Shaking Hands

The medical term for shaky hands or hands shaking involuntarily is "tremor." This symptom could indicate a physical problem or a mental health condition.

Sometimes, a brief episode of anxiety or stress can cause your hands to be shaky. It might not be a cause for concern, but if you repeatedly notice that your hand or hands become shaky, you should seek medical advice. Depending on the cause of the shaking, there may be treatment available that can help.

This article describes the symptoms, causes, possible treatments for shaking hands, and when you should seek medical attention.

Symptoms of Shaking Hands 

Involuntary shaking can affect one or both hands. This symptom typically comes and goes, or in some medical conditions remain constant. Shaky hands can be associated with stress and anxiety, even when it occurs due to a physical disorder and not as part of a mental health condition.

The symptoms can include:

• A rapid tremor in one hand
• A tremor in both hands, which can involve both arms
• Movements of the fingers that appear like pill rolling
• Shaking while at rest
• Tremors that occur only with action or movement
• Shaking may appear only during times of anxiety or stress
• Shaking that occurs even without anxiety can sometimes worsen during times of anxiety or stress

If you experience episodic shaking of your hand or hands, it’s important to note the triggers that cause it. Describing the pattern to a healthcare provider can help them determine its cause.

Some tremors caused by medical conditions may have other associated symptoms, including:

• Sweating
• Fever
• Hand pain or weakness
• Tremulous, shaky voice
• Slow movement
• Stiff movements
• Problems with balance and coordination
• Feeling overwhelmed, tired, upset, or scared

Causes of Shaking Hands 

Involuntary shaking can be caused by diminished control over physical movements, which may be associated with issues like fatigue, stress, medication, medical illnesses, or mental health disorders. 

Common causes of shaking hands include:

• Anxiety
• Fatigue
• Fever or infection
• Dehydration or electrolyte disturbances
• Carpal tunnel syndrome, arthritis, or a pinched nerve
• A seizure
• A movement disorder, such as Parkinson’s disease
• Medication side effect
• A neurological condition, such as multiple sclerosis (MS), stroke, brain tumor, meningitis (infection or inflammation of the tissue surrounding the brain), or encephalitis (inflammation or infection of the brain) 
• Alcohol or drug intoxication or withdrawal
• Overactive thyroid
• Traumatic brain injury
• Mercury poisoning from food or the environment
• Excessive caffeine intake

These conditions each affects the hands differently, which may lead to shaking.

How to Treat Shaking Hands 

The treatment for shaky hands depends on the condition that is causing it. Some treatments can be definitive, with complete resolution of shaking hands. Other treatments may need to be ongoing, depending on the underlying cause, and may slow or reduce your tremor.

Treatments for shaky hands can include:

• Getting enough rest if fatigue is causing shaky hands
• Treatment with intravenous (IV) fluids and electrolytes if dehydration or other electrolyte disturbance is causing shaky hands
• Treatment with glucose or insulin if altered glucose level is causing the problem
• Counseling or therapy for managing anxiety
• Antiepileptic medication if seizures are causing shaky hands
• Treatment for movement disorder with medication
• Treatment for neurological conditions, such as MS
• Medication or surgical intervention for managing a musculoskeletal disorder, such as carpal tunnel syndrome or arthritis
• Physical therapy as needed

Sometimes, more than one treatment may be necessary. A combination of treatments can often be more effective than trying only one approach. For example, physical therapy, counseling, and medication can be more effective for managing anxiety-induced shaky hands than one treatment alone.

Are There Tests to Diagnose the Cause of Shaking Hands? 

In general, the cause of shaking hands is diagnosed based on a medical history and physical examination.

Sometimes anxiety disorders can be difficult to identify, especially when you are experiencing physical signs of anxiety without recognizing and acknowledging those feelings of anxiety. In some situations, it can take several medical visits and discussions to establish that anxiety is a cause of shaking hands.

A physical examination can identify other signs indicating conditions associated with shaky hands. For example, MS often causes changes in reflexes, sensation, and motor strength. And Parkinson’s disease typically causes a pattern of motor stiffness. 

Diagnostic testing can also be a part of this process. Diagnostic tests would be ordered based on a symptom history and a physical examination.

Some tests that might help determine medical causes of shaking hands can include:

• Blood tests: May identify electrolyte disturbances or signs of infection
• Brain imaging tests: Can detect signs of MS or meningitis
• Electroencephalogram (EEG): Is used to recognize signs of an underlying seizure disorder

When to See a Healthcare Provider 

Shaky hands can be disruptive, may interfere with your day-to-day life, and can be upsetting to you. Furthermore, shaky hands can be a sign of a medical condition that requires treatment.

It’s important to make an appointment to see a healthcare provider if you have recurrent episodes of shaky hands.

Get prompt medical attention if you experience any of the following symptoms along with your shaking hands:

• Changes in consciousness
• Changes in vision
• Uncontrollable shaking
• Balance problems
• Changes in body temperature
• Excessive sweating
• Difficulty speaking or communicating

Additionally, if you are concerned or if your hand shaking is severe, persistent, or continuous, you should seek medical attention.

Summary 

Shaking hands can be a sign of many different medical and psychological conditions. You may experience shaking of one or both hands, and it can occur frequently, or it may only happen in certain situations.

It’s important to get medical attention for this problem because it can be caused by serious medical issues that require treatment. And even when shaking hands is caused by a condition that is not otherwise harmful, it is still essential to get treatment so that you can avoid the physical and emotional distress associated with shaking hands.