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Tremor and Shaking Hands — Causes and Treatment
Also described as shaking hands, hand tremor, involuntary shaking.
Tremor that appears when holding a posture or reaching for something is usually essential tremor, while tremor at rest that improves on movement points towards Parkinson's disease. Thyroid overactivity, medication and caffeine also cause it. The pattern determines the diagnosis, so a neurological examination is the key step.
🚨 Get emergency care if you have
- •Tremor with slowness, stiffness or shuffling steps
- •Tremor developing suddenly over days
- •Tremor with confusion, fever or agitation
- •Tremor on one side only, with weakness
- •Tremor with unexplained weight loss and rapid pulse
What causes tremor?
Essential tremor
Tremor on holding a posture or reaching, often affecting both hands, sometimes the voice or head.
Parkinson's disease
Rest tremor, often one-sided at first, with slowness, stiffness and reduced arm swing.
Thyroid overactivity
A fine fast tremor with weight loss, palpitations and heat intolerance.
Medication or caffeine
Salbutamol inhalers, some antidepressants, lithium and high caffeine intake all produce tremor.
Alcohol withdrawal
Coarse tremor hours after the last drink, sometimes with sweating and agitation.
How it is investigated
- ✓Neurological examination of tremor at rest, on posture and on movement
- ✓Thyroid function tests
- ✓Medication review
- ✓MRI brain or a DaT scan in selected cases
Not every patient needs every test. The consultation decides which of these apply to you.
Frequently asked questions
Does tremor mean Parkinson's disease?▼
Usually not. Essential tremor is far more common, and unlike Parkinson's it occurs on action rather than at rest and often affects both hands symmetrically. Parkinson's tremor typically appears at rest, starts on one side, and comes with slowness and stiffness. A neurologist distinguishes them on examination.
Is tremor treatable?▼
Yes. Essential tremor often responds to propranolol or other medication, and disabling cases can be treated with focused interventions. Parkinson's tremor responds to dopaminergic therapy. Where the cause is thyroid disease, caffeine or a drug, correcting that resolves it.
This page is general health information, not a diagnosis or a substitute for a consultation. Symptoms overlap between harmless and serious conditions, and only an examination can tell them apart. If you are worried, see a doctor.
Plan your first visit
Not sure which specialist to see? Tell our care team the reason for your visit and we will help you choose.
- Bring previous prescriptions, relevant test reports or scan images, a medication list and photo ID.
- If you plan to use insurance, bring your policy details. OPD, tests and admission benefits depend on your individual plan and approval.
- Your first consultation determines which tests or treatments are needed; not everyone needs every test listed on this page.
Appointments are requests until confirmed. In a medical emergency, call 044 2025 2025 or go to the nearest emergency department.