Why Do Your Hands Shake, and Do You Need a Neurologist for Tremors in NYC?

See a neurologist for tremors when shaking lasts, gets worse or makes daily tasks hard. Writing, typing, eating and holding a coffee cup are common trouble spots. Many tremors come from caffeine, stress, a medicine or an overactive thyroid. Others come from essential tremor or Parkinson's disease. A neurologist can tell the types apart with a careful exam. Shaking with sudden weakness, confusion or trouble speaking is an emergency. Call 911.

You notice it when you sign a receipt. Or when you hold your phone on a crowded train. Your hand won't stay still. It's easy to worry about the worst. The good news is that most tremors aren't dangerous. Still, the right diagnosis matters, because each type has a different plan. If you want an expert look, our Lower Manhattan neurology team evaluates tremors and other movement disorders.

Want answers about the shaking? Book an appointment with our NYC neurologist or call (347) 667-8272 to schedule your visit.

A tremor is shaking you can't control. It most often affects the hands. It can also affect the arms, head, voice, legs or torso. The National Institute of Neurological Disorders and Stroke notes that tremor isn't life threatening. But it can make tasks like writing, eating and dressing harder.

Doctors sort tremors by when they happen:

• Rest tremor shows up when your hand sits still, like in your lap.
• Action tremor shows up when you move or hold a position, like reaching for a glass.

That one detail tells your neurologist a lot.

Not every tremor points to a brain problem. Common causes include:

• Too much caffeine. Extra cold brew can do it.
• Stress, anxiety or fatigue. These can make any tremor worse.
• Medicines. Some asthma inhalers, steroids and psychiatric medicines can cause shaking.
• An overactive thyroid. Your doctor can check this with a blood test.
• Low or high blood sugar. This matters if you have diabetes.
• Alcohol withdrawal.
• Essential tremor. A common movement disorder that often runs in families.
• Parkinson's disease. Tremor is one possible sign, but not everyone with Parkinson's has it.
• Dystonia. This causes muscles to tighten or twist on their own, sometimes with a tremor.
• Stroke, multiple sclerosis or injury to parts of the brain that control movement.

Your primary care doctor can check for thyroid and blood sugar problems first. Those labs are often part of the blood tests in a primary care checkup.

The question of essential tremor vs Parkinson's comes up at almost every first visit. Here's how they often differ.

Book a visit if:

• The shaking lasts more than a few weeks
• It keeps getting worse
• It makes writing, eating, typing or dressing hard
• It affects one side more than the other
• It comes with stiffness, slowness or balance problems
• Your voice or head shakes
• It runs in your family and now affects you

Not sure if your symptom fits? Other common signs also show when to see a neurologist.

Call 911 right away if shaking comes with:

• Sudden weakness or numbness on one side
• Slurred speech or trouble understanding words
• Sudden confusion
• A drooping face
• Loss of consciousness or a seizure
• Shaking, sweating and confusion in someone with diabetes, which can signal very low blood sugar

Most tremor diagnoses come from a careful history and exam. Your neurologist asks:

• When did the shaking start?
• Which body parts shake?
• Does it happen at rest, during movement or both?
• Does anything make it better or worse, like coffee or alcohol?
• Does anyone in your family have a tremor?
• What medicines do you take?

Then your doctor watches the tremor. You might hold your arms out, touch your nose, write a sentence or draw a spiral. Your neurologist also checks muscle tone, reflexes, balance and walking.

You may not need tests at all. If you do, they could include:

• Blood work to check thyroid levels and other causes
• An MRI or CT scan if your doctor wants to rule out a structural cause
• An EMG to look at muscle and nerve activity

Neurology care at Umbrella Health includes EMG and nerve conduction studies and coordinated brain imaging. Other tests can run through our diagnostic testing services.

• Take a short phone video of the tremor when it's at its worst.
• List every medicine and supplement.
• Track how much coffee and alcohol you drink for a week.
• Bring a handwriting sample from before the tremor started, if you have one.
• Ask a relative about family history.

Treatment depends on the type and how much it affects your life. Mild tremors may need no treatment at all. Options can include:

• Treating the cause, like adjusting a medicine or treating a thyroid problem
• Cutting back on caffeine
• Getting enough sleep
• Stress management
• Prescription medicines for essential tremor or Parkinson's
• Occupational therapy and tools like weighted utensils
• Referral for advanced options when medicines don't help enough

A tremor can make small city moments harder. Tapping your card at the turnstile. Holding a pole on a moving train. Signing for a package. These tips may help while you wait for your visit.

• Use both hands to hold a cup or phone.
• Rest your elbows on a table when you write or eat.
• Choose mugs with lids and big handles.
• Try a heavier pen or a phone stand.
• Plan tricky tasks for times of day when the tremor feels lighter.
• Cut back on coffee and energy drinks.

Small changes add up. Still, they don't replace a proper diagnosis. A neurologist for tremors can tell you what's behind the shaking and what will help most.

Dystonia causes muscles to pull or twist on their own. It can affect the neck, eyelids, voice or a hand. Some people also have a tremor with it. If you need a neurologist for dystonia in NYC, ask whether the practice evaluates movement disorders. Umbrella Health's neurology team evaluates dystonia and other movement disorders.

Umbrella Health is at 32 West 14th Street, New York, NY 10011, near Union Square. Patients come from Greenwich Village, Chelsea, the Flatiron District, SoHo, NoHo and across New York City. Neurology works alongside primary care and pain management in one location.

Ready to stop guessing about the shaking? Book an appointment with our NYC neurologist. You can also contact Umbrella Health to book a visit or call (347) 667-8272 to schedule.

New to the practice? Umbrella Health brings primary care and specialists together under one roof.

Memory changes too? A neurologist for memory loss can check what's normal and what isn't.

Living with headaches? Frequent attacks are a reason to see a neurologist for migraines.

Feeling foggy or slow? A neurologist for brain fog can look for the cause.

This article shares general information. It isn't medical advice, a diagnosis or treatment. Talk with a qualified clinician about your own symptoms. Please don't share personal health details in comments or on social media. If you think you have a medical emergency, call 911 or go to the nearest emergency department right away.