The cause of hand tremor may be physiological, and may be caused by pathological factors such as idiopathic tremor disease, Parkinson’s disease, hyperthyroidism and other diseases. 1. Physiological causes: mainly related to the patient’s nervousness, emotional excitement and other reasons leading to sympathetic nerve excitation, when the patient’s mood is stable after the writing hand tremor symptoms naturally disappear. 2. Pathologic causes (1) Idiopathic tremor: it is a kind of benign tremor, which is mainly manifested as shaking of the head or shaking of the hands, especially when the patient is exercising or concentrating, so the symptoms of shaking hands can appear when writing. (2) Parkinson’s disease: the tremor of Parkinson’s patients is mainly stationary tremor, which can be combined with action tremor, and hand tremor occurs when writing. In addition, there are typical pill-rubbing tremor of the hands and resting tremor of the lower limbs, with slowed, straightened movements, abnormal gait, and reduced expression. (3) Hyperthyroidism: Due to excessive thyroid hormones, sympathetic nerves are more excited in patients with hyperthyroidism, which will lead to hand tremor, and the tremor will be more obvious when writing or pinching vegetables. Patients appear to write hand shaking, if the exclusion of physiological factors, should promptly seek medical attention to identify the cause and active treatment.