What causes hand tremor?

The types of hand tremor are caused by a variety of different diseases, disorders, and conditions.

  • Essential tremor is most common of the many types of tremor. The exact cause of essential tremor is not known, but a genetic component is involved in many cases. This means that you can inherit essential tremor from your parents. Essential tremor is usually amplified by extreme emotion, stress, physical exhaustion, and low blood sugar.

  • Parkinsonian tremor is caused by changes in the brain that lead to abnormal movements. People with Parkinson’s disease also experience rigidity of the arms, legs, and trunk and eventually develop bradykinesia, which is a slowness of movement that includes sudden freezing of muscle movement. They also have problems with balance and coordination. The exact cause of Parkinson’s disease is not known, but research suggests that both genetic and environmental factors play a role.

  • Cerebellar tremoris caused by brain damage from a stroke, tumor, or degenerative disease, such as multiple sclerosis. Chronic alcoholism can also cause cerebellar tremor. Cerebellar tremor is most pronounced in the hands during a particular action, such as reaching out for something or touching the tip of your nose. Cerebellar tremor may also be called intentiontremor.

Hand tremor can also be due to drug or alcohol use, low blood sugar, medications, mental health disorders, metabolic conditions, genetic disorders, and other abnormal processes. Hand tremor can occur with peripheral neuropathy as a complication of diabetes. In some cases, the cause of hand tremor is not known.

Potential causes of hand tremor

Hand tremor may arise from a variety of diseases, disorders, and conditions including:

  • Alcoholism and alcohol withdrawal

  • Brain damage from a stroke or tumor

  • Essential tremor

  • Extreme emotion, anxiety, or stress

  • Hyperthyroidism

  • Low blood sugar (hypoglycemia)

  • Movement disorder (dystonia)

  • Multiple sclerosis

  • Nerve damage (peripheral neuropathy)

  • Parkinson’s disease

  • Physical exhaustion

  • Psychological disorder

Potential medications that cause tremor symptoms

Medications and drug withdrawals that can produce tremor symptoms include:

  • Amiodarone (used to treat ventricular arrythmia)

  • Antidepressants

  • Anti-seizure medication

  • Benzodiazepine withdrawal

  • Bronchodilators

  • Lithium

  • Pseudoephedrine

  • Theophylline

Questions for diagnosing the cause of hand tremor

To diagnose your underlying condition, your licensed health care practitioner will ask you questions related to your symptoms. Providing complete answers to these questions will help your provider diagnose the cause of your hand tremor:

  • How long have you had tremors?

  • Do you have a family history of tremor?

  • What medications are you taking (including nonprescription drugs and supplements)?

  • What makes your hand tremor better or worse?

  • Have you ever had a head injury?

What are the potential complications of hand tremor?

Hand tremor is usually not due to a serious or life-threatening condition. However, the embarrassment associated with a hand tremor can be debilitating. And because hand tremor can be due to a serious condition, failure to seek treatment can result in complications. It is important to contact your health care provider when you experience tremors without an obvious cause, such as short-term low blood sugar. Once the underlying cause is diagnosed, following the treatment plan outlined by your doctor can lower your risk of potential complications including:

  • Difficulty performing daily tasks

  • Embarrassment

  • Impaired coordination

  • Withdrawal or depression


  1. Tremor. American Family Physician. http://www.aafp.org/afp/2003/1015/p1545.html.
  2. Tremor fact sheet. National Institute of Neurological Disorders and Stroke, National Institutes of Health. http://www.ninds.nih.gov/disorders/tremor/detail_tremor.htm

What is hand tremor?

Hand tremor is an involuntary muscle movement, trembling, or shaking of the hands.... Read more about hand tremorintroduction


What other symptoms might occur with hand tremor?

Hand tremor may occur with other symptoms, which vary depending on the underlying disease, disorder or condition. Additional symptoms can be characteristic of a variety of different conditions including essential tremor, multiple sclerosis, stroke, hyperthyroidism, or Parkinson’s disease.

Symptoms that may occur along with hand tremor

Other possible symptoms that may oc... Read more about hand tremorsymptoms

Medical Reviewer: Cynthia Haines, MD Last Annual Review Date: Aug 2, 2013 Copyright: © Copyright 2014 Health Grades, Inc. All rights reserved. May not be reproduced or reprinted without permission from Health Grades, Inc. Use of this information is governed by the HealthGrades User Agreement.

This Article is Filed Under: Bones, Joints and Muscles

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