Tremour troubles: 5 reasons behind your shaky hands

Tremour troubles: 5 reasons behind your shaky hands
Hands are one of the most common locations for a tremour episode. ©Shutterstock

Tremour, especially in the hands, is a condition experienced mostly by the elderly population. Though not life-threatening, it could be the sign of some serious ailments.

Written by Editorial Team |Published : April 26, 2019 1:58 PM IST

Do you find your hands shaking while holding t out? Well, this condition, experienced by many, especially the older population, is not life-threatening. But uncontrollable tremour or shaking can be debilitating for sure in extreme cases. Tremour is an involuntary oscillation of muscles caused by contraction. Though it can affect your face, arms, trunk, legs, and voice, hands are the most common locations for a tremour. It may be occasional or temporary and can be classified into two types: Resting tremour and action tremour. The former occurs when the muscles are in a relaxed position and the latter happens when your muscles are in some voluntary movement like writing, lifting something, etc. While several lifestyle factors like sleeplessness, smoking, anxiety and high caffeine intake can increase the risk of a tremour episode, there are certain diseases that can also scale up your chance of developing this condition.

Overactive thyroid gland

When your thyroid gland, situated just above your collarbone, becomes overactive (hyperthyroidism), all the processes of your body gain an abnormal speed. You are likely to experience it in your hands when you stretch them out. However, it can affect your legs, jaw, lips, head and trunk also. You can go through this tremour with a frequency of 10 times per second. Known as physiologic tremour, it can also be triggered by low blood sugar levels, some drugs, or withdrawal from some sort of addiction. To treat a physiologic tremour, your doctor needs to identify the underlying cause first and then take the necessary actions. He may prescribe beta blockers that reduce the frequency of tremour. It works by blocking the effect of adrenaline hormone. Beta blockers are also used to treat conditions like high blood pressure and heart palpitations.

Family history

Family history (due to genetic mutation) could be another cause behind your tremour episodes. In the medical fraternity, it is known as essential tremour, one of the most common movement disorders. Mostly occurring in older people, it is estimated to affect around 4 to 39 people per 1000 persons worldwide, says a study published in the journal Movement Disorders. It is generally prominent in one side of the body and worsens with movement. Affecting your head, essential tremour will be characterized by either a yes-yes or a no-no motion of the head. Factors like stress, caffeine intake, fatigue, or extreme temperature can aggravate this condition. To diagnose essential tremour, doctors first try to rule out other through neurological examinations (checking muscle strength, posture, and tendon reflexes), laboratory tests (ruling out thyroid diseases, drug side-effects etc.), and performance tests (including, writing, drinking from a glass). Then, they review your family history. There are various medications and surgical options like deep brain stimulation to help you manage the symptoms of the condition. Focussed high intensity ultrasound can also help. As the cause of essential tremour is genetic, it cannot be prevented.

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Parkinson s Disease

It is a progressive neurological disorder that occurs due to the deficiency of dopamine, a brain chemical and affects your movement. It causes tremour mostly in limbs, hands, or fingers. It is characterized by unstable gait, slow motion, tremour in hands, arms, legs, jaw, or head and stiffness of the limbs and trunk, impaired speech, swallowing problem, disrupted sleep. Parkinson's Disease mostly affects people of the older generation and the risk factor is increased by exposure to certain environmental toxins. To diagnose Parkinson s Disease, doctors recommend certain blood tests that rule out other possibilities. Then they perform imaging tests like MRI, CT scan, brain ultrasound, PET scan, or DAT scan (to check the level of dopamine in the brain). As far as its treatment is concerned, doctors prescribe some drugs to raise the levels of dopamine in the brain. If the medicines do not provide sufficient relief from the symptoms, a surgical option, known as deep brain stimulation is performed. Moreover, regular exercise (to increase muscle strength), physical therapy and speech therapy are also recommended to enhance the quality of life. A person with this condition is generally given foods high in fibre and adequate amount of fluid to prevent constipation (a common symptom of the disease).

Multiple sclerosis

Multiple sclerosis (MS) causes a type of tremour known as intention tremour. MS is a central nervous system disorder in which your body s own immune cells attack the protective covering of a nerve fibre known as myelin and causes problem in communication between your brain and the rest of the body. Its severity depends on how much nerve damage has occurred. MS is characterized by numbness in one or both limbs, sensation of electric shock especially during neck bending, vision problem, fatigue, dizziness, or slurred speech. It is considered as an autoimmune disease and doctors haven't yet been able to pinpoint the cause. Various factors including age (usually affects people between the age of 16 and 55), sex (women are more prone than men), family history, race, deficiency of vitamin D, and smoking may increase your risk of developing this condition. The diagnosis of this condition may need various methods: Neurological exams, imaging scans, spinal fluid analysis, measurement of the electrical activities of the brain. Though, there is no cure of this disease, certain medications may help relieve the symptoms. Also, physical therapy, cognitive rehabilitation, speech therapy, plasma exchange, vitamin D supplements, and hyperbaric oxygen therapy may make the lives of MS patients better. Yoga can also be a good option. However, you need to consult your doctor before starting your yoga classes.

Wilson Disease

It is an inherited disease that occurs due to copper deposition in the liver. Characterized by fatigue, speech problem, muscle stiffness, eye discoloration, and yellowing of the skin, it causes tremour in patients. Your body absorbs copper from the food you eat, and the excess amount gets excreted. However, in case of Wilson Disease, the excess copper does not get flushed out and gets stored in the liver, brain, eyes, and other organs. This eventually can become life-threatening. However, if diagnosed early, this condition can be treated. Blood and urine tests, along with eye examinations, biopsy, and genetic testing can help diagnose Wilson Disease. The general line of treatment includes medications to prevent copper build-up. In severe cases, where the liver is destroyed, liver transplant may be required. Your doctor may advise you to limit the consumption of foods containing carbon, such as, mushrooms, nuts, chocolates, etc.