A tremor is a type of shaking movement. A tremor is most often noticed in your hands and arms, but it may affect any body part (even your head or voice).
There are three main types of tremors:
See also: Essential tremor
Tremor - hand; Hand tremor; Tremor - arms; Kinetic tremor; Intention tremor; Postural tremor
Tremors can happen at any age but tend to be more common in older people. Everyone has some tremor when they move their hands. Stress, fatigue, anger, fear, caffeine, and cigarettes may temporarily make this type of tremor worse.
However, a tremor that does not go away over time may be a sign of an underlying medical problem and should be evaluated. You may learn that your tremor is perfectly normal, but eliminating medical reasons for the shaking is important.
Essential tremor is the most common tremor. It is rarely seen when the hands are not being used. It becomes most apparent when you are trying to do something, such as reaching for an object or writing. It is not caused by an underlying disease. This type of tremor may also run in families.
Tremor may be caused by:
For tremors caused by stress, try relaxation techniques like meditation, deep relaxation, or breathing exercises. For tremors of any cause, avoid caffeine and get enough sleep.
For tremors caused by a medication, talk to your doctor about stopping the drug, reducing the dosage, or switching medications. Do NOT change or stop medications on your own.
For tremors caused by alcohol abuse, seek treatment and support to help you avoid alcohol.
Severe tremors may interfere with your ability to perform daily activities. You may need assistance with these activities. Take precautions to avoid injury during activities such as walking or eating.
Assistive devices may help with everyday activities, including:
Call your doctor if:
Your doctor will perform a physical examination, including a detailed brain and nervous system (neurologic) examination. The following medical history questions may help your doctor evaluate the cause of your tremors:
The following tests may be performed:
Once a cause of the tremor has been determined, the appropriate treatment for the disease will be prescribed.
You may not need treatment unless the tremor interferes with your daily activities or causes embarrassment.
Treatment depends on the cause. Tremor caused by a medical condition, such as hyperthyroidism, will likely get better when the condition is treated.
If the tremor is caused by a certain medicine, stopping the drug will usually help it go away. Never stop taking any medicine without first talking to your doctor. See: Drug-induced tremor
Medicines may help relieve symptoms. How well medicines work depends on the patient and the cause of the tremor.
Fahn S. Hypokinesia and hyperkinesia. In: Goetz CG. Textbook of Clinical Neurology. 3rd ed. St. Louis, Mo: WB Saunders; 2007:chap 34.
Deuschl G, Raethjen J, Hellriegel H, Elble R. Treatment of patients with essential tremor. Lancet Neurol. 2011 Feb;10(2):148-61.