Ankylosing Spondylitis Shaking Hands: Causes & Care

Quick Answers Overview

Yes, the tremor you sometimes feel in your fingers can be linked to ankylosing spondylitis (AS). If the shaking is new, getting worse, or shows up with fever, night pain, or loss of coordination, treat it as a redflag and call your rheumatologist. Simple selfchecks and a few gentle stretches often calm the shakes, but a professional evaluation is the safest path.

Why Hands Shake

Inflammation spillover to nerves

AS is a chronic inflammatory disease that mainly attacks the spine and sacroiliac joints. Over time, the lingering inflammation can spill over to nearby nerves, sending mixed signals that sometimes manifest as tremors in the hands. A 2020 study published in found a modest connection between ASrelated inflammation and peripheral nervous system irritability.

Medication sideeffects

Most of us with AS rely on NSAIDs, TNF inhibitors, or newer JAK inhibitors to keep pain at bay. Unfortunately, a few of these medsespecially highdose steroids or certain biologicslist tremor as a possible sideeffect. If you notice shaking after starting a new prescription, check the drugs leaflet and discuss it with your doctor.

Paindriven anxiety

Living with constant back stiffness can be mentally exhausting. Anxiety triggers the fightorflight cascade, releasing adrenaline that makes your hands jitteryjust like when youre nervous before a big presentation. Many people on AS forums describe the sensation as my hands shake when the pain spikes.

Coexisting movement disorders

Its also possible that the tremor isn't caused by AS at all. Essential tremor, earlystage Parkinsons disease, or even a thyroid issue can coexist. Differentiating ASrelated shaking from a primary neurological tremor is something your rheumatologist (or a neurologist) can help you sort out.

Red Flag Symptoms

If any of the following show up, dont waitschedule an appointment right away.

RedFlag	Description
Persistent tremor at rest	Shaking doesnt improve with movement or stretching.
Fever or night sweats	Could indicate infection or an inflammatory flare (see septic arthritis complications).
Sudden, severe back or joint pain	May signal a fracture or severe flare.
Weakness, numbness, or loss of balance	Potential neurological involvement.
Shaking accompanied by fatigue and loss of appetite	Could be a systemic infection.

Use the as a quick reference when youre unsure whether what youre feeling is just a flare or something more serious.

How Doctors Diagnose

Clinical interview & symptom diary

First, your rheumatologist will ask you to describe the tremors onset, frequency, and triggers. Keeping a simple diarynote when the shaking starts, whether its after a stretching session, medication change, or a stressful daymakes this conversation much smoother.

Physical exam: neurological screening

During the exam youll likely be asked to perform a few simple tasks: fingertonose testing, rapid alternating movements, and a quick gait assessment. The doctor will also check for classic AS signs like reduced spinal flexibility using the Schobers test.

Imaging & lab work

Blood tests for Creactive protein (CRP) and erythrocyte sedimentation rate (ESR) gauge inflammation levels. An MRI of the sacroiliac joints can confirm AS, while a brain MRI or EMG may be ordered if your doctor suspects a distinct neurological issue.

Specialist referrals

If the tremor looks more like essential tremor or early Parkinsons, youll be sent to a neurologist for a deeper workup. Collaboration between rheumatology and neurology ensures you get the right diagnosis and treatment plan.

Managing Shaky Hands

Stretching & movement protocols

Gentle, regular movement is the backbone of AS care. Here are two proven routines that many patients swear by.

Morning AS Stretches (5minute quick start)

• Neck & shoulder roll 30seconds, slow circles.
• Thoracic extension on a foam roller 1minute, breathe into the stretch.
• Wrist flexor & extensor stretch 30seconds each side.
• Handshake massage 1minute, gently rock each hand sidetoside.

These moves increase blood flow, reduce stiffness, and can calm the nervous system enough to lessen tremor intensity.

McKenzie exercises for ankylosing spondylitis

The McKenzie method focuses on repeated lumbar extensions to improve spinal alignment. A typical session includes:

1. Prone pressup position, hold for 510 seconds.
2. Repeat 1015 times, rest, then a second set.
3. Gradually increase hold time as comfort allows.

According to , these extensions can reduce night painremember that many of us ask, Why is ankylosing spondylitis worse at night? because inflammation often peaks while were lying still.

Pharmacologic tweaks

If your current regimen includes a highdose NSAID thats rattling your nerves, your doctor might switch you to a COX2selective option or add a lowdose antidepressant that can dampen tremor. Biologic users should report any new shaking promptly; dose adjustments are sometimes enough to resolve the sideeffect.

Stressreduction tools

Mindbody practicesdeep breathing, guided meditation, or even a short walk in naturecan lower adrenaline levels, which in turn calms shaky hands. A simple 478 breathing pattern (inhale 4seconds, hold 7seconds, exhale 8seconds) works wonders during a flare.

Nutrition & supplements

While no pill replaces medical therapy, a few nutrients support overall joint health:

• VitaminD essential for bone remodeling; many AS patients are deficient.
• Omega3 fatty acids antiinflammatory properties; found in fish oil.
• Magnesium helps relax muscles and may reduce tremor severity.

Always discuss supplement plans with your rheumatologist to avoid interactions.

Frequently Asked Questions

Can ankylosing spondylitis cause tremors in the hands?

Yes. Inflammation, painrelated anxiety, medication sideeffects, or an overlapping neurological condition can all lead to shaky hands in AS patients.

When should I worry about my tremor?

See the redflag checklist aboveespecially if the shaking persists at rest, worsens at night, or appears with fever, weakness, or sudden pain.

Do McKenzie exercises reduce hand shakiness?

They improve spinal mobility and lower paindriven stress, which often translates into a milder tremor for many people.

Is a fever a sign of a serious AS complication?

A fever can signal infection, an inflammatory flare, or a rare systemic issue. Prompt medical attention is advisable.

How do I differentiate essential tremor from ASrelated shakes?

Essential tremor typically intensifies with purposeful movement and may improve after a small amount of alcohol. ASrelated shaking often appears alongside pain, stiffness, or after a prolonged period of inactivity.

Community RealWorld Experiences

On the subreddit, users frequently post threads titled My hands started shaking after starting Humiraanyone else? The consensus is that a brief medication adjustment helped most, while a few found relief with added magnesium.

One anonymous 34yearold shared: I noticed my hands trembled when my morning stiffness hit its peak. After adding the quick stretch routine and checking with my rheumatologist about my NSAID dose, the shaking dropped from constant to once in a while. It felt like getting my life back, one stretch at a time.

Stories like these illustrate that while shaking hands can be unsettling, many find practical ways to manage it with a blend of medical guidance, movement, and selfcare.

Bottom Line Summary

Shaky hands in ankylosing spondylitis are not a mysterytheyre usually a mix of inflammation, medication, anxiety, or an unrelated movement disorder. Use the quickchecklist to spot redflags, try the morning stretch routine and McKenzie extensions to ease stiffness, and keep a symptom diary for your rheumatologist. If any warning signs appear, book an appointment without delay; early evaluation prevents complications. Wed love to hear your storydrop a comment, share your own tips, or ask a question. Together, we can turn tremors into triumphs.