Harvard Men's Health Watch

What causes shaky hands?

Q . I've started to notice a slight shakiness in my writing hand. Is this just normal aging or should I get it checked out?

A. If the shakiness is sudden or recent, you should talk to a doctor. It may be nothing serious—for example, just a reversible side effect from a medication or from too much caffeine. However, tremor could be an early sign of a more serious condition, like Parkinson's disease. In that case, you could benefit from early diagnosis and starting treatment.

The most common form of hand shakiness is known as essential tremor. Its exact cause is uncertain, but it becomes more common with aging and may run in families. The shakiness in essential tremor is more pronounced with movement, especially when reaching for an object or pouring a drink. Caffeine and anxiety tend to make it worse; drinking alcohol lessens it. A person with essential tremor may notice changes in handwriting, which will appear messy.

Compared with essential tremor, Parkinson's disease tremor is typically present at rest, moves at a slower rate, and improves with activity. Handwriting may become smaller. In addition, muscle stiffness and problems with walking can accompany Parkinson's disease.

Essential tremor is not the start of Parkinson's disease, but sometimes the two conditions can be confused. There are some general differences in the appearance of the tremors, and additional neurologic problems are usually absent in essential tremor. In both conditions, the tremor can worsen over time and medication helps reduce the tremors.

— William Kormos, M.D.
Editor in Chief, Harvard Men's Health Watch

Click here for a symptom guide on hand tremor. This guide will ask you a series of questions about involuntary hand shaking, trembling, or what is more commonly called tremors.