A tremor is a movement disorder, very common in occurrence. A rhythmic, involuntary muscle contraction causes the shaking. Tremors are most common in the hands, but they can also occur in the vocal cords, head, arms, torso, and legs.

Tremors can be intermittent, happening after every once in a while, or constant. Sometimes tremors signal an underlying health issues or might develop on their own.

Shaky hands lead to difficulty in writing and drawing. A person may also have trouble holding and using utensils, such as cutlery and tools.

Issues which affect the brain are usually responsible for tremors.

In rare cases, the cause is unknown, but tremors usually result from movement disorders, neurological conditions or other health problems.

Neurological conditions

Some neurological conditions that can cause shaky hands include:

•  Stroke: An ischemic stroke occurs when a blood clot blocks an artery, preventing blood from reaching the brain. It can cause lasting damage to neural pathways and lead to tremors.

• Multiple sclerosis (MS): Many people with MS experience some degree of tremor. This often develops when the disease damages areas in the pathways of the central nervous system that control movement.

• Traumatic brain injury: Physical injury to the brain can also damage nerves that play a role in coordinating movement. Hand tremors usually occurs, when an injury affects certain nerves.
• Parkinson’s disease:  Related action tremor is seen in people with Parkinson’s disease, along with a more common resting tremor in one or both hands. Tremors usually begin on one side, and they might spread to the other side. During periods of stress or strong emotion, shaking may become more pronounced.

The following health related problems can also cause shaky hands:

• Alcohol abuse or withdrawal
• Mercury poisoning
• Psychiatric conditions, like depression or post-traumatic stress disorder
• Inherited degenerative disorders, such as hereditary ataxia or fragile X syndrome • •Hyperthyroidism, or an overactive thyroid
• Liver or kidney failure
• Anxiety or panic

Certain drugs can also cause hand tremors, such as:

• caffeine
• corticosteroids
• some asthma medicines
• amphetamines
• medicines used to treat certain neurological as well as psychiatric disorders

Tremor can be classified into two main categories:

• Resting tremor occurs when muscles are relaxed, such as in situations, when the hands are resting on the lap.  With this disorder, a person’s arms, hands or legs may shake even when they are at rest. More often, the tremor only affects the hand or fingers. This type of tremor is often seen in people with Parkinsonism and is called a “pill rolling” tremor because the hand movements and circula finger resemble rolling of small objects or pills in the hand.  

• Action tremor occurs along with the voluntary movement of a muscle. Almost all types of tremors are considered action tremor.  Action tremor is also sub classified, many of which overlap.

• Kinetic tremor is associated with any voluntary movement, such as moving the wrists up and down or closing and opening the eyes.
  Postural tremor happens when a person tries to maintain a position against gravity, such as when holding the arms outstretched.

• Intention tremor is produced with purposeful movement towards a target area, such as lifting a finger to touch the nose.  Typically the tremor becomes worse as the individual gets closer to their target.

• Isometric tremor occurs while making a voluntary muscle contraction which is not accompanied by any movement such as holding a dumbbell or a heavy book in the same position.
  Task-specific tremor only appears when performing highly-skilled, goal-oriented tasks such as handwriting or speaking.

   

A physical therapist can guide individuals with tremor to increase and strengthen the coordination of muscular movements. In many cases, this helps improve their muscle control. Thus an initial assessment of the patient will be performed, including:

• The degree of muscle control
• The type of tremor
• The position in which tremor onset occurs
• The muscular strength
• The level of functional muscle skil

Physical therapy will then be started, focusing on coordination exercises, and exercises to increase the balance of the body. Patients also learn the way to help reduce the occurrence of tremor while using the affected body part. When a tremor comes on, bracing the limb is often useful.

Occupational therapy helps to identify different kinds of adaptations which are useful to optimize function with a tremor. These may include large-handled cups and utensils, splints, and weights.

Tremors can be reduced by improving grip strength. For this exercise, use a small rubber ball or exercise putty. Hold the ball or putty in the palm and squeeze for two to three seconds. Relax and repeat 10 times, repeating to three sets in a row.

Strengthen your hand and wrist by using a lightweight dumbbell, that’s 1 to 3 pounds in weight. Position your hand and wrist — palm side up — over the edge of a table. Place the weight in your hand. This way, move your wrist up and down 10 times.

Improve Overall Conditioning

Regular exercise can help lower stress levels, decrease your risk of disease and improve your overall health. Individuals should aim for 150 to 300 minutes of moderate-intensity physical activity per week.

Weight-Bearing Exercises

Bearing light weight through your hands can temporarily reduce tremors and also helps to strengthen your upper extremities. Perform body-weight resistance exercises, such as planks and pushups, as part of a regular exercise routine.

Adaptive Equipment and Tools

Hand tremors reduce through the use of adaptive equipment and tools, making everyday tasks easier. For example, increasing the diameter and weight of writing tools and eating utensils reduces tremors. These items can also be strapped to your hand to improve stability. Wearing weights on wrist for hand tremors also improves your function.

If using weighted tools is not effective for you, adaptive equipment is available to make daily tasks easier. For example, elastic shoelaces eliminate the need for tying. While keeping your elbow tucked against your side, long handled combs can be used to groom your hair— another tip for reducing hand tremors.

Our reliable and experienced caregivers are trained to make use of various healthcare practices and technology. As a result, they can help your affected family member recover faster and more comfortably at home.