There are physiological and pathological causes of hand shaking while writing. Pathological factors include hyperthyroidism, Parkinson’s disease and idiopathic tremor, etc., which can be treated by medication such as antithyroid drugs and surgery. 1. Physiological factors: incorrect pencil grip, depression and anxiety, fear of excitement, and shaking hands after strenuous exercise can all occur when writing. Symptoms can be relieved by improving the pencil grip, relieving emotions in time, and actively participating in physical exercise. 2. Hyperthyroidism: it often shows symptoms such as tachycardia, fatigue, trembling hands and sweating, etc. It can be treated by anti-thyroid drugs such as imidazole and propylthiothiothiophene, β-blockers such as propranolol, etc., or surgical resection of the thyroid gland if the condition is serious. You need to choose the appropriate drugs under the guidance of your doctor. 3. Parkinson’s disease: the disease is mainly manifested as resting tremor, bradykinesia, myotonia, resting tremor is mainly hand tremor, which also occurs in writing, and requires timely diagnosis and treatment. 4. Idiopathic tremor: this disease is a benign movement disorder, mainly manifested as involuntary shaking of the head or hands, which is easy to appear when concentrating or doing fine movements, so hand tremor can also appear when writing. When patients experience discomfort, they should go to the hospital immediately.