If your hands shake and you think rheumatoid arthritis (RA) is the cause, you aren’t alone. On myRAteam, several members have discussed shaky hands. Sometimes, shaky hands interfere with daily life. One member said, “I am a scrub in the operating room, and my hands shake really badly, especially when I have to do things like load very fine sutures.”

Shaky hands can make many daily activities more difficult. “I have arm and hand tremors,” another member shared. “My hands shake so badly I can’t eat soup with a spoon. I can’t even write my Christmas cards, and my grocery lists look like a two-year-old wrote them.”

If your hands shake and you’re not sure why, here’s what you need to know. Work with a healthcare provider to determine the cause of your shaky hands and how to manage this symptom.

Does RA Cause Shaky Hands?

Rheumatoid arthritis doesn’t directly cause your hands to shake, but shaking could be indirectly caused by inflammation from RA. RA is an autoimmune disease where your body’s immune system attacks the tissues in the lining of the joints, including those in the hands and fingers. These attacks lead to inflammation, which usually presents as stiff, swollen, painful joints.

Swelling and inflammation from RA may also weaken the muscles in your hands and lead to deformities and instability. These effects may also cause your hands to shake.

RA can lead to other medical conditions that may cause shaky hands, including peripheral neuropathy and carpal tunnel syndrome.

Peripheral Neuropathy

Sometimes, RA inflammation can affect your nerves and lead to peripheral neuropathy — a condition that causes weakness and numbness from nerve damage. Neuropathy may cause hand shaking, but you can have peripheral neuropathy without any shaking. Peripheral neuropathy may occur in up to 50 percent of people with RA. Peripheral neuropathy with RA may also be called rheumatoid neuropathy.

Peripheral neuropathy can also be caused by other health conditions. If your rheumatology team suspects peripheral neuropathy, they’ll work with you to determine why you’re experiencing it. You may find that it’s caused by a different health condition, not RA.

Carpal Tunnel Syndrome

RA may indirectly cause carpal tunnel syndrome — when there’s pressure on one of the nerves that controls the movement of your hands. Carpal tunnel syndrome is common in people living with RA. While shaky hands aren’t a common symptom of carpal tunnel syndrome, the syndrome may cause you to want to intentionally shake your hands.

Carpal tunnel is a form of nerve entrapment because the inflamed tissues in your hands compress the nerve and keep it from moving around freely. In a few cases, this kind of entrapment has been known to cause shaking. Scientists need to do more research to determine if shaking is truly associated with carpal tunnel syndrome.

Treatment for hand shaking from swelling and inflammation is different from treatment for shaking due to nerve damage. You and your rheumatologist will need to work together to determine why your hands are shaking and to find the best treatment intervention.

What Else Causes Shaky Hands?

There are many other causes of shaky hands that aren’t related to rheumatoid arthritis.

Essential Tremor

Essential tremor can cause your hands to shake. It’s a neurological condition that produces uncontrollable shaking. Essential tremor is most common in the hands, but it doesn’t usually mean that there’s anything seriously wrong with your body.

Parkinson’s Disease

Parkinson’s disease is another common cause of shaking. Shaking, or a tremor, is often one of the first symptoms of this neurological condition, but it doesn’t usually occur alone. These tremors are often present in the hands, though they may present differently than other kinds of shaking.

It’s unclear whether Parkinson’s disease is connected to RA. While some studies show that RA seems to protect a person against developing Parkinson’s, others have found that people with RA are more likely to develop it. Scientists need to do more research on this topic to determine if the two conditions are connected in any way. In the meantime, your healthcare provider may evaluate you for Parkinson’s if your hands are shaking.

Hyperthyroidism

When severe, hyperthyroidism can result in fine tremors of the hands. It’s advisable to evaluate your thyroid function. Work with your rheumatologist to determine if hyperthyroidism is the possible cause of your hand shaking, especially if you are on thyroid medications. Adjusting the dose may help relieve the symptom.

Other Causes

Beyond the causes mentioned here, shaking in your hands can be caused by many other factors, like:

• Too much caffeine
• Alcohol withdrawal
• Hypoglycemia (low blood sugar)
• Certain medications
• Stroke
• Stress
• Fatigue
• Other neurological disorders

If you start shaking when you haven’t before, talk to a healthcare professional. They’ll figure out what’s going on, so you can be sure to get the right treatment for your body.

Managing Shaking Hands

There are several ways to treat shaky hands and adapt your routines and surroundings to this symptom.

Medication

Depending on the cause of your shaking, there are certain medications that may help. For essential tremor, your doctor may give you beta-blockers, tranquilizers, seizure medications, or nerve medications to help limit the shaking.

If your doctor thinks your hand shaking is due to RA inflammation, they might adjust your RA treatment plan to see if it helps reduce the shaking.

Some members of myRAteam have seen improvements from medication for shaky hands. One explained, “My general practitioner sent me to a neurologist who diagnosed me with age-related essential tremors. Now I am on medication for them — just half a pill at night. It has done wonders. If I am upset or if I am in a stressful situation, the shakes do return, but other than that, I am back to normal.”

Hand Exercises

Some healthcare providers may recommend hand exercises for people living with rheumatoid arthritis. These can help you stretch your hands, gain more control over your movements, and strengthen the muscles that move your fingers. Physical therapy can be a good way to learn these exercises from a trained professional. If inflammation from RA is causing your shaky hands, certain exercises may help reduce the shaking.

Changes to Your Environment and Daily Life

You may need to change certain aspects of your environment to minimize the impact of your shaking hands. One member of myRAteam wrote, “I stayed away from any easy-to-spill foods.”

Similarly, you may need to avoid certain tasks and stop carrying open containers of liquid. Doing so may change the way you eat, drink, cook, clean, and more. These changes should lower the impact your shaky hands have on your daily life.

When your hands shake, something that ordinarily takes only one hand may now take two. One member shared, “I had to use both hands to even sign my name on anything,” they said.

While such adjustments may be time-consuming, they can help you accomplish tasks and maintain your independence. Occupational therapists can help you craft custom workarounds. These professionals work with you to determine new ways of approaching daily tasks affected by symptoms like tremors.

Talk With Others Who Understand

On myRAteam, the social network for people with rheumatoid arthritis and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with rheumatoid arthritis. Members commonly discuss ways to manage the many symptoms of RA.

Have you experienced shaky hands while living with RA? How did the shaking affect your quality of life? Share your experience and advice in the comments below, or start a conversation by posting on your Activities page.