Essential tremor

By Medically reviewed by hellodoktor


What is essential tremor?

Essential tremor (ET) is a nerve disorder which causes patients not to control shaking, or “tremors,” in different parts and on different sides of the body. The major areas which are affected often include the hands, arms, head, larynx (voice box), tongue, and chin. The lower body is rarely affected.

Although essential tremor isn’t dangerous or life-threatening, it can be worse over time. Sometimes, this disorder is confused with Parkinson’s disease.

How common is essential tremor?

Essential tremor is the most common movement disorder, affecting up to 10 million people in the U.S. While ET can occur at any age, it most often strikes for the first time during adolescence or in middle age (between ages 40 and 50). Please discuss with your doctor for further information.


What are the symptoms of essential tremor?

The common symptoms of essential tremor are:

  • Uncontrollable shaking that occurs for brief periods of time
  • Shaking voice
  • Nodding head
  • Tremors that worsen during periods of emotional stress
  • Tremors that get worse with purposeful movement
  • Tremors that lessen with rest
  • Balance problems (in rare cases)
  • Can include a “yes-yes” or “no-no” motion of the head
  • May be aggravated by emotional stress, fatigue, caffeine or temperature extre

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?


If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.


What causes essential tremor?

Tremors can be caused by alcohol abuse, an overactive thyroid, a stroke, and a variety of neurological conditions. However, these tremors are not characterized as essential tremor.

About 50% essential tremor cases are associated with a genetic mutation, although a specific gene hasn’t been identified. This form is referred to as familial tremor. It isn’t clear what causes essential tremor in people without a known genetic mutation.

Risk factors

What increases my risk for essential tremor?

There are many risk factors for essential tremor, such as:

  • Genetic mutation. The inherited variety of essential tremor (familial tremor) is an autosomal dominant disorder. A defective gene from just one parent is needed to pass on the condition. If you have a parent with a genetic mutation for essential tremor, you have a 50 percent chance of developing the disorder yourself.
  • Essential tremor is more common in people age 40 and older.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is essential tremor diagnosed?

Neurological examination

In a neurological examination, your nervous system’s function will be surveyed, including:

  • Tendon reflexes
  • Muscle strength and tone
  • Ability to feel certain sensations
  • Posture and coordination
  • Gait

Laboratory tests

  • Your blood and urine may be tested for several factors, including:
  • Thyroid disease
  • Metabolic problems
  • Drug side effects
  • Alcohol levels
  • Levels of chemicals that may cause tremor

Performance tests

To evaluate the tremor itself, your doctor may ask you to:

  • Drink from a glass
  • Hold your arms outstretched
  • Write
  • Draw a spiral

How is essential tremor treated?


  • Beta-blockers, such as propranolol limit adrenaline and prevent tremors from getting worse
  • Blood pressure medications, such as flunarizine, limit adrenaline.
  • Anticonvulsant medications, such as primidone, work to reduce the excitability of nerve cells.
  • Mild tranquilizers, such as alprazolam, are also a treatment option.


Occupational therapists can help you adapt to living with essential tremor. Some certain adaptive devices to reduce the effect of tremors on your daily activities, including:

  • Heavier glasses and utensils
  • Wrist weights
  • Wider, heavier writing tools, such as wide-grip pens


  • Deep brain stimulation (DBS) is a procedure in which small electrodes are placed in the area of your brain that controls movement to block the nerve signals that cause tremors.

Stereotactic radio surgery is a procedure in which high-powered X-rays are pinpointed on a small area of the brain to correct tremors.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage essential tremor?

The following lifestyles and home remedies might help you cope with essential tremor:

  • Avoid caffeine. Caffeine and other stimulants can increase tremors.
  • Use alcohol reasonably, or quit it. Some cases show that the tremors improve slightly after drinking alcohol, but drinking isn’t a good solution. Tremors tend to worsen once the effects of alcohol wear off. Also, increasing amounts of alcohol eventually are needed to relieve tremors, which can lead to alcoholism.
  • Learn to relax. Stress and anxiety are involved to make tremors worse, and being relaxed may improve tremors. Although all stress can’t be eliminated from your life, you can change how you react to stressful situations using a range of relaxation techniques, such as massage or meditation.
  • Make lifestyle changes. Use the hand less affected by tremor more often. Find ways to avoid writing with the hand affected by tremor, such as using online banking and debit cards instead of writing checks.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.


Review Date: July 24, 2017 | Last Modified: September 12, 2019

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