tremor that comes and goes

Overview

A tremor that comes and goes is an involuntary, rhythmic shaking of a part of the body that happens on and off. It can affect the hands, arms, head, voice, or legs. The shaking may last for seconds, minutes, or longer, and then stop. This type of tremor is not always a sign of a serious condition, but it can be bothersome.

Yes, many people experience occasional shakiness at some point in their lives. Intermittent tremors are common, especially in situations like stress or after too much caffeine.

It can affect anyone, but it is more common in adults over 40, and in people with certain health conditions like an overactive thyroid or anxiety. Sometimes it runs in families.

Symptoms

Common symptoms

• Shaking in the hands or arms that lasts a few minutes and then stops
• Tremors that appear when you are stressed, tired, or after drinking coffee
• A rhythmic tremor that may affect one side more than the other
• Trembling that goes away when you sleep or relax

Symptoms in children

• In children, tremors that come and go may be caused by low blood sugar, anxiety, or fever. The child may shake during moments of excitement or fear and then stop when calm.

Symptoms in older adults

• Older adults may experience tremors related to essential tremor (a common movement disorder) or Parkinson's disease. In essential tremor, the shaking often happens when using the hands. In Parkinson's, the tremor is more noticeable when the hand is resting.

Causes

Main causes

• Essential tremor – a common cause of rhythmic shaking, often inherited
• Anxiety or stress – temporary tremors triggered by nervousness
• Fatigue – lack of sleep can cause shaking
• Low blood sugar (hypoglycemia) – common in people with diabetes or after skipping meals
• Caffeine or other stimulants – can cause temporary tremors
• Overactive thyroid (hyperthyroidism) – can cause shakiness and other symptoms
• Certain medications – some asthma drugs, antidepressants, or steroids can cause tremor as a side effect

Risk factors

• Family history of tremor or movement disorders
• Anxiety disorders or chronic stress
• Use of stimulants (caffeine, nicotine, some medicines)
• Age over 40
• Medical conditions like diabetes, thyroid disorders, or multiple sclerosis

When to see a doctor

See a doctor urgently if:

• If the tremor is severe and comes on suddenly with confusion, slurred speech, or weakness on one side
• If you also have a high fever, stiff neck, or sensitivity to light

Book a routine appointment if:

• If the tremor lasts for more than a few weeks or keeps getting worse
• If it interferes with eating, writing, or daily tasks
• If you notice a tremor when your hand is resting (not moving)

Diagnosis

A doctor will take a detailed history and do a physical exam. They may watch you perform tasks like holding out your hands or writing. They will ask about your family history and any triggers.

Tests that may be done

• Blood tests to check for thyroid problems, low blood sugar, or other medical conditions
• Neurological exam to test nerve function and coordination
• Sometimes a brain scan (MRI or CT) if the doctor suspects a structural problem

What to expect at your appointment

The doctor may ask you to keep a diary of your tremors – when they happen, how long they last, and what you were doing. This helps find patterns. Most tests are simple and done in the doctor’s office.

Treatment

Treatment depends on the cause. If a tremor is mild and does not bother you, no treatment may be needed. When it is bothersome, treatments can help reduce the shaking.

Self-care at home

• Reduce or avoid caffeine, nicotine, and other stimulants
• Get enough rest – fatigue makes tremors worse
• Manage stress with relaxation techniques like deep breathing, meditation, or yoga
• If you have diabetes, keep blood sugar stable with regular meals
• Avoid heavy alcohol use – while small amounts may temporarily calm tremor, alcohol can make it worse later

Medical treatments

If self-care is not enough, a doctor may suggest prescription medications to reduce tremor. These are usually taken daily. In some cases, injections of a medicine that weakens muscles (botulinum toxin) can help with head or voice tremor. There are also devices (weighted utensils, tremor-canceling spoons) that can help with eating and writing.

When is surgery considered?

In very severe cases that do not respond to medication, a procedure called deep brain stimulation (DBS) may be considered. This involves placing a device in the brain to regulate abnormal signals. It is not common but can be very effective for certain types of tremor.

Living with this condition

Living with an intermittent tremor involves learning what triggers it and making small adjustments. Use adaptive tools like weighted pens, easy-grip utensils, and non-slip mats. Plan activities when you feel steady – for example, do tasks after resting.

Lifestyle tips

• Keep a consistent sleep schedule to avoid fatigue
• Find healthy ways to cope with stress – exercise, talk to friends, or take up a hobby
• If tremor affects your confidence, consider occupational therapy to find new strategies

Diet and exercise

Eat regular meals to keep blood sugar stable. Avoid large amounts of caffeine and sugary drinks. Light exercise like walking, stretching, or tai chi can help with balance and reduce anxiety. Yoga and mindfulness may also help calm the nervous system.

Mental health and emotional wellbeing

Tremors can be embarrassing or frustrating, especially in social situations. It is normal to feel anxious or self-conscious. Talking to a counselor or support group can help. Remember that many people have tremors, and most are not serious.

Prevention

It is not always possible to prevent tremors, especially if they run in your family. However, you can reduce the chance of temporary tremors by avoiding triggers like excessive caffeine, lack of sleep, and stress. Managing underlying conditions (like diabetes or thyroid problems) also helps.

Complications

If left untreated

• Difficulty with fine motor tasks like writing, sewing, or eating
• Social embarrassment or withdrawal because of visible shaking
• In rare cases, progression to a more constant tremor that affects daily life

Long-term outlook

For most people, intermittent tremor is manageable and does not lead to serious health problems. With the right strategies and medical care if needed, you can continue to lead a full and active life. Many causes are treatable, and new treatments continue to improve.

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