Hands are shaking


A tremor of the hands occurs in many people in different forms.

Hand tremors can have many causes. Some causes are harmless, others are serious illnesses.

The fact that our muscles tremble is basically a completely normal process of the body, which, among other things, ensures that our muscles are ready for action more quickly.
Usually, however, the tremor is so minor that you cannot see it or can hardly see it. For example, if you stretch out your hand, you can often notice a slight tremor in your hands, which is quite normal.

However, if there is, for example, physical or psychological exhaustion or excitement, the tremors can increase and become visible to the outside world, which is uncomfortable for many people.

But not only such harmless explanations are possible for the tremor, neurological or organic diseases can also be the trigger.

The shaking can sometimes become so strong that everyday activities can no longer be carried out. This is particularly the case when the tremor does not occur at rest but when moving. Those affected often feel severely restricted in their quality of life.

Causes of the trembling of the hands

Often when our hands are shaking it is a increased physiological tremors.

At cold For example, it can be strengthened, it is used by our body to generate energy and warmth.

An increased tremor of the hands can be a result of Nervousness, excitement and fear arise, but also by a high Caffeine and nicotine consumption.

If too high and chronic alcohol consumption Muscle tremors can be a result of a short term or long term Alcohol withdrawal be.

Besides these causes can also organic diseases stand behind the shaking hands.
In order to infer an illness are mostly primarily Nerves, brain and muscles examined diagnostically.

Also Medication are possible triggers for increased tremors. These drugs include Valproate, lithium and some Drugs from the group of antidepressants, Antiarrhythmics, Psychotropic drugs, Cytostatics (Chemotherapy drugs) and Immunosuppressants.

A Hyperthyroidism or one Overactive parathyroid glands can also cause hand tremors. The patients are characterized by a severe restlessness and nervousness out.

Furthermore, it can be through a low blood sugar levels, Vitamin B12 deficiency and with one low potassium levels come to a tremor.

Shaking hands under stress and strain

Strong psychological stress and stressful situations can lead to pronounced tremor symptoms, whereby in this case the tremor is usually not limited to the hands, but affects the entire body.

You may also be interested in the following article: Trembling hands in adolescence

In the course of the mental stress of soldiers during the First World War, the so-called "War tremors" described in which men were so traumatized that this triggered strong tremors in them, in some cases it also occurred Signs of paralysis.

In the case of a strong psychological tremor one speaks of a psychogenic or emotional tremor.
Psychogenic tremor occurs suddenly and usually disappears suddenly. In the case of psychogenic tremor, a psychiatrist should be consulted for treatment.

Stress or strain does not always immediately trigger a psychogenic tremor. In most cases it is more like a increased normal muscle tremorswhat happens to most people excitement occurs.
Trembling is an evolutionary process in fear and stressful situations. The body produces warmth and energy through the tremor and thus prepares itself for increased exertion, such as an escape.

Shaking hands and alcohol

Severe hand tremors can occur during alcohol withdrawal or alcohol intoxication. The tremor typically has a very high frequency and usually occurs in the form of a Holding and intention tremors on.

In the case of alcohol withdrawal, the tremors improve relatively quickly after further consumption of alcohol, which is of course not very helpful for completely giving up alcohol.
The tremor can be a sign of a Predelirs This is usually accompanied by increased sweating, severe irritability and sleep disorders.
Sometimes sensory disorders such as hallucinations can also occur.

After two to three days of alcohol withdrawal, a Predelir into a dangerous one Alcohol withdrawal delirium pass over.

Alcohol stimulates GABA receptors in the brain cells. GABA is a dampening messenger substance. At the same time, alcohol inhibits glutamate receptors. Glutamate is an exciting messenger substance, so it is the antagonist of GABA.
If there is chronic alcohol consumption, the body reacts by increasing the production of glutamate receptors.
If alcohol is no longer effective due to alcohol withdrawal, the increased level of glutamate due to the higher density of receptors leads to increased arousal.

This increased arousal is responsible for various withdrawal symptoms, such as increased muscle tremors.

Read more on the subject at:

  • Consequences of alcohol
  • Alcohol withdrawal

Shaking hands and blood pressure

Both too high (Hypertension) as well as a low blood pressure (Hypotension) may cause your hands to shake.

Trembling in one high blood pressure is one of the early symptoms that go hand in hand with high blood pressure. Often this is still through, for example a headache and Difficulty concentrating accompanied.

Similar symptoms also occur in one too low blood pressure and are more typical of low blood pressure than high blood pressure. It often happens with low blood pressure a feeling of weakness, Dizziness and tremors.

If a tremor occurs due to the blood pressure, it is sometimes referred to as a so-called tremor orthostatic tremor. "Orthostatic" means that it affects the upright posture.
This orthostatic tremor usually occurs with a blood pressure that is too low and is usually also caused by Dizziness, a steadfast and gait security and a ringing in the ears accompanied. Sometimes a brief disturbance of consciousness in the sense of fainting can also occur.


The shaking is technically known as tremor.
A characteristic of a tremor is that it occurs rhythmically and opposing muscle groups alternately contract.

Depending on when the tremor occurs, there are different types of tremor.

Resting tremor

A tremor at rest without any movement is known as Resting tremor. This comes with the Parkinson's Disease before, is not yet conclusive for this disease.

If movement is carried out in the case of a resting tremor, the shaking decreases again. At first, Parkinson's usually only affects one hand.
It is typical to observe the so-called Pill twisting phenomenon, in which there is an isolated tremor of the index finger and thumb on one hand.

Also Medication can trigger a resting tremor. Often, medication triggers tremors that create similar conditions for the neurotransmitters in the brain to those found in Parkinson's disease.

Intention tremor

Another type of tremor is the so-called Intention tremorthat causes hands to shake when moving.

The closer you get to the goal you are aiming for, such as a glass of water, the more your hand begins to tremble.
This form of tremor occurs, for example Diseases of the cerebellum on.
The Cerebellum is for the Fine coordination of movements responsible.

Also within the Multiple sclerosis an intention tremor can occur. Also a Alcohol abuse or certain medications play a role here.

Holding tremor

The third and final type of tremor is that Holding tremor.
It occurs when the hands have to be held against gravity. The holding tremor can be associated with fear occur or signs of a Drug, medication, or alcohol withdrawal be.

Also Liver and kidney diseaseWhen the body cannot be properly detoxified, it can trigger a gross tremor.
Rarely can the so-called Copper storage disease (Wilson disease), in which there is an accumulation of copper in the body, as the body cannot excrete the copper sufficiently. The copper then has a toxic effect and, above all, damages Brain, liver and eyes.
In the Copper storage disease it is an inheritable disease.

An important and frequent cause of tremors is the so-called essential tremor It is probably an inheritable disease because it occurs in families. The tremors sometimes start at a very young age, but can also only appear at an advanced age.

The essential tremor usually occurs in the form of a Holding tremors on, however, is often followed by a Action tremor accompanied, which is described by those affected as particularly disturbing.
In most cases, the tremor affects both hands, followed by the head and voice. Paradoxically, the tremor is relieved by moderate consumption of alcohol.
The disease of the essential tremors is annoying, but not dangerous. The reason for this has not yet been clarified.

Accompanying symptoms when shaking hands

If the trembling of hands is based on a neurological disease, this can be with others Movement abnormalities accompanied.
These include, for example unsafe gait or one increased muscle stiffness.
Furthermore, it can too mental health problems such as dementia or depression come.

The tremor is often not just limited to the hands, although the hands are most commonly affected and diseases that include tremors usually begin on the hands.

Shaking hands at a young age

If the hand shake occurs at a young age, it is often one increased form of physiological (normal) muscle tremors, which is often associated with Consumption of caffeine, nicotine or alcohol occurs or as a symptom of a increased nervousness or anxiety occurs.

Also the one already described essential tremor can occur at a young age. It usually manifests itself around the age of forty, but it can also occur in childhood.

Also one Hyperthyroidism is not atypical at a young age and is sometimes, but not necessarily, accompanied by a tremor.

Hand tremors in old age

The trembling of the hands in old age could be based on an increase in physiological muscle tremors, but the likelihood of Parkinson's disease also increases with age.

As people get older, hand tremors are more common Parkinson's Disease. About one percent of all over 60 year olds are affected by the disease.
Furthermore, with increasing age there is often an increase in the physiological trembling of the muscles, which normally should not be visible.


Therapy depends entirely on the underlying cause.
Is it a increased physiological tremor, this is usually not treated with medication, but instead, for example, coffee or nicotine consumption is reduced.

Lies the tremor of one pathological anxiety or nervousness basically, one can psychotherapy to be recommended.

Is there a neurological cause drugs are increasingly used. These include anti-epileptic drugsthat ensure that the nerve cells are less excitable.
Comes as a common anti-epileptic drug Primidon used for muscle tremors.
Also Beta blockerswhich are more commonly used for heart failure or arrhythmia, can be used to treat tremor.

At Parkinson's there is a lack Dopamine so that drugs are used to ensure that dopamine is available again. Usually this is done L-dopa used, it is a precursor of dopamine.
As an alternative, drugs that increase the effect of dopamine can also be used.

Is a severe form of the essential tremors or the Parkinson's Disease before, which cannot be adequately treated with medication, there is the operative method deep brain stimulation.
In this procedure, electrodes are placed in a specific area of ​​the brain and an electrode is connected to a pacemaker under the skin. Nerve cells can now be inhibited via the pacemaker so that the trembling is suppressed. This method shows good therapeutic success in most patients.