Back to Living Better

Shaky hands — normal or not?

Everyone’s hands shake at some point or another, so you should not be alarmed if you notice a slight shake here and there. This happens because the tiny muscle fibers in your hands and arms constantly contract and relax at random, and sometimes there is an imbalance between muscle groups, which causes the timing of these contractions to be off.

However, Gathline Etienne, M.D., a neurologist at Piedmont, says it is cause for concern if the shakiness begins to interfere with daily tasks like eating, drinking, writing, buttoning a shirt, dialing a phone, etc. In these cases, it may warrant a visit to your doctor to test for a neurological or underlying metabolic issue.

Common causes of shaky hands

The following factors can cause shaky hands:

  • Lack of sleep. When you do not get enough sleep, this may trigger neurological reflexes that cause shakiness.

  • Too much caffeine. Caffeine stimulates your body, causing your muscles to move out of sequence.

  • Low blood sugar. Low blood sugar causes shakiness because the nerves and muscles are deprived of necessary fuel.

  • Anxiety. When you become anxious, stressed or even angry, your nerves are heightened, causing shakiness.

  • Some medications. Some people are more sensitive to medication than others. Asthma medications, antidepressants, lithium and even antihistamines can cause your hands to shake.

  • Essential tremor. Essential tremors often run in families. They are most noticeable when you are doing something with your hands, not while you are at rest. They occur sporadically and usually start in the hands, but can also affect the head, other body parts and even your voice. According to the International Essential Tremor Association, an estimated 10 million Americans have this condition, which typically gets worse with age.

Other causes of shaky hands

More serious, but less common causes of shaky hands include:

  • Underlying thyroid disease. Overactive thyroid is more common in women than in men, and it presents itself most commonly between the ages of 20 and 30. It can bring on shakiness along with other side effects. Your doctor can diagnose this condition with a simple blood test to check your thyroid hormone levels.

  • Parkinson’s disease. Parkinson’s disease is by far the most serious diagnosis associated with tremors. In this case, the shaking is worse when you are resting and not while you are using your hands. “The shaking in Parkinson’s disease is often called ‘pill rolling’ because it is like rolling a small pill between your thumb and the side of your index finger,” says Dr. Etienne.

She says there are medications available to treat Parkinson’s disease as well as essential tremors.

“You know your body best,” says Dr. Etienne. “If you feel shaky after a couple cups of coffee or as you prep for a public speaking engagement, it may very well be the caffeine or adrenaline causing your shakiness, and there is no cause for alarm. But if you can’t control it, even when you aren’t using your hands, this might be a sign to seek your doctor’s advice.”

Learn more about brain and spine health.

Need to make an appointment with a Piedmont physician? Save time, book online.

Related Stories

Schedule your appointment online

Piedmont App

Download the Piedmont Now app

  • Directions
  • Indoor Hospital Navigation
  • Find & Save Physicians
  • Online Scheduling

Download the app today!

Questions? Comments? We're here to help! Please let us know your concerns, questions or general feedback on our site and services. Send a message