For many people with a tremor, a specific disease cause is not found. Some types of tremors run in families. A tremor may also be part of a long-term brain or nerve disorder.

Some medicines can cause tremors. Talk with your health care provider if a medicine may be causing your tremor. Your provider may lower the dosage or switch you to another medicine. Do not change or stop any medicine before you talk with your provider.

You may not need treatment for your tremor unless it interferes with your daily life or is embarrassing for you.

Most tremors become worse when you are tired.

• Try not to do too much during the day.
• Get enough sleep. Ask your provider about how you can change your sleep habits if you have problems sleeping.

Stress and anxiety can also make your tremor worse. These things may lower your stress level:

• Meditation, deep relaxation, or breathing exercises
• Reducing your caffeine intake

Alcohol use can also cause tremors. If it is the cause of your tremors, seek treatment and support. Your provider can help you find a treatment program that may help you stop drinking.

Excess caffeine use can also cause tremors and should be limited if this aggravates symptoms.

Tremors can worsen over time. They may begin to interfere with your ability to do your daily activities. To help in your day-to-day activities:

• Buy clothes with Velcro fasteners instead of buttons or hooks.
• Cook or eat with utensils that have larger handles that are easier to grip.
• Drink from half-filled cups or use sippy cups to avoid spilling.
• Use straws to drink so you do not have to pick up your glass.
• Wear slip-on shoes and use shoehorns.
• Wear a heavier bracelet or watch. It may reduce a hand or arm tremor.

Your provider may prescribe medicines to relieve your tremor symptoms. How well any medicine works may depend on your body and the cause of your tremor.

Some of these medicines have side effects. Tell your provider if you have these symptoms or any other symptoms you are concerned about:

• Fatigue or drowsiness
• Stuffy nose
• Slow heart rate (pulse)
• Wheezing or trouble breathing
• Problems concentrating
• Walking or balance problems
• Nausea

In severe cases, a deep brain stimulator can be used to help.

Contact your provider if:

• Your tremor is severe and it interferes with your life.
• Your tremor occurs with other symptoms, such as headache, weakness, abnormal tongue motion, muscle tightening, or other movements that you cannot control.
• You are having side effects from your medicine.

Shaking - self-care; Essential tremor - self-care; Familial tremor - self-care

Haq IU, Liebenow B, Okun MS. Clinical overview of movement disorders. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 105.

Jankovic J, Lang AE. Diagnosis and assessment of Parkinson disease and other movement disorders. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 24.

Okun MS, Ostrem JL. Other movement disorders. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 379.

Updated by: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.