Hand Tremors: Several Reasons Your Hands Are Shaking

Hand tremors is the most common type of movement disorder, according to a 2011 study in American Family Physician. And your hands are the most likely part of your body to suffer.

A hand tremor can stem from a number of underlying causes, ranging from diseases like Parkinson’s to a benign caffeine overload.  There are several causes for hand tremor, and to tell one from another.

Hand: Essential Tremor

By far the most common form is chronic hand tremor, 4% of the population, may experience it. Essential tremor is a shaking that comes on when you’re trying to perform some kind of work or action with your hands. For example, picking up a glass.

It can be mild, almost unnoticeable, or so pronounced that you can’t complete daily tasks. But there’s one easy way to tell if what you’re experiencing is essential tremor: Have a stiff drink. If you do and the tremor goes away, there’s your diagnosis right there.

In fact, drinking has long been a way for people with essential tremor to manage their shaking.

If the tremors get worse, medications may help. Beta blockers or anticonvulsants may help. In extreme cases, non-invasive ultrasound surgery has worked.

Hand: Parkinson’s Disease

While essential tremor is apparent when your hands are active, the type of hand movement associated with Parkinson’s is called a “rest tremor” because it shows up when the hands are idle.

Also, while essential tremor looks more like shaking, the type of tremor associated with Parkinson’s often has a kind of rhythmic quality to it, he says. For many patients, the tremor starts as a kind of “pill rolling” motion between the thumb and index finger.

Parkinson’s is a neurodegenerative disease in which certain brain cells gradually die off. While it’s not well understood why that cell die-off starts, it leads to a shortage of the brain chemical dopamine. This chemical shortage eventually produces tremors, as well as other motor symptoms like facial tics, poor posture, and difficulty speaking.

Parkinson’s tends to show up in the elderly; age 60+, although a small percentage of patients develop it younger. There is no cure for Parkinson’s, but medications and physical activity can help.

Hand: Stress:

Every person has a very mild, basically invisible form of tremor that results from their heart beat, blood flow, and other processes going on inside their bodies. This is called a physiologic tremor. But under certain conditions, this tremor can become more pronounced.

One of those situations: periods of high stress or anxiety. If your hands or voice have ever started shaking before a public speaking engagement, you’ve experienced this sort of tremor, which is known as “enhanced physiologic tremor.

Stress-relief activities like meditation, yoga, or listening to music, as well as anti-anxiety meds, can help.

Hand: Caffeine

Just as stress can heighten your normally undetectable physiologic tremor, so can caffeine. If you notice your hands shaking after coffee or other sources of caffeine, it’s time to cut back,or switch to half-caffeine.

Caffeine can also make essential tremor more noticeable. If you think your tremors are more than a simple caffeine overload, let your doctor know about it.

Hand: Medications

Like stress and caffeine, some medications,notably, asthma medications like bronchodilators, can lead to hand tremors. Amphetamines, some statins, and selective serotonin reuptake inhibitors (SSRIs) can also cause hand tremor.

If you notice your tremors after using your meds, or if the shaking seemed to come on when you started on a new prescription, try an alternative drug that will eliminate the shaking.

Hand: Fatigue

Yet another cause of enhanced physiologic tremor is fatigue.

Sleep deprivation or a grueling workout, can increase tremors of the hands and other body parts.

But again, fatigue can also make essential tremor more pronounced. So if your hands always shake, but it becomes really bad when you’re tired or sleep-deprived, get a doctor to check it out.


Yoga Based Therapy Techniques Debuted at Regency Heritage

We hosted a  “Positioning – Yoga Based Techniques” at Regency Heritage on Thursday August 17th, which was presented by Dalia Zwick PT, PhD.

Our Administrator, Marty Bengio welcomed the therapists and spoke about the facility.

We had many people in attendance from all over New Jersey and all were quite impressed with our mazing program.

Dr. Zwick presented the right subject at the right time. This timely course, especially for those patients who are suffering from joint contracture or stiffness, clearly demonstrated how to utilizes slow and control stretching followed by correct positioning supported by appropriate bolsters.

Take a look:



Allergies Triggered By Specific Immune Cells Identified

Allergies triggered by specific immune system cells have been identified by scientists. This will eventually lead to the development of a blood test that will improve treatment.


Allergies Reactions


Allergy reactions result from weak immune responses to benign substances such as mold and peanuts.  50 million Americans suffer from nasal allergies, and approximately 200 die from serious food allergies each year.

Researchers report that they identified a Type-2 helper T-cell (TH2) that shows if  a person has an allergy. These cells display a “signature” that reacts to common allergens such as peanut,  grass pollen, and mold. TH2 cells were present in every person that displayed allergic symptoms. However, they were absent  in persons who displaying no symptoms.

Right now, doctors use skin pricks to test reactions to allergy-causing substances. These tests are inaccurate and consequently treatment is ineffective.

Allergies Testing

Researchers believe these results will eventually lead to identify the exact substance triggering the allergic reaction. Consequently, accurate diagnosis and treatments can be administered.

Current Allergies Medications

Allergy medications are currently a  hodgepodge of general options. They are available as pills, liquids, inhalers, nasal sprays, eye drops, skin creams and injections.  Here is a brief summary of allergy medications and their application.


 Antihistamines block histamine, a symptom-causing chemical released by your immune system during an allergic reaction.

Pills and liquids

Oral antihistamines ease a runny nose, and itchy-watery eyes, hives, and swelling.

 Antihistamines that cause drowsiness include:
  • Diphenhydramine
  • Chlorpheniramine

These antihistamines are less likely to cause drowsiness:

  • Cetirizine (Zyrtec Allergy)
  • Desloratadine (Clarinex)
  • Fexofenadine (Allegra Allergy)
  • Levocetirizine (Xyzal)
  • Loratadine (Alavert, Claritin)

Nasal sprays

Antihistamine nasal sprays help relieve sneezing, itchy or runny nose, sinus congestion, and postnasal drip. Side effects of antihistamine nasal sprays include a bitter taste, drowsiness or fatigue. Prescription antihistamine nasal sprays include:

  • Azelastine (Astelin, Astepro)
  • Olopatadine (Patanase)


Antihistamine eye drops, treat  itchy, red, swollen eyes. These drops have a combination of antihistamines and other medicines.Side effects include headache and dry eyes.  Examples include:

  • Azelastine (Optivar)
  • Emedastine (Emadine)
  • Ketotifen (Alaway)
  • Olopatadine (Pataday, Patanol, Pazeo)
  • Pheniramine (Visine-A, Opcon-A, others)


Decongestants are used for quick, temporary relief of nasal and sinus congestion. They often cause insomnia, headache, increased blood pressure and irritability. They’re not recommended for pregnant women and people with high blood pressure, cardiovascular disease, glaucoma or hyperthyroidism.

Pills and liquids

Oral decongestants relieve nasal and sinus congestion caused by hay fever. Many decongestants, such as pseudoephedrine (Afrinol, Sudafed, others), are available over-the-counter.

A number of oral allergy medications contain a decongestant and an antihistamine. Examples include:

  • Cetirizine and pseudoephedrine (Zyrtec-D)
  • Desloratadine and pseudoephedrine (Clarinex-D)
  • Fexofenadine and pseudoephedrine (Allegra-D)
  • Loratadine and pseudoephedrine (Claritin-D)


Corticosteroids relieve symptoms by suppressing allergy-related inflammation.


Inhaled corticosteroids treat asthma caused by airborne allergy triggers (allergens). Side effects are minor and can include mouth and throat irritation and oral yeast infections.

Some inhalers combine corticosteroids with other asthma medications. Prescription inhalers include:

  • Beclomethasone (Qvar)
  • Budesonide (Pulmicort Flexhaler)
  • Ciclesonide (Alvesco, Zetonna)
  • Fluticasone (Advair Diskus, Flovent Diskus, others)
  • Mometasone (Asmanex Twisthaler)

Skin creams

Corticosteroid creams relieve itching, redness, and scaling.

Side effects include skin discoloration and irritation. Long-term use is dangerous as it results in thinning of the skin and disruption of normal hormone levels. Examples include:

  • Betamethasone (Dermabet, Diprolene, others)
  • Desonide (Desonate, DesOwen)
  • Hydrocortisone (Cortaid, Micort-HC, others)
  • Mometasone (Elocon)

Smell Your Breath To Know If You Are Healthy

Your breath is the window into your health status.  If you have any one of the following indicators, your immediate attention is necessary.

Breath Snoring

Your mouth gets dry if you snore or sleep with it open and creates bacteria that causes morning breath.  Also, food lodged in your teeth also creates bacteria. Brush and floss before going to bed.



Breath-Gum Disease

Bacteria growing under the gum line creates leads to inflammation and infection and creates a metallic smell. The technical term for this is   periodontitis.  Smoking and not brushing/flossing regularly also creates gum disease.



Acid Reflux

This condition makes stomach acid flow the wrong way, back into the tube that connects your throat to your stomach (your esophagus). It gives off a sour smell and bring up bits of food or liquid into your mouth. The acid also damages your throat and mouth, making it  a breeding ground for more smelly bacteria.




If you are diabetic, fruity breath indicates that your body is using fat for fuel instead of sugar (glucose). Most importantly, this tells you that you’re very low on the hormone insulin.  Call your doctor.



Respiratory Infections

Colds, coughs, and sinus infections sends mucus filled with bacteria through your nose and mouth and makes your breath smell.

Breath And Your Medication

Several medicines cause bad breath because they dry out your mouth. Moreover, drugs that treat heart conditions, chemotherapy for cancer, and sleep aids, release chemicals that make your breath smell.



Saliva cleans bacteria out of your mouth. Dehydration causes insufficient saliva that causes foul odors in your mouth. Stay hydrated at all times.  Most relevant, conditions that affect the glands that make saliva,  such as  Sjögren’s syndrome and scleroderma , cause dry mouth and bad breath.


Proper mouth hygiene will keep you healthy and happy.



What Is Polypharmacy and How Does It Affect Seniors?

Polypharmacy is a subject and a term many people are unfamiliar with. However, its clinical ramifications, especially for seniors, can be significant.

I’ll never forget when I personally became familiar with that term. I was studying for my Nursing Home Administrators License and found a reference to it in the “red Townsend book” (that’s a very popular book for Administrators in Training).

I had an epiphany at the time and mistakenly thought that only hypochondriacs and valetudinarians were engaged in “polypharmacy.”

I later learned that this belief was a myopic distortion of a potentially significant problem that doesn’t necessarily begin with, or stem from, hypochondria.

So what exactly is Polypharmacy?

Polypharmacy is the use of four or more medications by a patient, generally adults aged over 65 years. Polypharmacy is most common in the elderly, affecting about 40% of older adults living in their own homes.

The truth is, Polypharmacy is not always bad, but it is bad in many instances, often being more harmful than helpful or presenting too much risk for too little benefit.

Healthcare professionals will tell you that too many medications will often cause adverse reactions when one reacts negatively to the other.

Adverse reaction to drugs is never a good thing, so medications, especially when seniors rely on multiple pills for different ailments, must be monitored at all times This is especially true given the statistics which show that Polypharmacy can be associated with decreased cognition and quality of life.

In fact, The American Society of Consultant Pharmacists warns that: “Medication-related problems are estimated to be one of the top five causes of death in that (65 years and older) age group, and one of the leading causes of confusion, depression, falls, disability, and loss of independence.”

At Regency Nursing and Rehabilitation Centers, we are extremely vigilant with respect to the medications we provide, to always ensure that they are directly commensurate with the doctors orders and we are extremely mindful of any and all reactions (adverse, or otherwise) of our patients to the drugs they need to be on.

Medication is designed to promote and support well being and healing and never to detract from it.


Should You Be Enrolling In Medicare?

The answer to “Should you be enrolling in Medicare?” is usually right away — though with a few caveats. After all, it’s estimated by the folks at Fidelity Investments that a 65-year-old couple will, on average, spend about $260,000 out of pocket on healthcare expenses during their retirement — and that’s including expenses covered by Medicare. You don’t want to face healthcare costs without some kind of coverage, and Medicare is the best place to start. (You can always buy additional coverage beyond Medicare.)

Selena Maranjian writing today for the Motley Fool makes the above observation and adds some additional excellent points for us to consider.