Hand tremors are common in elderly individuals. While sometimes a normal part of the aging process, they can also signal underlying medical conditions that warrant attention. Understanding the characteristics of different tremors and their potential causes can help differentiate between benign occurrences and those that may require medical evaluation. This article clarifies why these movements happen and when to seek professional advice.
Categorizing Hand Tremors
Hand tremors are broadly classified based on when they occur, providing clues about their origin. A resting tremor manifests when the hand is at rest. This type of tremor typically lessens or disappears during voluntary movement.
Conversely, an action tremor appears during voluntary movement or when maintaining a posture against gravity. A postural tremor is evident when a person holds a position against gravity, such as extending the arms forward. A kinetic tremor occurs during any voluntary movement, like moving the wrists or bringing a hand to the nose. A specific type of kinetic tremor is an intention tremor, which becomes more pronounced as the hand approaches a target. These classifications help understand the physical manifestation of tremors.
Underlying Medical Conditions
Several medical conditions can lead to hand tremors in older adults. Essential tremor is a common neurological disorder characterized by rhythmic shaking, primarily affecting the hands and arms during action or when holding a posture. It often affects both sides of the body, though one side might be more affected, and can also impact the head or voice.
Parkinson’s disease frequently presents with a characteristic resting tremor, most noticeable when the hands are at rest, resembling a “pill-rolling” motion. This tremor often begins asymmetrically, affecting one side more, and may lessen with intentional movement. Other symptoms like stiffness and slowed movement often accompany Parkinson’s tremor.
Certain medications can induce tremors as a side effect, including some asthma drugs, antidepressants, and anti-seizure medications. These drug-induced tremors are often a form of enhanced physiologic tremor, which can also be caused by excessive caffeine intake or alcohol withdrawal. Medication review is relevant when evaluating new or worsening tremors.
An overactive thyroid, or hyperthyroidism, can cause a fine, rapid tremor, often in the hands. This is another example of an enhanced physiologic tremor. Anxiety and stress can also temporarily cause or worsen tremors by increasing physiological arousal and muscle tension. Less common causes of tremors include other neurological conditions such as stroke or multiple sclerosis, which can cause intention tremors due to brain damage.
When to Seek Professional Advice
Consult a healthcare professional if hand tremors are new, worsen, or interfere with daily activities. Sudden onset or rapid increase in severity warrants medical evaluation. Tremors making routine tasks difficult, such as eating, writing, or dressing, also require assessment.
Seek medical advice if tremors are accompanied by other symptoms, including balance issues, difficulty walking, muscle stiffness, changes in speech, or problems with memory. These signs may suggest an underlying neurological condition requiring specific diagnosis and management. A healthcare provider can conduct a thorough medical history and physical examination, and may order tests to determine the cause of the tremor.