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Right Hand Shaking When Writing An Essay

What causes shaky hands?

Shaky hands are commonly referred to as a hand tremor. A hand tremor isn’t life-threatening, but it can make daily tasks difficult. It can also be an early warning sign of some neurological and degenerative conditions. You should speak with your doctor if you experience hand tremors.

Many people associate shaky hands with Parkinson’s disease, but the most common cause of shaking hands is actually essential tremor.

Essential tremor is also the most common neurologic disorder affecting adults, but it’s not well-understood. It’s likely caused by a disruption in the normal functioning of the cerebellum. Researchers aren’t entirely sure what causes the interruption nor how to stop it. They’re also unclear about whether it’s a degenerative process.

People with essential tremor experience frequent shaking. The shaking can’t be controlled and most often occurs in the hands, arms, head, and vocal cords.

Keep reading: Essential tremor »

By comparison, people with Parkinson’s disease typically experience a hand tremor when their muscles are at rest and see a reduction in the tremor when their muscles are in use. Shaky hands can also be caused by:


What medications treat shaky hands?

Not everyone with shaky hands will need treatment, but if your doctor decides you’re a good candidate, you may first begin by taking prescription medication.

Commonly prescribed medications

The most commonly prescribed medications for essential tremors or shaky hands are:

Propranolol is a beta-blocker designed to treat arrhythmia and hypertension, while primidone is an antiseizure medication.

If these do not work for you, your doctor may recommend other medications.

Other beta-blockers

Sotalol (Betapace) and atenolol (Tenormin) are also beta-blockers that may be used to treat essential tremor. Your doctor may prescribe one of these medications if other medications don’t help your tremor.

Other antiseizure medications

Gabapentin (Neurontin) and topiramate (Topamax) are other medications primarily used to treat seizures. They may be helpful for people with essential tremor.

Anxiety medication

Alprazolam (Xanax) is used to treat anxiety and panic disorders, but research indicates that it may be an effective treatment for essential tremor. This drug should be taken with great caution because it’s known to be habit-forming.


Botulinum toxin type A (Botox) shows promise as a treatment for essential tremor in the hands. This medicine may cause permanent muscle weakness where injected, so be sure to talk with your doctor about the potential risks and benefits. The benefits from a successful injection can last up to three months. Subsequent injections may be needed.


What surgeries treat shaky hands?

Your doctor is unlikely to recommend surgery as your first treatment option. Surgical treatments are typically reserved for people who have a severely disabling tremor. Surgery may become an option as you age or if the tremor worsens.

Deep brain stimulation (DBS)

Deep brain stimulation (DBS) is a surgical procedure used to treat a tremor. During a DBS procedure, a surgeon will place an electronic device called an electrode in your brain. Once in your brain, the device emits an electronic signal that interferes with the brain activity responsible for the tremor. DBS is currently only recommended for people with advanced or severe limb tremor.


Thalamotomy is another surgical option. During this procedure, your surgeon will cut a small lesion in your brain’s thalamus. This interrupts the brain’s normal electrical activity and reduces or stops the tremor.


What therapies treat shaky hands?

Your doctor may recommend one or more lifestyle changes as a way to possibly help ease the symptoms of essential tremor. Suggestions may include to:

  • Use heavier objects. You may need to replace lightweight or delicate objects, such as glasses, silverware, or plates, with heavier versions. The extra weight may make the item easier to handle.
  • Use specially designed utensils and tools. Gripping and controlling pens, pencils, garden tools, and kitchen utensils may be difficult if you have shaky hands. You may need to seek out versions of these items that are designed for individuals with grip and control issues. For example, there are many adaptive utensil options available on Amazon.com.
  • Wear wrist weights. The extra weight on your arm may make control easier. Find a great selection of wrist weights here.

Is there a cure?

Is there a cure for shaky hands?

Treatment options will be determined by the cause of your hand tremor, though there is no cure for most tremors. If your tremor is caused by an underlying condition, treating that condition may reduce or eliminate the tremor. If caffeine, alcohol, or other stimulants affect your tremor, consider removing them from your diet. If your tremor is a side effect of medication, speak with your doctor about your options.

If your shaky hands are caused by essential tremor, there is no cure. The problem, which often begins in early adulthood, will likely worsen as you age. Treatments may offer some symptom relief. The types of treatment you use will depend on how severe the shaking is and the potential side effects of each treatment option. You and your doctor can weigh your options.

Talk to your doctor

Talk to your doctor about treatments

If you’ve experienced shaky hands or symptoms of essential tremor, make an appointment to speak with your doctor. Your doctor will likely request several medical and physical tests to rule out other possibilities before a diagnosis can be made.

Once a diagnosis has been made, you can begin to discuss treatment options. Treatment may not be necessary if the tremor is mild and doesn’t interfere with day-to-day activities. If the shaking becomes too difficult to manage, you can revisit the treatment options. Finding one that works well with minimal side effects may take time. Work with your doctor and any therapists or specialists you visit to find a plan that best suits your needs.

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Shaky hands

Normally, our hands shake very, very slightly all the time we are awake. This is because the tiny muscle fibres in our hands and arms constantly contract and relax at random. It is only when shakiness of our hands begins to interfere with writing, holding a cup of coffee or using a knife and fork that it becomes a problem. When people notice their hands are shaky, they often start to worry that they have Parkinson’s disease, but this is usually not the case.

If you are worried about shakiness, consult your doctor rather than try to work out the cause yourself. There are many varieties of shakiness that are difficult to describe, but doctors can recognize the common types easily from experience. Also, some simple tests, such as a blood test for thyroid overactivity, might be appropriate. Your doctor may use the word ‘tremor’ to describe shakiness that consists of small movements.


Common causes of shaky hands

Anxiety. We all become trembly if we are angry, stressed, anxious (‘shaking with nerves’) or very tired.


Low blood sugar causes shakiness because the nerves and muscles are deprived of fuel. The adrenaline system responds by kicking in, and this can make the shakiness worse for a while. The circumstances will make it obvious if this is what is happening in your case. A low blood sugar is most likely to occur if you eat a lot of sugary snack foods; these raise the blood sugar sharply, but then it plummets down again. The answer is to eat more slowly digested carbohydrates, such as porridge for breakfast instead of a sweet cereal and fruit instead of sweet puddings. Low blood sugar can also occur after excessive exercise.


Too much coffee and tea can make you a bit shaky, particularly in combination with a low blood sugar. So cut down the amount of coffee or strong tea that you drink, and avoid snack ‘meals’ that are mainly sweet foods and lots of coffee.


‘Essential tremor’ is one of the most common types of shakiness. Instead of contracting at random, the tiny muscle fibres contract and relax together (‘synchronization’), resulting in more noticeable movements. (In medicine, the word ‘essential’ has a special meaning – it is used to describe a condition that is not caused by any other medical condition or disease, but simply exists on its own.)

  • Essential tremor is unusual in young people, but affects 1 in 20 of the population over the age of 40.
  • It tends to run in families, so some of your close relatives may also have it.
  • It usually affects the hands, often the head, and sometimes the voice and other parts of the body as well.
  • It becomes worse when you use your hands to do something, such as picking up a small object, or if you try to maintain a position, such as holding a cup steady. If you rest your hands quietly on your lap, the shaking usually stops.
  • It is uncontrollable and does not mean you are ‘nervy’ or ‘neurotic’ (although, frustratingly, it becomes worse when you are anxious).
  • An alcoholic drink often improves it, but obviously you should not overdo this remedy.
  • If the shaking is really troublesome, your doctor can prescribe a drug such as a beta-blocker or primidone. Avoid too much coffee and strong tea.

Less common causes

Medications can sometimes be responsible, in particular some asthma medications, some antidepressants and lithium. A few medications, such as some tranquillizers, can cause shakiness if you stop taking them suddenly. Similarly, a heavy drinker may get ‘the shakes’ the morning after a binge.


Parkinson’s disease is much less common than essential tremor. It does cause shaking of the hands but, unlike essential tremor, the shaking is worse when you are resting and not using the hand. The shaking in Parkinson’s disease is called ‘pill rolling’ because it is like rolling a small pill between your thumb and the side of your index finger.


Overactive thyroid is more common in women than in men, and occurs most commonly in the people in their 20s and 30s. If your thyroid is overactive, shakiness will not be the only symptom; for example, you usually lose weight even though you are eating well. Your doctor can do a blood test to check your thyroid hormone levels.

Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Friday, February 26th 2010


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