You notice the most vibrations in the morning, while texting or drinking coffee. Or it could be a constant pain that shakes every time your arm hangs out to your side.
You are not alone. Shaking and shaking of a part of the body, called tremors, is the most common form of movement disorder, according to a 2011 study by the American Family Physician. And your hands are the most painful part of your body.
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What is causing your tremors? Hand tremors can have a number of underlying causes, from Parkinson’s disease to caffeine overload, says Joseph Jankovic, M.D., professor of neurology and movement disorders at Baylor College of Medicine.
How do you know if your hands are shaking? Most of the time you can’t. But your doctor can depend on when and how your tremors are detected.
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For example, you may have “action” tremors, which manifest when you lift or manipulate something with your hands, Yankovic says. This type of tremor is most pronounced when working against gravity, such as when eating or drinking or trying to pick up something and hold it in front of the face. You may also have “resting” tremors, which means that your hands are still or move from side to side and vibrate.
Regardless of the type of tremor, if it interferes with your ability to work or makes you feel uncomfortable around other people, it’s time to see someone, Yankovic says. (Okay! Here are the 7 worst things people lie to their doctors about.)
Here, he and other experts explain the common causes of hand tremors and how to tell them apart.
The most common form of hand tremors—affecting 1 in 25 people, or 4% of the population—essential tremors are tremors that occur when you try to perform a task or action. “With your hands,” says Gordon Baltuch, MD, MD, professor of neurosurgery and associate director of the Parkinson’s Disease
Baltuch explains that if your hand shakes when you try to type or write, or you notice it when you reach for a salt shaker or a glass, it could indicate a type of tremor.
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It can be mild or barely noticeable, or it can be so obvious that it interferes with daily activities. But there’s an easy way to tell if the vibrations you’re feeling are: solid or not. “If your tremors go away, that’s where your diagnosis is,” he said.
In fact, drinking alcohol has long been a way for people with essential vibrations to regulate their vibrations. Baltuch said patients came to his office drunk and the office staff tried to send them home. “I had to tell them no, the patient had to drink to function,” he said.
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What causes essential tremors? “We don’t know,” he said. “We know it runs in families, so there seems to be a genetic component, but we don’t really understand why.” This may be because the part of the brain that controls motor skills sends and receives information, he said. But the details are murky.
Essential tremor usually starts in one hand, usually the person’s dominant hand, and eventually moves to the other hand. The risk of tremors increases with age, but it can occur at any age. “I have kids who come in really shaken up,” Baltuch said.
What can you do about it? If it’s very soft, you don’t need to do anything. It may or may not get worse with age. But leaving it untreated likely won’t cause any problems, he said. (These are the 6 best brain foods you can eat as you age.)
If it’s interfering with your life, there are medications to help. “The mainstay of treatment is beta-blockers,” he said. “If those don’t work, anticonvulsants may work.”
If drug therapy is ineffective, some surgeries are possible. Baltuch performs a non-invasive form of ultrasound surgery that can change the lives of patients with exceptional circumstances.