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Alternative Names Return to topTremor - arms or hands
Definition Return to top
A tremor is a type of involuntary shaking movement. Involuntary means you shake without trying to do so. A tremor is often most noticeable in your hands, but may affect any body part (even your head or voice).
There are three main types of tremors:
Considerations Return to top
Tremors can happen at any age but tend to be more common in older people.
You can develop a tremor from fatigue, stress, anxiety, or even rage. However, an ongoing tremor that is not associated with a change in your emotional state may be a sign of an underlying medical condition and should be evaluated. You may learn, as many do, that your tremors are perfectly normal, but eliminating medical reasons for the shaking is important.
It is especially important to have tremors evaluated if body parts other than the hands are involved, like your tongue or head, or if you have other types of involuntary movements other than shaking.
Essential tremor is common in older people. Essential tremor is rarely present when the hands are not being used. It becomes most apparent when the affected person is trying to do something, like reaching for an object or writing. It is not caused by an underlying disease.
Another common type of tremor is called familial tremor which, as the name implies, tend to run in families.
Both essential and familial tremors may be suppressed by drinking alcohol. This is a useful fact for making the diagnosis, but alcohol is not a desirable treatment.
Causes Return to top
Tremors may be caused by:
Home Care Return to top
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, consult with 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. Assistance with these activities may be necessary. Precautions should be taken to avoid injury during activities such as walking or eating.
When to Contact a Medical Professional Return to top
Call your doctor if:
What to Expect at Your Office Visit Return to top
Your doctor will perform a physical examination, including a detailed neurologic examination. The following medical history questions may help your doctor evaluate the cause of your tremors:
Once a cause of the tremor has been determined, the appropriate treatment for the disease will be prescribed.
For certain types of tremors, like essential tremor and familial tremor, medications such as beta-blockers, gabapentin, primidone, and others may be an option. If medication doesn't work, your doctor may even consider surgery. Botox injections, given in the hand, have been used to treat essential hand tremors.
References Return to top
Fahn S. Hypokinesia and Hyperkinesia. In: Goetz, CG. Textbook of Clinical Neurology. 3rd ed. St. Louis, Mo: WB Saunders; 2007: chap 16.Update Date: 6/19/2008 Updated by: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.