Shaky hands or hand tremors can be alarming for an otherwise healthy person. If it has happened to you for the first time, you may wonder why my hands are shaking.

The answer may not reveal anything serious, as in the case of essential tremors. On the other hand, a tremor in the hands may indicate some underlying neurological disease.

Whatever the case be, shaking hands need to be evaluated by a doctor.

Shaking or tremors may begin all of a sudden or develop gradually. You might have noticed the hands shaking during an illness or a stressful episode.

Hands are most commonly affected by shaking though the tremors may affect one's head, voice, mouth, or feet. The hand tremors causes are varied in different people.

Some of the most common causes of hand tremors are the following;

1. Essential tremors

Essential tremors usually start in your hands or one of the fingers of the hand. It then spreads to involve other body parts like the arm or head.  Voice is also affected by essential tremors.

Essential tremors are different from other shaking hand conditions. These affect the hands upon movement. That is, the tremors are noticeable during physical activity and are absent at rest. Such tremors occurring on activity are also called intention tremors.

Researchers attribute genetic tendency as the causative factor for essential tremors. The condition runs in families.

Environmental toxins and infectious diseases are also suggested to play a role; however, there is a lack of evidence in this regard.

Perhaps the most likely cause of essential tremors remains the degenerative changes in the brain due to aging. The condition usually affects people over the age of forty though no age is exempt.

The underlying fault lies with the normal functioning in certain parts of the central nervous system, the cerebellum.

Essential tremors are not, life-threatening and they do not indicate any debilitating nervous disorder.

However, the condition is itself incapacitating as it limits the ability to perform everyday work. Simple tasks like eating, drinking, and writing becomes tedious and challenging for an individual. It also tends to worsen with time, with factors like stress and fatigue influencing it. This can have an impact on one's emotional health.

Essential tremors are more disturbing because it is resistant to treatment.

Medications like beta-blockers and anti-seizure drugs are sometimes prescribed if your doctor thinks you are a good candidate to receive them.

Newer remedies include botox injections. However, they should opt after careful evaluation of an individual's case.

Deep brain stimulation is a surgical option where a device is implanted into the brain to control the tremors.

Another surgical option is thalamotomy. It involves MRI-guided radiofrequency sound waves to surgical induce permanent abrasions in a very small area of the brain's thalamus. The procedure is aimed at interrupting the brain's normal electrical activity to reduce the tremor activity.

2. Parkinson’s disease

Another prevalent of shaky hands causes is Parkinson's disease. Hand tremors are one of the earliest signs of the disease, occurring in stages I and II of the condition.

The handshaking of Parkinson’s is called resting tremors because it is present at rest. The shaking disappears on movement. Shaking also subsides during sleep.

Often the hand tremor affects one side of the body and may involve the hand, foot, or a single finger on hand in the early phase. It may progress to involve other parts of the body as well, including the jaw and tongue.  The tremors may be felt by the patient as shaky internal movements in the chest and abdomen.

The tremors of Parkinson's are rhythmic, slow, and continuous. They are not random jerks or muscle spasms.

Emotions like stress and excitement, anxiety, fatigue, and illnesses worsen the tremors of Parkinson’s. 

Medications called dopamine agonists, and anticholinergic drugs are used to treat tremors of Parkinson's disease. Drugs for hypertension and schizophrenia may also be used to treat these tremors.

Avoiding stimulants like caffeine, chocolate, and other recreational drugs help to cut back the severity of tremors due to Parkinson's disease.

Deep brain stimulation remains the surgical remedy.

3. Multiple sclerosis

MS targets your immune system, brain, nerves, and spinal cord.

The autoimmune disease destroys the protective myelin sheath of the nerve cells, resulting in impaired relaying of the message across nerve cells. One of its symptoms is tremors or shaky hands. The tremors of MS also affect the foot.

Anti-anxiety, anti-seizure drugs, and beta-blockers are usually given to manage the tremors of MS.

Hand and arm braces and braces for your knee and ankle help control the shaky movements and make movement possible. Adding extra weights to the arms and feet also helps to control the tremors.

The use of medical cannabis is touted to be an effective remedy for controlling trembling hands. The topic is under active research, and more evidence is required for its efficacy of use.

Deep brain stimulation is the last resort because it requires surgical intervention.

4. Alcohol withdrawal syndrome

Why do my hands shake? This may be a side effect of withdrawal if you consume excess alcohol for extended periods, usually weeks, months, and years.

Alcohol has depressive effects on the brain. Over time, the brain becomes used to the high levels of alcohol and functions tediously to keep the brain in the awake state. The hyper-functioning of the brain continues in case of sudden withdrawal of alcohol which leads to tremors in the hands.

Shaky hands are a side effect of alcohol consumption that becomes apparent after six hours of having the last drink. The condition may last few weeks. A proper rehab and detox program can help manage the symptoms of withdrawal and relieve hand tremors.

5. Medicine induced handshaking

Dopamine blocking drugs like Thorazine or Largacti, Reglan, Resperdal, etc., are commonly related drugs that cause handshaking and tremors. These drugs are used to balance mood and reduce abrupt changes in mood and behavior.

Usually, the tremors caused by dopamine antagonists resolve on stopping the drug.

Similarly, bronchodilators used for treating asthma, statins that lower cholesterol, amphetamines, and selective serotonin reuptake inhibitors (SSRIs) can also cause shaky hands.

6. Deficiency of B12

The deficiency of vitamin B12 is also linked to tremors in the hands. B12 vitamin is important for preserving brain and nerve cell health. Even mild deficiency of B12 can cause shakiness.

So if you are questioning why my hand is shaking, get your B12 levels checked. Getting a shot of B12 usually resolves the shaky hand condition.

Alternatively, increase the consumption of foods high in Vitamin B12 in your diet. Some of these foods are shellfish, liver, fish, fortified soy products as tofu and soymilk, B12 fortified cereals, red meat, low-fat dairy, cheese, and eggs.

7. Stress-induced tremors

Our bodies experience tremors that are not measurable. These arise due to the continuous body processes occurring in our bodies as heartbeat, blood circulation, bowel movements, etc. These are called physiologic tremors. These may become pronounced under some conditions as stress or excitement.

Have you ever experienced shaky legs and trembling voices when faced with public speaking? This is due to the enhancement of the physiologic tremor.

Stress-induced tremors arise from physiologic tremors. These are caused by continued stressful situations like at the workplace, marital relationships, etc. Events that result in extreme emotional outbursts like intense anger may also cause tremors. 

Stress-relieving activities like tending to a hobby, meditation, yoga, or anti-anxiety medicines help resolve such tremors.

8. Excessive caffeine intake

Caffeine is the most common stimulant known and is present in all kinds of foods and beverages.

The fast-paced lifestyles of the millennials keep them on their toes and require high-grade performance. It has led to an increase in the consumption of caffeine-enriched energy drinks, coffee, and teas.

Regular consumption of such ingredients in excess amounts can result in trembling hands and shakes in the periods when you do not have them. Caffeine also intensifies pathological tremors. If you find yourself asking why my hands shake when I hold something, it's time to cut back on your cup of Joe.

9. Low blood sugar levels

Extreme hunger can lower your blood sugar levels. This stimulates the body's natural stress response and causes tremors of the hands or the whole body.

The nerves and muscles of our bodies are fueled by sugar derived from carbohydrates. If the blood sugar levels become low, as in diabetes, extended fasting period, medications, or excess alcohol intake, tremors will strike.

The remedy is to follow your diet and medication schedule religiously

10. Hyperthyroidism

Thyroid hormones are responsible for maintaining the body's metabolism, regulating heart rate, and balancing other body functions.

When the thyroid gland is in an overdrive state, it revs up all the body's systems. This may enhance the physiologic tremor of the body and increase the shaky hand condition.

Tests for thyroid function confirm any such diagnosis. Treating the condition resolves the tremors.

11. Nerve damage

Any injury, disease, or disturbance with the functioning of your central nervous system can cause tremors. Peripheral neuropathy is a condition where the nerve supply of the body is damaged. It can affect your hands and feet, causing shakiness and tremors.

Nerve damage is usually due to an underlying cause. Treating such a cause may improve the tremor condition to some extent.

12. Sleep debt

Sleep is when our body recuperates its energy levels, repairs the everyday damage, and follows the growth process where required.

A one hour of sleep debt requires at least four days of adequate rest to catch up with regular sleep. If you are not getting enough sleep, you should not expect your brain to send the right signals at the right time to the right place. The same goes for tremors.

Sleep debt results in a jittery state. Fatigue, exhaustion, and sleep deprivation can enhance the physiologic tremor of the body. Such states can also worsen the pathologic or essential tremors.

The solution is to gradually recover your sleep timings and take plenty of rest.

13. Smoking

Smoking induces anxiety contrary to the belief that it eases stress. Nicotine constricts the blood vessels when it enters the bloodstream. With time, the vessels become hard and present with increased resistance to blood flow, increasing the heart's workload.

 The blood pressure rises with time, and so does the heart rate. This has detrimental effects on the body functioning experienced as varying symptoms, one of which is tremors and handshaking.

Quitting smoking is the only way to reverse back the hand tremors.

14. Pheochromocytoma

This is a rare tumor that affects the adrenal gland. Though benign, the tumor growth raises your blood pressure. This causes intense sweating, shortness of breath, and headache besides shaking of the body and hand tremors.  

The tumor can cause heart attack and stroke, so it is best to remove it via surgery. This alleviates any tremor affecting the hands or body.

15. Liver disorders

Shaking hands is a symptom linked to a few liver disorders, for example, in Wilson's disease, where abnormal amounts of copper build up in the body. The genetic condition damages the liver and brain tissues.

Treating the underlying cause usually resolves the tremor.

What can you do to treat shaky hands?

Shaky hands or tremors are not always due to the disease process. Lifestyle modifications may help relieve them, especially the essential tremors.

Some tips include;

• Use heavier objects while performing a task. Do not handle lightweight objects. The extra weight helps to execute the task at hand by cutting back on tremors.
• Tasks that require gripping action may be difficult to perform. Try to manage specially designed tools and gadgets for your everyday work.
• Wearing wrist weights works the same way as handling heavier objects. The extra weight makes the control of hand movement easier. Similarly, ankle weights may help you to walk with ease if the tremors affect your feet.
• Use mindful techniques while performing a task. That helps to re-create the nerve pathways in the brain in case of damaged neuronal routes. For example, if hand tremors make writing difficult, the exercise improves your writing skill by paying attention to the act. Regular exercise of the mind and the hand helps to manage the tremors and boost your self-confidence and esteem.