This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalized guidance and treatment.

What causes tremors?

The exact cause of essential tremor is not fully understood, but research points to changes in brain networks that include the cerebellum and other parts of the nervous system involved in motor control. Family history is common: many people with essential tremor report relatives with similar shaking, which suggests a genetic component. Age is also a factor—symptoms often begin in midlife or later. Differentiating essential tremor from other causes, such as medication side effects or neurological disorders, is an important step in diagnosis.

How do tremors affect the hands?

Hands are among the most commonly affected body parts in essential tremor. Tremors typically occur during intentional movements—reaching for an object or holding a cup—so “shaky hands” often become more noticeable with tasks that require fine motor control. Severity varies from mild, intermittent shaking to persistent tremor that interferes with dressing, eating, and writing. Occupational therapy, adaptive utensils, and targeted exercises can help people maintain independence and manage hand-specific functional challenges.

When should shaky hands prompt medical care?

Seek medical evaluation if tremors begin suddenly, worsen quickly, or interfere with daily activities. A clinician will assess the tremor’s pattern (action versus resting), medication history, family history, and other neurological signs. A medical visit is also important to rule out secondary causes such as metabolic problems, thyroid disease, or medication-induced tremor. Early assessment helps guide appropriate medical treatments and referrals to specialists such as neurologists or movement disorder clinics and informs decisions about local services and supportive therapies.

Medications used in treatment

First-line medical options for essential tremor commonly include propranolol, a beta-blocker, and primidone, an anticonvulsant. Propranolol can reduce tremor amplitude for many people but may not be suitable for those with certain cardiac or respiratory conditions. Primidone may be effective when beta-blockers are insufficient; side effects can include drowsiness or dizziness. Other medications—such as gabapentin or topiramate—are sometimes tried off-label. Medication choice depends on symptom severity, medical history, and tolerability; ongoing adjustments and follow-up are often necessary.

Procedures and nervous system interventions

For people with severe tremors that do not respond to medication, procedures targeting the nervous system are options. Deep brain stimulation (DBS) implants electrical leads in a thalamic target to reduce tremor and is adjustable and reversible, though it involves brain surgery and carries surgical risks. Magnetic resonance–guided focused ultrasound and stereotactic radiosurgery are less invasive ablation techniques that target the thalamus; focused ultrasound is noninvasive and may be approved in some regions for unilateral treatment. Botulinum toxin injections can reduce tremor in selected muscles, particularly for head or voice tremors, but may cause temporary weakness.

Therapies and lifestyle changes for hands

Noninvasive therapies help many people manage shaky hands. Occupational therapy provides exercises, splints, and adaptive tools (weighted utensils, stabilizing devices) that make daily tasks easier. Physical therapy can improve coordination and balance. Simple lifestyle adjustments—reducing caffeine, getting adequate sleep, and managing anxiety—may lessen tremor amplitude for some individuals. Alcohol can temporarily reduce essential tremor in some cases, but it is not a recommended treatment because of risks and potential for dependence. Discussing supportive therapies with a healthcare provider or local services can identify tailored strategies.

Conclusion

Essential tremor is a manageable but variable condition affecting the hands and other parts of the body. Treatment decisions balance symptom impact, medical history, and personal goals—ranging from lifestyle and therapy measures to medications and, for selected patients, procedures that target the nervous system. Regular follow-up with a qualified clinician helps monitor effectiveness and side effects, refine treatment, and ensure that functional needs are addressed.