From the Guidelines
Shaking hands are most commonly caused by essential tremor, a neurological disorder that can be effectively treated with beta-blockers like propranolol, as indicated by recent studies 1. The causes of shaking hands can be diverse, ranging from neurological disorders to lifestyle factors. Essential tremor is a significant cause, characterized by rhythmic shaking, typically in the hands, head, or voice. According to a 2022 study in the journal Hypertension 1, propranolol has been used to treat essential tremor for more than 40 years, and other beta-blockers like metoprolol may also be effective. Some key points to consider about the causes of shaking hands include:
- Essential tremor: a neurological disorder causing rhythmic shaking, typically in the hands, head, or voice
- Parkinson's disease: characterized by resting tremors that improve with movement
- Lifestyle factors: stress, anxiety, caffeine consumption, medication side effects, alcohol withdrawal, low blood sugar, thyroid disorders, and multiple sclerosis can contribute to hand tremors
- Physical exhaustion and aging can also contribute to hand tremors Treatment options depend on the underlying cause, and beta-blockers like propranolol are a recommended treatment for essential tremor, as supported by the 2022 study in Hypertension 1. In terms of managing symptoms, reducing caffeine and alcohol intake, managing stress through relaxation techniques, and ensuring adequate rest can help reduce symptoms related to lifestyle factors.
From the Research
Causes of Shaking Hands
- Shaking hands, also known as tremors, can be caused by various factors, including neurological disorders such as Parkinson's disease (PD) and essential tremor (ET) 2, 3, 4.
- Essential tremor is characterized by symmetric bilateral postural and kinetic tremor, which may respond to low alcohol consumption, and is often associated with a family history of ET tremors 2.
- Parkinson's disease, on the other hand, is typically characterized by an asymmetric rest tremor, which is treated with dopaminergic agents such as levodopa 2.
- Other conditions, such as multiple sclerosis, stroke, and trauma, can also cause tremors 3.
- Internal tremor, a feeling of tremor in the extremities or trunk without actual movement, is a prevalent symptom in PD, MS, and ET, and is associated with anxiety and visible tremors 5.
Factors Contributing to Shaking Hands
- Patient-assessed tremor severity is a significant predictor of depression in PD and ET patients who have undergone deep brain stimulation (DBS) 6.
- Physician-reported motor symptom severity, on the other hand, is not a significant predictor of depression or anxiety in these patients 6.
- The patient's perception of their illness plays a greater role in depression than objective physical disability, regardless of the time since surgical intervention 6.
- Anxiety may be attenuated by DBS, but patient-assessed return of tremor over time can increase anxiety, highlighting the importance of long-term follow-up for behavioral health features in chronic neurological disorders 6.