Types of Hand Tremors

The Different Types of Hand Tremors

What are the different types or categories of hand tremor? We generally classify tremor by the way it appears and by its cause. I have listed 22 types of tremors in this post to form a glossary of sorts to help you define hand tremors in general terms.

Overview of Tremor

Most common Tremor occurs in the hands or head, it is involuntary and repetitive. Tremor can be the result of several health problems or it can be a problem all by itself.

Action Tremor

Action tremor happens as you try to move or accomplished a task. It is a Category of Tremor as most types of tremor are considered to be an action tremor. You will find that many of the classes of action tremor will overlap.
Postural Tremor this Tremor happens as a person is sitting up straight or standing, or holding arms or legs outstretched. The action of holding your body against gravity causes the Tremor.
Intention Tremor is created has you make a targeted or purposeful movement, for example reaching to touch a button with your finger. This tremor will generally worsen as your finger approaches the target.
Kinetic Tremor happens in conjunction with a voluntary movement. It could be anything from lifting your hands and arms up and down to opening your eyes and closing them.
Task-Specific Tremor happens only when doing precise and goal-oriented skills or tasks like speaking, writing or drawing.
Isometric Tremor happens as your muscles contract in one position. Examples are, holding a heavy object, dumbbell or book without moving, clenching your fist or pushing against a wall.

Benign Tremor/ Benign Essential Tremor Syndrome

Both benign tremor and Benign Essential Tremor result from abnormal muscle contractions. They are both synonyms for essential tremor, which is a Neurological disease. The effect of the disease is a shaking of the muscles that are involved when they are either at rest or when the muscles are in use.

The most commonly affected areas are:
Hand tremors
Head tremors where the head shakes up and down or side to side
Voice tremors where vocal folds are shaky as one tries to speak

It is possible to have all three symptoms or just one and each symptom can have a unique degree of severity.

Benign tremor is an obsolete term since the tremor does tend to worsen with time.

Bilateral Hand Tremors

Simply stated, these are tremors that affect both sides of the body, both hands at the same time.

Cerebellar Tremor

Cerebellar tremor is generally slow and easy to observe and affects the body's extremities like the arm or leg.

  • The tremor usually happens at the end of a targeted movement such as when pressing a button.
  • This tremor is caused by damage to the cerebellum hence the name, and is usually caused by a stroke or tumor.

Damage to the cerebellum can also be caused by diseases such as:

  • Multiple Sclerosis
  • Ataxia (a disease that causes loss of muscle control in the body's extremities)
  • Fragile X Syndrome
  • Alcoholism.

Child or Toddler Hand Tremors

Childhood tremors or toddler hand tremors are fairly rare and diagnosing them is a challenge for doctors. There are many different genetic conditions that may cause tremors as well as several diseases. A tremor in a child is potentially very serious and parents should be very persistent to get a prompt referral to a neurologist and a comprehensive evaluation to investigate and understand the cause of tremor.

Dystonia Tremor

"Distonic tremor" is the disorder that accompanies the movement disorder called Dystonia. This disorder causes muscles to be overactive after receiving wrong signals from the brain and results in unwanted movements and odd abnormal posture. Usually occurs in young or middle-aged adults. It can affect any muscle in the body. Complete relaxation may at times relieve the symptoms.
There are some similarities between Essential tremor and Dystonia tremor I have listed the differences below.

Dystonia Tremor:
• effects the same body parts, but effects the head more often without tremors in the arms or hands
• will sometimes act like a resting tremor, such as the tremor seen in Parkinson's disease
• touching the body part or muscle may reduce the dystonic tremor severity
• dystonic tremors are irregular and jerking not rhythmic and consistent like essential tremor
• can cause abnormal body postures resulting from powerful muscle cramps and spasms

Essential Tremor

Essential tremor (once called by the obsolete terms: benign essential tremor or familial tremor) is perhaps the most common of all movement disorders. No one has been able to pinpoint the cause. Some people will experience a very mild tremor that is unchanged for many years. Others can have a virtually debilitating Tremor that causes difficulty with almost every task. Read more about essential tremor here...

Fibromyalgia Tremor

Fibromyalgia is a rather tricky condition to diagnose. The primary symptoms of fibromyalgia are tenderness and pain in muscles throughout the joints in your body. It is very quirky and hard to define specifically since it seems everyone experiences it differently. However, once you have been diagnosed with fibromyalgia one of the symptoms can be muscle twitching or cramping that causes tremors.

Functional Tremor

A type of tremor that combines characteristics of the rest tremor, postural tremor, and action tremor is called functional tremor. There is no recognized medical cause and it is considered to be a presentation of known or sometimes known as stresses. Doctors who examined for this Will determine if the tremor is more severe when you are distracted or less severe when distracted. (ex. distraction such as moving the fingers of your opposite hand) Non-functional tremors tend to get worse when you are distracted.

Holmes Tremor

First, Holmes tremor is very rare. It occurs as a result of damage to a person's midbrain and presents itself as both a postural and rest tremor. These comers tend to move slowly but have very large movements that make the affected limbs virtually useless. These tremors generally begin within several months after an event like a brain stem stroke or some other kind of trauma.

Parkinson Disease Tremor/ Parkinsonian Tremors

One of the symptoms for Parkinson's disease includes tremors or shaking in one or two hands while hands are at rest. Sometimes the tremors can affect the face, usually the lips or chin and sometimes the legs. Early in the disease tremors might occur on only one side of the body, or only affecting one limb. The tremors may spread to both sides of the body as the disease progresses. As with many tremors, these are worsened in stressful or highly emotional situations. People diagnosed with Parkinson's disease have a greater than 25% chance of experiencing tremors.

Physiologic Tremor/Enhanced Physiologic Tremor

Physiologic tremors are normal. It is not a disease but is simply the result of the normal physical functioning of our bodies. We have within us rhythmic activities such as breathing heart beating and various muscles working consistently in the background. These tremors are not visible normally because they are so mild. These effects are most notable when doing very refined tasks such as threading a needle.

Enhanced Physiologic Tremor

The simplest explanation for enhanced physiologic tremor is they will become more noticeable when an outside agent is added to what is a normal human condition. Again, this is not a neurological disease, but a reaction to alcohol withdrawal, certain types of drugs or different medical conditions such as hypoglycemia or an overactive thyroid. These tremors are usually curable once the cause for them is identified.

Here is a shortlist of things that commonly cause a physiologic tremor:

Alcohol or drug-related withdrawal
Fear, excitement, anxiety, and other strong emotions
Muscle fatigue from a long workout
Nicotine and caffeine Hyperthyroid--overactive thyroid
Various drugs like steroids, drugs for asthma or other breathing issues, and drugs used to treat psychiatric or neurological disorders

Be sure to consult your doctor before changing the way you take your prescribed medication if you suspect it is causing tremors or any other undesirable side effect.

Psychogenic Tremor

Sometimes also referred to as functional tremor, psychogenic tremors can present themselves like any other type of tremor. There are various symptoms but they tend to start abruptly and can affect all parts of the body. The main characteristic is an increase in tremors during stress and a decrease when the individual is distracted. Individuals with psychiatric problems like Post-traumatic stress disorder (PTSD) or depression have often experienced psychogenic tremors.

Resting Hand Tremor

Occurring when the muscles are relaxed, resting hand tremors often only affect fingers or hands. These tremors can occur both when active and when hands are relaxed and resting on your lap. Patients with Parkinson's disease often experience these tremors which are sometimes called "pillrolling" tremors because the hand movements look like someone rolling pills or other tiny objects in their hand.

Stroke Tremors

There are many abnormal movements that can occur either immediately or in some delayed fashion after stroke. Stroke hand tremors in particular and tremors that affect other parts of the body are often caused by damage to the inner brain that can occur with a stroke. Different locations in the brain that can be affected by a stroke and result in effects in different parts of the body. There is evidence to suggest that these tremors do improve over time

Sudden Onset Tremors

People who experience a sudden onset tremor should seek a medical evaluation to determine the cause. Medications, exposure to toxic substances, tumors, or a psychogenic tremor, are all possible suspects that need to be identified. Those who have a hand tremor with a gradual onset should also seek a medical evaluation with specific questions regarding Parkinson's disease.

Unilateral Rest Tremor

Unilateral rest tremor is evidenced by one hand or one side of the body shaking while it is at rest. Evidence of this tremor should encourage you to seek medical examination to determine if Parkinson's disease is at play.

Ending Thoughts

When tremors occur, the first thing to do is learn about what type of tremor you have. Seeking medical advice and discovering the cause and possible treatment for your tremor helps give you peace of mind.

Different terms doctors use such as "tremor syndromes" are descriptive of specific combinations of symptoms and signs of tremors that frequently happen at the same time. When doctors say "tremor syndrome" they mean that tremors are the only neurological symptom of either one or more neurological problems.

I do hope you have found this glossary for the types of hand tremor helpful.

As always, I appreciate your comments and questions and I look forward to hearing from you!


Please note: the information I have provided is not to be substituted for consulting with a doctor or receiving an examination. This material is not intended to provide advice on medical treatments that are specific to any particular circumstance.

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