Tremor - arms or hands

For tremors caused by stress, try relaxation techniques like meditation, deep relaxation, or breathing exercises. For tremors of any cause, avoid caffeine and get enough sleep.

For tremors caused by a medication, consult with your doctor about stopping the drug, reducing the dosage, or switching medications. DO NOT change or stop medications on your own.

For certain types of tremors, like essential tremor and familial tremor, medications such as beta-blockers, gabapentin, primidone, and others may be an option. If medication doesn't work, your doctor may even consider surgery. Also, botulinum toxin injections have been used for essential hand tremors.

For tremors caused by alcohol abuse, seek treatment and support to help you avoid alcohol.

Severe tremors may interfere with your ability to perform daily activities. Assistance with these activities may be necessary. Precautions should be taken to avoid injury during activities such as walking or eating.

Call your doctor if:

• Your tremor is worse at rest and gets better with movement, like when you reach for something.
• Your tremors are prolonged, severe, or interfere with your life.
• Your tremors occur with other symptoms, like headache, weakness, abnormal tongue motion, or other types of involuntary movements.

Your doctor will perform a physical examination, including a detailed neurologic examination. The following medical history questions may help your doctor evaluate the cause of your tremors:

• Is your tremor regular or irregular?
• Does it occur with activity, at rest, or when you have been holding your hand (or other body part) in a particular position for a long time?
• Are the movements small (fine) or large (coarse)?
• Are both hands affected? To the same degree on both sides?
• Are other body parts affected, including your voice or head?
• Does the tremor impair your ability to use your hands or other body parts?
• Does emotional stress or excitement make it worse?
• Does drinking an alcoholic beverage make the tremor better or worse?
• Do you have any other symptoms?

• Blood tests such as CBC, blood differential, thyroid function tests, and glucose test
• Urine tests
• Head CT scan
• MRI of the head
• EMG or nerve conduction studies

Once a cause of the tremor has been determined, the appropriate treatment for the disease will be prescribed.

Louis ED. Essential tremor. Lancet Neurol. 2005; 4(2): 100-110.

Louis ED, Ford B, Frucht S, Rabinowitz D, Ottman R. Evidence for familial aggregation of tremor in normal individuals. Neurology. 2001; 57(1): 110-114.