What is essential tremor?

Essential tremor is a type of shaking that usually happens when you’re using a part of your body—for example, when you’re eating, writing, or holding something—not when you’re resting. Essential tremor can also affect your head, voice, or other parts of your body. For some people, symptoms are mild. For others, essential tremor can make everyday activities more difficult.

About 1 in 100 people worldwide has essential tremor. It becomes more common with age, affecting about 1 in 20 adults over 65, and even more people in older age groups.

Essential tremor is different from Parkinson’s disease. While both disorders cause tremors, Parkinson’s disease tremors happen when you’re resting. Essential tremor, on the other hand, usually happens when you move.

What are the causes and risk factors of essential tremor?

The exact cause of essential tremor isn’t fully understood, but it often runs in families. If your parent or another close family member has it, your risk could be higher. While you can get it at any age, your risk increases as you get older.

Researchers believe that essential tremor is linked to changes in parts of the brain that help control movement. When nerve cells in these areas don’t communicate properly with each other, it can cause involuntary shaking.

How is essential tremor diagnosed?

There is no single test. Doctors make a diagnosis by:

• Asking about your symptoms and health history
• Doing a neurological exam
• Ruling out other conditions that can cause tremor

Because different types of tremor can look similar, diagnosis can take time. Your diagnosis might also change if new symptoms develop.

What treatments are available for essential tremor?

While there is currently no cure for essential tremor, a variety of treatments can help reduce symptoms and improve quality of life. Treatment is tailored to each person's symptoms, goals, and daily activities.

Everyday strategies and support

• Limit triggers that may worsen tremor, such as caffeine, nicotine, fatigue, stress, and certain medications
• Work with occupational therapy to make daily tasks easier
• Try speech therapy if your voice is affected by tremor
• Practice stress management techniques since anxiety can worsen tremors

Medications
Some medications can help reduce tremor, including propranolol, primidone, and topiramate.

Procedures and surgery
If symptoms are significantly affecting your daily life and medications aren’t helping, your care team may recommend:

• Deep brain stimulation (DBS): A surgical treatment that uses a small implanted device to deliver electrical stimulation to specific areas of the brain involved in tremor.
• Focused ultrasound: A noninvasive procedure that uses MRI-guided ultrasound energy to target a small area of the brain involved in tremor.

Not every treatment works for everyone, and your care team can help you weigh the benefits and risks of each option.

Living well with essential tremor
Essential tremor affects each person differently, but many people find ways to adapt and stay engaged in daily life. You may benefit from:

• Combining medication, therapy, and lifestyle changes
• Using adaptive tools to make tasks easier
• Addressing the emotional and social effects of living with tremor
• Working closely with your care team to make decisions that fit your goals

With the right support and resources, it’s possible to manage symptoms and maintain your independence.