​If you see your hands start to shake, thoughts of Parkinson’s Disease (PD) may spring to mind.

However, in most cases, hand tremors or trembling hands are normal.

“Hand tremors are common in healthy people and often go away without medical treatment. However, in some cases, tremors can affect a person’s quality of life or be a sign of something more serious,” shares Dr Li Weishan, Consultant from the Department of Neurology at National Neuroscience Institute (NNI), a member of the SingHealth group.

Tremors, or uncontrollable shaking or trembling, usually affect the hands but can also occur in the arms, legs, head, and vocal cords.

When hand tremors are normal

Hold your arms out in front of your body and you might see very slight movements in your fingers and hands. 

This type of trembling hands happen to everyone, but the trembling may be so fine that it goes unnoticed. These normal tremors (also known as physiological tremors) can be triggered or made worse by:

  • Taking caffeine

  • Low blood sugar levels

  • Lack of sleep

  • Severe exhaustion

  • Anxiety

  • Certain medications  

4 Ways to reduce normal hand tremors

The best way to reduce normal hand tremors is to identify and remove the triggers. These include:

  1. Drinking less coffee, tea and caffeine-enriched energy drinks

  2. Getting enough sleep

  3. Eating regular meals to prevent low blood sugar

  4. Reducing stress

If tremors continue to cause inconvenience despite removing triggers, see your family doctor for a checkup. 

Your doctor can check if your tremors could be caused by prescription medicines and, tweak the dose or change to another medication if necessary, or refer you to a specialist if they suspect it could be caused by a medical condition.

When hand tremors are caused by medical conditions

Trembling hands that are caused by a medical condition (also known as pathological tremors) can be attributed to two medical conditions: 

These conditions affect movement and are more common in the elderly, however there are key differences between their symptoms and management.

About essential tremors

Essential tremors are uncontrollable shaking that usually affect the hands but can also happen in other parts of the body. 

It occurs when the person is using the body part, such as shaking hands when using a spoon or holding a glass of water, or a shaky voice when speaking.

Cause of essential tremors

The cause of essential tremor is not known. About half of the cases are related to a genetic mutation which is why those with a parent or sibling with the condition are at higher risk, especially when tremors start in people aged below 65 years old.

Treatment for essential tremors

  • Avoiding triggers such as caffeine, stress and anxiety

  • Getting enough sleep

  • Reviewing and adjusting medication for other conditions that may worsen the tremor

  • Physiotherapy and occupational therapy to strengthen muscles and learn ways to get dressed, eat and do other daily tasks despite the tremor

If the tremors continue to affect the person’s quality of life, medication may be recommended or surgery (deep brain stimulation) in severe cases.

About Parkinsons' Disease

Parkinson’s disease (PD) is a condition which results in brain changes that get worse over time. Tremors in the hands, arms or legs are a common symptom in PD and happen when the hand or leg is resting. 

They often occur with three other movement difficulties: slowness, stiffness and/or poor balance. However, PD also causes other health problems including depression, constipation, loss of smell and sleep problems.

Cause of Parkinson's Disease

Parkinson's Disease occurs when the brain does not produce enough of a chemical called dopamine. Dopamine acts as a messenger, sending instructions from the brain to control movement.

Treatment for Parkinson's Disease

There is currently no cure for Parkinson's Disease (PD) and it gets worse over time. However, treatment is available to control the symptoms and help people with PD live well. 

PD affects people differently, so treatment is tailored for each person’s symptoms and may include:

  • Medication to control tremors and other symptoms – this will change over time as the condition progresses

  • When medications are no longer able to control symptoms well, deep brain stimulation surgery may be advised

  • Exercises to maintain strength and movement.
    Click here for our exercise videos for people with Parkinson's Disease.

  • Advice on planning daily activities around PD symptoms to improve quality of life

  • Installation of grab bars and other safety equipment at home to reduce the risk of falls

  • Voice training to make speech louder and clearer

Difference between essential tremors and Parkinson's Disease

Ref: H24

Parkinson's: Early Signs and Symptoms

What to Do When Parkinson's Strikes

How Speech Therapy Can Help Parkinson Patients

How Music Therapy Can Help Parkinson Patients

Suitable Leisure Activities for Parkinson Patients