Shakes are medically called tremor. Mostly noticed in the hands and arms, shakes can actually affect any part of the body. They can happen at any age, even though more common among older people. Certain factors are related with the condition, such as stress, anger, fear, caffeine, cigarette smoking, fatigue, etc. If the tremor does not go away over time, it is probably due to a medical problem. In this case, make sure to get a medical checkup and find the root cause of your tremor.

Why Do I Get the Shakes?

There are several reasons that can lead to shakes, including:

1.   Hypoglycemia

Hypoglycemia, commonly known as low blood sugar, is one of the factors leading to shakes. The human body regulates the levels of blood sugar through several mechanisms – including hormones such as insulin and glucagon as well as glycogen breakdown. In certain circumstances, such as in diabetic patients the levels of blood sugar can drop significantly due to the use of insulin. Poor diet plus exertion can also cause low blood sugar, leading to symptoms such as fatigue, lightheadedness and tremor.

2.   Stress, Nervousness, and Anxiety

When overwhelmed by stress, nervousness and anxiety, the adrenaline is being pumped to protect the body. The "Fight or Flight" system is activated, which produces the rushes of energy, making your body shake. 

3.   Alcohol Withdrawal

Why do I get the shakes? Well, one of the reasons is alcohol withdrawal. The withdrawal period is usually characterized by a physiological tremor which tends to get away as the withdrawal process ends. Tremor is caused by the damage of the nerve cells due to a prolonged and excessive use of alcohol. Episodes of tremor may occur also after the withdrawal process has ceased, in cases when the cerebellum of the brain is damaged due to chronic alcoholism.

4.   Caffeine

If you do consume high doses of caffeine daily, you are more likely to experience some of the side effects like restlessness, anxiety, increased heart rate as well as tremor. The caffeine tolerance varies from one person to another. Daily consumption of 600 milligrams is considered too much. However, caffeine is not harmful when consumed moderately, about 100 to 200 milligrams per day. 

5.   Muscle Fatigue

If you hold your muscles in one position for too long, you may notice your body shaking. If you work out when tired and sore or if you work harder than you normally do, it is more likely that you will have muscle fatigue followed by shaking. Normally, the muscles in the human body move efficiently due to motor units. If for any reason your muscles are fatigued, these motor units will stop working, leading to tremor. In these cases, you should only get enough rest and your tremor will stop. If you do not drink plenty of fluids while working out, dehydration can lead to tremor too.

6.   Medical Conditions

Why do I get the shakes? They are sometimes caused by medical conditions, including:

• Parkinson’s disease
• Multiple sclerosis
• Traumatic injury of the brain
• Tumors of the brain
• Stroke
• Hyperthyroidism
• The use of certain types of medications like antidepressants
• Disorders of the brain and nerve or movement disorders, etc.

Make sure to call your doctor and get the necessary medical help in cases when:

• Tremor is accompanied by other symptoms such as headache, weakness, muscle tightening, etc.
• Tremor is getting worse over time.
• Tremor is so severe that it interferes with your daily life activities.

How to Diagnose the Causes of Shakes

• During a physical examination, your doctor can determine whether your tremor occurs at rest or while performing an action. Any muscle weakness, muscle atrophy, decreased reflexes, sensory loss or asymmetry of the tremor will be closely monitored. 
• Your doctor will also ask for your family history to determine whether it is inherited or not. 
• Blood test and urine test will help your doctor detect any thyroid problems.
• MRI and CT-Scans can help detect a tumor that could be causing your tremor. 
• Neurological examination is always necessary as it will help your doctor analyze the nerve function as well as sensory and motor skills. 
• Electromyograms will help your doctor detect any muscle or nerve problem.

How to Manage Shakes

After the answer to "why do I get the shakes?" there are different options available for managing shakes, always depending on its underlying causes.

1.   Home Remedies

• If stress is the cause of your tremor, try different relaxation techniques like meditation, yoga, breathing exercises, etc.
• If medications are the cause of your tremor, talk to your doctor about reducing the dosage or replacing them with some other medications.
• If alcoholism and alcohol withdrawal is the cause of your tremor, get the necessary help and stop drinking alcohol.  
• Also avoid excessive use of caffeine.

2.   Medical Treatment

Medications commonly used for tremor treatment include:

• Beta blockers, which have been shown to reduce tremor in certain cases, even though they are routinely used for the treatment of high blood pressure and heart diseases.
• Anti-seizure medications, which are used in cases when beta blockers are contraindicated or when their use does not give any relief of the tremor.
• Tranquilizers, which help relieve the tremor caused by anxiety.

Botox Injections

Botox injections are also used for treating tremor. These injections are commonly used in cases when patients have a tremor of the face and head.

Physical Therapy

It is used to strengthen your body muscles and improve coordination. Use wrist weights and heavy utensils to relieve tremor.

Brain Stimulation Surgery

It is one of the last treatment options for tremor, usually used in cases of a debilitating tremor. The procedure is characterized by an insertion of the probes into the portion of the brain which is responsible for the tremors. The probe is connected to a small device with a wire. The device located in your chest sends regular impulses to the brain to stop producing tremors.

Thalamotomy

It is a medical procedure characterized by the creation of lesions in the thalamus. This medical treatment has been shown to be very effective in cases with parkinsonian tremor, cerebellar tremor or essential tremor. It is performed under local anesthesia. The lesions created in the thalamus will make your tremor go away, without interfering with the sensory or motor control.