If you’re living with systemic lupus erythematosus (SLE), you probably live with a wide variety of symptoms, like joint pain or muscle weakness. One less common symptom of lupus is hand tremors, instances when your hands shake involuntarily. These tremors, which can range from barely noticeable to severe, may be caused by certain lupus medications or something else entirely.

If your hands or other parts of the body are shaking, it can disrupt your life in unexpected ways. Here’s what you should know so you can get to the bottom of why you’re having the symptom and what you should do about it.

What Do Hand Tremors Feel Like?

A number of MyLupusTeam members experience hand tremors due to lupus. In fact, some had them as their first lupus symptom. “My first symptom was a right hand tremor, which eventually became a right and left hand tremor. It was my only symptom for a while.”

One member said their hand tremors “are definitely worse” during a flare-up.

Hand tremors can be severe. One member described theirs as follows: “I don’t drink coffee. The tremors in my hands shake like I’ve drunk 10 cups.”

These types of tremors can interfere with daily life in a number of ways, including making holding onto things difficult. As one member explained, “My hand tremors are the worst they’ve been. I have to use two hands to hold something.”

Having shaky hands can also make you drop things. One member said, “I call what I have the dropsies. No matter what I pick up, everything drops.”

Another added, “My hand will tremble then just lose grip on whatever I have and then it breaks.”

Hand tremors can lower your overall sense of well-being. One member put it this way: “I’ve definitely experienced bad hand tremors, especially during my worst flare-ups. I struggled so hard one day just trying to drink water out of my Yeti cup. I couldn’t … . I felt so helpless.”

What Causes Shaky Hands With Lupus?

There are a variety of potential causes for hand tremors with lupus. They could be related to the condition itself, to lupus medications, or to factors entirely unrelated to lupus.

Neurological Symptoms of Lupus

Sometimes people with lupus experience neurological symptoms, or symptoms related to your nervous system. Neurological symptoms of lupus can include headaches, dizziness, seizures, or mild cognitive problems (issues with thinking, reasoning, or remembering). Tremors are a less common neurological symptom of lupus.

Chorea

Chorea is a condition that causes sudden uncontrolled movements that may or may not repeat. While this is not a tremor specifically, it can feel like one — especially if you experience several movements associated with chorea together or in close succession. In a study of 83 children with SLE between the ages of 1 and 16, 6 percent experienced chorea. Scientists aren’t sure exactly how lupus can cause chorea.

Thyroid Problems

Some people with lupus have problems with their thyroid, the gland located in your neck that produces hormones integral to body functions such regulating blood pressure, body temperature, and metabolism (how your body makes use of energy). Approximately 6 percent of people diagnosed with lupus have hypothyroidism (underactive thyroid) and around 1 percent have hyperthyroidism (overactive thyroid), according to Johns Hopkins Lupus Center. Tremors, including hand tremors, are one symptom of hyperthyroidism.

If you’ve been diagnosed with lupus and your hands start shaking, you may want to have your thyroid tested, especially if you’re also experiencing unintended weight loss or heart palpitations.

Lupus Medications

Tremors can be a side effect of several lupus medications. Not everyone on these medications will experience these symptoms. If you suddenly start experiencing them, you should talk to your doctor — especially if you have recently started a new medication, changed medications, or changed how much of a medication you are taking.

Among medications used to treat lupus that can cause tremors are:

• Hydroxychloroquine (Plaquenil)
• Cyclosporine
• Mycophenolate mofetil (CellCept)
• Corticosteroids

Other Causes

Your tremors may also be caused by something other than lupus. Possible causes include:

• Tumors
• Parkinson’s disease
• Essential tremor — A neurological condition that causes parts of your body — most often hands — to rhythmically shaking involuntarily
• Physiological tremor — Tremors caused by factors such as excess caffeine, alcohol withdrawal, or hypoglycemia (low blood sugar)

Your doctor can help you decide if you need to investigate other causes or if your tremor is likely caused by lupus or lupus medications. There is no way to know, without testing, what is causing your hands or other parts of your body to shake.

Managing Hand Tremors With Lupus

There are a few things you can do to limit the effect your hand tremors have on your daily life.

Treat Lupus Effectively

If your tremors tend to indicate that your lupus is flaring, keeping your condition under control with the right treatment may help. You have a wide variety of options, and you may need to try several or combine a few to figure out what works for you.

Weigh the Pros and Cons of Changing Medications

If you and your doctor think that medications are causing your tremors, weigh the pros and cons of switching to a different medicine. If your tremors are rare or don’t interfere with your life, you may not want to switch, particularly if the medication is working well for you. However, if they’re severe and are preventing you from doing certain activities or caring for yourself, you may want to try something else.

Experiment With Avoiding Alcohol and Caffeine

Your tremors may get worse when you drink alcohol or caffeine. Also, if you’re taking steroids to manage your lupus, you need to avoid excessive sugars. These substances can affect motor control, so you may want to see if eliminating or reducing your intake helps. If it does, you can continue to avoid them. If it doesn’t, you can keep enjoying them as normal, even when you have tremors.

Add Weight to Your Hand

Wearing something heavy on your wrist, like a weighted bracelet or a heavier watch, may help reduce the amount of trembling you experience. Sometimes, the sensory feedback that your hand is heavier than usual can trigger the brain to stop or reduce trembling. This may not work for everyone who experiences tremors, but it’s an easy remedy to try.

Talk to Your Doctor

If you experience new or worsening tremors or if you know tremors are an indication that your lupus is in a flare-up, talk to your doctor as soon as you notice the shaking. They can help you determine what is causing your tremors and find solutions.

Find Your Team

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 222,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Are your hands shaking due to lupus? Share your experience in the comments below, or start a conversation by posting to your Activities page.