People diagnosed with the autoimmune condition rheumatoid arthritis (RA) know that RA can affect joints in all parts of the body — especially those in their hands. However, RA can lead to symptoms beyond joint pain. Some people with RA notice their hands have begun to shake or tremble. These tremors can make everyday actions — particularly those that require fine motor skills — more difficult.
Here is what you need to know about having hands that shake and RA, a topic that’s come up on myRAteam boards multiple times. We’ll start with the experiences of some myRAteam members whose hands shake, then dive into what can cause such movements, and how they can be managed.
Several myRAteam members have shared information about their experiences with hand tremors.
One member posted, “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. And,” they continued, “trying to write can be difficult sometimes.”
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Added another member, “I have had arthritis my entire life and in the last few weeks, I have developed something sort of new: hand and body tremors.”
In one case, a member shared that their shaking extended past their hands up to their arms. They reported that the shaking impacts certain tasks so much that they are nearly impossible to tackle. “I have arm and hand tremors,” they posted. “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 2-year-old wrote them.”
Others experience hand tremors caused by conditions other than their RA. As one member explained, “I have tremors in my hands. They are considered benign essential tremors. I see a neurologist for daily headaches and classic migraines. He discovered my tremors and keeps tabs on them.”
Occasionally, members wonder if their hand tremors are related to their medications and not a byproduct of RA itself. “I have tremors,” wrote one member. “I think it might be because of my methotrexate, but I won’t know for sure till I go back to my rheumatologist.”
Hand tremors can have significant impacts on a person’s daily life, from changing the foods they can eat to making work or other tasks difficult, if not impossible. If you experience this kind of shaking, managing your tremors could greatly improve your overall sense of well-being and quality of life.
Researchers do not fully understand why some people with rheumatoid arthritis develop tremors or shakes at all. The symptom seems to be very rare in people with RA. Take, for example, the observations of a team of Johns Hopkins researchers. They scoured 36 cases of rheumatoid diseases, looking for people who had movement disorder symptoms. Only two of the 36 people experienced tremors. Further, they determined one of the two had an unusual case of Parkinson’s disease that caused their shaking. It is possible that further research will provide more information on connections between RA and tremors.
Tremors may be caused by conditions, treatments, and things unrelated to a person’s RA. Such causes can include:
Some people believe hand tremors in those with RA may stem from carpal tunnel syndrome, a nerve condition that causes pain in the hands and arms. However, carpal tunnel syndrome does not usually cause shaking.
Medications commonly taken to treat RA, like methotrexate, are not associated with an increased risk of shaking and tremors. That said, it is possible someone could develop hand tremors around the same time they take methotrexate (or other drug therapies). The root cause of such shaking could simply be an idiopathic response (a response with no relation to the medicine) unique to that person.
Neither of the above — carpal tunnel or methotrexate — seem to be linked with diagnosed rheumatoid arthritis.
Some people believe that Parkinson’s disease is associated with rheumatoid arthritis. There have been some documented cases of the two conditions occurring alongside one another. However, recent research seems to indicate that being diagnosed with RA actually lowers a person’s chance of developing Parkinson’s. Researchers are not yet sure why.
Any tremor needs to be investigated by a health care professional. That enables your doctor or rheumatologist to rule out any other conditions that may be causing your tremors. Managing the condition that causes the tremors is the key to eliminating the shaking or lessening how frequently you experience it.
One myRAteam member explained that seeking medical advice helped them uncover the cause of their shaking and find the right treatment. “I have tremors. Having them has been so difficult and stressful,” they posted. “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.”
Another member shared a similar experience. “I have benign essential tremors in my hands,” they wrote. “My migraine medicine seems to keep the tremors manageable because it is also an epileptic medication.”
After speaking with a rheumatologist, there are also some steps you can take to manage your RA and deal with hand tremors to minimize their impact on your daily life.
You may need to change certain aspects of your environment to minimize the impact of your shaking hands. One member wrote, “I stayed away from any easy-to-spill foods.” You may decide to avoid soups, sauces, and other potentially messy foods when hand tremors crop up.
Similarly, you may need to avoid certain tasks and stop carrying open containers (cups, glasses, bottles, buckets, etc.) of liquid. Doing so may change the way you eat and drink, cook, clean, and more. But these changes should lower the impact your hand tremors have on your daily life.
You may also need to change how you approach doing certain things. For instance, when your hands shake, something that ordinarily takes only one hand may take two. One member shared that when experiencing tremors, they had held a piece of paper in place with one hand and then wrote with the other hand. “I had to use both hands in order to even sign my name on anything,” they posted.
While such adjustments may be frustrating, they can also help you get things done — and maintain your independence. Occupational therapists can help you craft custom workarounds. These professionals work with you to determine new ways of approaching tasks affected by your tremors.
You may need to get some help around your house. Though seeking such help may feel difficult, an extra set of hands to aid you in cooking, cleaning, or other demanding tasks can eliminate many personal battles.
On myRAteam, the social network for people with rheumatoid arthritis and their loved ones, more than 191,000 members come together to ask questions, give advice, and share their experiences with others who understand life with the condition.
Do you deal with shaking hands that may be related to rheumatoid arthritis? How do you cope? Share your experience or tips in the comments below or by posting on myRAteam.