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Why Your Hands Shake, And When It Should Worry You

Medical Daily logo Medical Daily 4/19/2018 Sadhana Bharanidharan
Hands © Hands Hands

Since involuntary shaking of hands is widely associated with Parkinson's disease, it can cause panic and concern among people when they experience it out of the blue. However, the disease is only one of the many causes that can leave your hands trembling.

Sometimes my hands tremble when I'm pouring tea or trying to hold something steady. Should I be worried?

Involuntary shaking or trembling movements are known as tremors. Hand tremors during delicate activities are considered to be quite common.

"Some degree of tremor during movements is normal for everyone," stated the Washington University Physicians website.

The tremor present in all people is referred to as a physiologic tremor, typically influenced by lifestyle factors.

What are the factors? And what happens if the tremors persist even if these factors are controlled?

1. Fatigue: Have you been cutting down on your nightly rest? Tiredness, lack of sleep or reduced quality of rest may also be the reasons behind your hands shaking as they reach for your morning coffee, which brings us to the next factor.

2. Beverages: Excessive alcohol intake or consuming more than 300 mg of caffeine

3. Stress: General stress and anxiety-inducing situations may cause an enhanced physiologic tremor

4. Medications: Taking medications such as amphetamines, thyroid hormones, lithium, antidepressants etc.

But if the tremors seem to continue even when those stressors are alleviated, it may be a sign of essential tremor, which is the most common tremor syndrome observed in adults, usually occurring after the age of 50.

"If you're resting and not doing anything, your hands are very still, whereas when you try to do something with your hands, such as writing or even holding a coffee cup, your hands will be tremoring," said Dr. Lauren Schrock, a neurologist affiliated with the University of Utah.

How dangerous is it to have an essential tremor?

Experts have identified it as a permanent nerve disorder that affects about 1 in 25 people, making it somewhat common. The condition typically occurs in older adults and worsens with age. The tremors occur sporadically and do not affect anything apart from movement and voice. Symptoms range from mild or moderate, due to which essential tremors are not considered life-threatening or dangerous. Older patients may find it difficult to eat, write, paint, wear makeup, shave, etc. 

A neurologist will first diagnose the tremor by observing it, understanding your family history, looking at your medications, etc. Diagnosis is important to rule out Parkinson's disease, which is rare but the most serious cause of tremors.

Most people who first notice their hands shaking are worried about this. What are the signs that someone may have Parkinson's?

For people who may have Parkinson's, the shaking is worse when the hand is at rest and not performing any activity, unlike an essential tremor.

"The shaking in Parkinson’s disease is often called ‘pill rolling’ because it is like rolling a small pill between your thumb and the side of your index finger," explained Dr. Gathline Etienne, a neurologist at Piedmont Healthcare in Georgia.

Stiffness will become evident as you hunch over and start shuffling instead of walking. Another sign to watch out for is a change in speech pattern and facial expressions. Your voice can become soft or hoarse, while your face can appear "depressed" due to small facial muscles being unable to move. Furthermore, you may lose your sense of smell and find your handwriting becoming smaller.

Slideshow: 13 symptoms of serious health matters (Courtesy: 


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