it worse when you try to use your hand (action tremor)?
  • Do specific postures (e.g., holding arms extended horizontally) make the tremor worse?

+ + Which postures?

• relieving factors
  • Is the tremor better after you rest?
  • Is the tremor better after you sleep?
  • Does drinking an alcoholic beverage make the tremor less?
  • Does L-DOPA (levodopa medication) make the tremor less?

• other
  • What other symptoms are present?

Diagnostic tests that may be performed include:

• blood tests such as CBC, blood differential, thyroid function tests, and glucose test
• head CT scan
• MRI of the head
• EMG or nerve conduction studies

Once a cause of the tremor has been determined, the appropriate treatment for the disease will be prescribed.

After seeing your health care provider:
If a diagnosis was made by your health care provider related to a hand tremor, you may want to note that diagnosis in your personal medical record.