Why Do My Hands Shake? Hand Tremor Causes, Types & Treatment

If you’ve noticed your hands shaking, you’re not alone. Many people experience hand tremors at some point in their lives. These are small, involuntary shaking movements that can feel unpredictable and sometimes unsettling, affecting everyday activities like holding a coffee cup or writing. If you notice this symptom, it’s natural to wonder, “Why do my hands shake?” and what might be causing it.

While seeing your hands shake can be concerning, most hand tremors are not life threatening. In fact, tremors have many possible causes—most of which can be diagnosed and managed with care.

Some hand tremors are mild and linked to common problems like too much caffeine, stress, or even being a little tired. Others might be related to conditions like essential tremor, Parkinson’s disease, or other neurological disorders.

In this guide, we’ll explore hand tremors' causes, when you should see a doctor, and what kinds of treatments—including new non-invasive devices—can help. Our goal is to help you understand the basics of tremors, reduce fear, and offer hope for improved quality of life and confidence.

Shaky Hands And Hand Tremors

What Are Hand Tremors?

Hand tremors are involuntary, rhythmic shaking movements that can affect one or both hands.

This symptom can look different in each person. For some, it can look like the hands are moving up and down or side to side, while others notice a circular pattern. It is also possible to experience tremors only during certain activities like when writing, holding a glass, or using your phone.

The intensity of tremors can also vary. Sometimes, these are mild and temporary, just a frustrating symptom that eases down on its own. However, sometimes, tremors can worsen over time, appear suddenly, and interfere with daily life.

What Shaky Hands Usually Mean

Tremors can manifest in unique ways and have different causes. Not all tremors occur in the same situations, and understanding when your hands shake can help your doctor identify the cause. Common types include:

Tremors at rest: These happen when your hands are relaxed and not moving. It may happen due to underlying conditions. For example, people with Parkinson’s disease often notice tremors most when their hands are at rest.
Tremors with action: These appear when you are using your hands—such as reaching for a glass (intention tremor) or trying to hold your hand steady in a certain position (postural tremor).

Additionally, it is important to keep in mind that tremors are different from the kind of shaking that comes from being very cold or having a fever. An easy way to tell the difference is:

Tremors are usually rhythmic and caused by changes in your nervous system. Tremors can occur at rest, while holding a posture, or with movement.
Other kinds of shaking, such as irregular shaking or shivering, can happen with cold temperatures, fever, or low blood sugar—these are not considered true tremors.

Sometimes, hand tremors are mild and temporary. For example, some people have a natural, mild physiologic tremor in their hands, which is not usually noticeable unless it gets worse. Everyday factors like stress, too much caffeine, fatigue, or not getting enough sleep can make shaky hands more noticeable. This is called an enhanced physiologic tremor.

Quick self‑check

If you notice your hands shaking, doing a quick check can help you understand what type of tremor you might be experiencing. Remember, this is not a medical diagnosis, but it can help you describe your tremor to your doctor.

Shakes most at rest and gets better when you move: This is common in Parkinson’s disease. The tremor often starts on one side of the body, and can be accompanied by slower movements or stiffness.
Shakes when holding a posture or using your hands (like eating or typing): This can be due to neurological conditions, temporary factors, or certain medications. People with postural tremors often notice it while extending their arms or holding them steady.
Tremor is worse as you reach for something (like bringing a cup to your mouth): This may indicate an intention tremor or cerebellar tremor, which is linked to issues in the part of the brain that helps coordinate movement. If you notice this, it’s a good idea to get medical advice.
Whole-body chills, sudden shakiness, sweating, or fast heart rate: This is usually not a hand tremor. It may be related to shivering from cold, fever, or low blood sugar (for example, if you’ve skipped a meal or have diabetes).

If you’re unsure about what’s causing your symptoms, or if the hand shaking is new, getting worse, or interfering with your daily activities, don’t hesitate to contact your doctor.

Why Your Hands Might Be Shaking

Hand tremors can have many different causes. Sometimes, hands shaking is simply caused by everyday triggers like too much caffeine, anxiety, or not enough sleep. In other cases, tremors are a sign of a medical condition that affects your nerves, brain, or metabolism. Understanding the possible causes can bring you clarity and facilitate your discussion with a medical provider.

Everyday triggers

Everyday triggers can be substances and factors that can change the way your nerves and muscles communicate. They often make normal physiologic tremor worse, leading to shaky hands, even if you are healthy. Common triggers include:

Stress, anxiety, panic: Stress has a profound impact on the nervous system. It can activate your “fight-or-flight” response, releasing stress hormones like adrenaline. These can increase nerve and muscle activity and lead to involuntary muscle movements like shaking.
Caffeine or other stimulants (energy drinks, decongestants, nicotine): Stimulants can modify the communication between nerves and muscles, which can trigger or worsen shaking.
Sleep deprivation, fatigue, dehydration: Lack of rest, nutrients, or fluids affects the production of energy in the body and the effectiveness of nerve signals. This can impact muscle control and lead to involuntary movements.
Low blood sugar (missed meals), alcohol hangover/withdrawal: In people with diabetes or when blood sugar drops, the brain and muscles don’t get enough energy, leading to shaky hands and other tremor symptoms.
Fever or cold exposure: Quick and involuntary muscle contractions may be your body’s response to cold as it tries to generate heat.

Medical Conditions

Certain medical conditions can affect the nervous system, metabolism of energy, blood sugar levels, or hormone productions. or other organs. These can lead to whole-body or systemic symptoms, including tremors. Possible causes include:

Essential tremor: This is the most common cause of hand tremor in adults, and it affects over 24 million people. Essential tremor usually affects people over 40 and often runs in families, in which case it is also called familial tremor. It can result from abnormal electrical signals between certain areas of the brain responsible for controlling movement.
Parkinson’s disease: Parkinson’s disease causes the loss of important brain cells, which are responsible for producing dopamine and controlling movement. This often causes a “resting tremor” or pill-rolling movement. This symptom typically starts on one side of the body and manifests when muscles are relaxed.
Thyroid disease (overactive thyroid): Too much thyroid hormone speeds up your body’s metabolism and can make nerves and muscles easily excitable, which can cause tremors.
Neurological conditions: Certain conditions can cause damage to the central nervous system (the brain and spinal cord) or the peripheral nervous system (the nerves outside of the brain and spinal cord). Damaged nerves become unable to control movement, resulting in tremors. Common conditions causing this symptom may include multiple sclerosis, stroke or post-stroke tremors, or cerebellar disease.
Metabolic, genetic, or toxic causes: Diseases such as liver failure, Wilson disease, and heavy metal poisoning can lead to a build up of chemicals in the body that poison or damage nerves.

Medications and Substances

Some medications and chemicals can change how the nervous system works, causing hands to shake. These are called drug induced tremors.

Antidepressants (SSRIs/SNRIs like sertraline, venlafaxine; bupropion): These influence the release of brain chemicals and sometimes increase nerve activity, triggering tremors.
Mood stabilizers/antiepileptics (lithium, valproate): These drugs affect how electrical signals move in brain cells, which can lead to hand tremors as a side effect.
Cardiac/thyroid drugs (amiodarone, thyroid hormone): These medications alter heart rate or hormone balance, potentially causing shaking.
Respiratory medications (beta-agonist inhalers like albuterol): These can stimulate nerves and muscles throughout the body, possibly causing your hands to shake.

Other triggers may include:

Stimulants (caffeine, nicotine)
Alcohol withdrawal
Some antibiotics, antivirals, or immunosuppressants that interfere with normal nervous system function.

Before starting new medications, always discuss side effects with your doctor.

When To See A Doctor

Hand tremors are usually not dangerous, but sometimes they can indicate an underlying medical condition that needs attention. Knowing when to look for help can give you peace of mind and help you take control of your health.

If you experience any of the following, it’s important to talk to your doctor:

New or worsening tremor
Tremor interferes with daily tasks
Tremor with other neurological symptoms (i.e.: slowness, stiffness, poor balance, weakness, problems with vision, or speech changes)
Red flags: Some symptoms may indicate a potentially life-threatening condition. For instance, sudden tremors, facial drooping, arm weakness, or trouble with speech can indicate severe damage to the central nervous system or stroke. Similarly, shaking after a head trauma accompanied by head pain or headaches can point to brain injury. In these cases, be sure to seek emergency medical help right away.

How Doctors Check For Tremor

Your doctor can use several diagnostic techniques to identify the cause of tremors. These include:

Evaluation of your medical history and symptoms
Assessment of lifestyle factors that may contribute, like alcohol use
Review of medications and supplements
Neurologic exam to check for nerve damage and classify tremors
Specific tests when underlying conditions are suspected, like tests for thyroid issues, diabetes, nutritional deficiencies, muscle activity, or MRI tests to check for a stroke or tumor affective nerve function.

Ways To Calm Shaky Hands

Several practical strategies can reduce shakiness. These include:

Reduce lifestyle triggers: Cut back on caffeine and other stimulants, practice regular sleep habits and stress management, eat balanced meals to avoid low blood sugar, and treat thyroid or glucose problems if present.
Medications: Some medicines, such as propranolol or primidone, can treat essential tremor. Specific treatments, like dopaminergic therapy can help Parkinson's disease tremors, but this should be administered by a doctor.
Procedures for severe tremor: Advanced options like deep brain stimulation, MR-guided focused ultrasound, or radiosurgery (Gamma Knife) may be considered for severe, disabling tremors and are only performed by specialists.
Devices and supports: Occupational therapy and certain modifications, like weighted utensils, button hooks, straws, and slip-on shoes, can make daily tasks easier.

The future is also looking brighter. New non-invasive medical devices, like the VILIM ball, use gentle vibrotactile stimulation to calm tremors temporarily. This approach is CE-marked and supported by clinical studies, offering a safe and user-friendly way to help manage tremors alongside other strategies.

Managing Your Hand Tremors and Regaining Confidence

If you are experiencing tremors, remember: you are not alone, and many options exist to help. With your doctor’s support and tools like the VILIM Ball, you can take a step toward better control, greater confidence, and more independence in your daily life.