Essential tremor (ET) is the most common movement disorder in the
United States, characterized by involuntary and rhythmic shaking.
While not life-threatening, this condition can have a significant impact
on an individual’s quality of life. The symptoms, causes and treatment
options for essential tremor are summarized below.
Symptoms of Essential Tremor
Essential tremor is characterized by involuntary shaking. While essential tremor can affect almost any part of the body, trembling is most often present in the hands. Learn more about the full range of symptoms of essential tremor.
Involuntary Shaking
The most commonly observed symptom of essential tremor is a rhythmic, involuntary shaking. The symptoms of essential tremor generally appear gradually, and in some individuals, may be more prominent on one side of the body. Many who are diagnosed with essential tremor notice symptoms in the hands first, but a slight shaking motion of the head may be noticed as well. Ultimately, this shaking may affect an individual’s hands, arms, legs, torso, or head.
Difficulty with Daily Tasks
The involuntary shaking associated with essential tremor can make it difficult for individuals to complete daily tasks, such as eating with utensils or drinking from a cup. Writing, drawing, and computer work can also be difficult. In addition, those with essential tremor may experience a shaky voice, as this condition can affect the voice box.
Essential Tremor Vs. Parkinson’s Disease
Essential tremor is often confused with Parkinson’s disease, but essential tremor is actually eight times more common than Parkinson’s Disease, affecting an estimated 7 million people in the U.S. While both essential tremor and Parkinson’s disease are movement disorders, meaning both interfere with an individual’s movement, there are key differences:
Essential tremor:
Essential tremor is characterized by a rhythmic, involuntary shaking, which affect the hands, head, torso and legs. Essential Tremor can also be known as postural or action tremor, whichreferstotremorthat occurs when someone holds up a part of the body against the force of gravity, for example, holdinganarmoutinfront of the body. Most types of tremor are considered action tremor.
Parkinson’s Disease:
Unlike essential tremor, Parkinson's disease is also associated with numerous problems such as poor balance, difficulty swallowing, and stooped posture. Those with Parkinson's disease may experiencerestingtremor or action tremor. Resting tremor refers to a tremor that occurs when the body part is at rest. For example,restingtremor can be seen in a hand while someone is seated and the hand is resting on the thigh. Patients with both Essential Tremor and Parkinson’s disease often present with tremors during muscle contractions, including during intentional activities such as outstretched hands (postural tremors) and when hands are in motion during tasks (kinetic tremors).
Articles on ET Symptoms:
Causes of Essential Tremor
The cause of essential tremor is not known, and this neurological disorder is not associated with any particular
disease. However, some medical experts speculate that the following factors may contribute to this condition:
Hereditary Factors
Essential tremor can be passed through generations in families, which is why essential tremor is sometimes called
familial tremor. While the inheritance pattern for essential tremor can vary, if you have a parent with a genetic
mutation for essential tremor, you have a 50% chance of developing the disorder yourself.
Essential tremor is not limited to those with family history, however. Some individuals who begin to show symptoms
of this neurological disorder have no known previous family history of the disorder. In these instances, essential
tremor appears to occur spontaneously for unknown reasons.
Age
Essential tremor is more common in people aged 40 and older, but essential tremor may affect anyone of any age,
including children. Also, if the essential tremor is inherited, its effects may appear earlier in life. Age is also
related to the progression of this disorder. In general, as an individual ages, tremor frequency (the speed of the
tremor shakes) may be reduced; however, the severity of the tremor will actually increase.
Lifestyle Factors
There are many lifestyle factors that health experts have found can worsen essential tremors. These factors
include:
Physical and mental stress
Fatigue
Hunger
Extreme temperatures
Caffeinated drinks
Excessive alcohol intake
Cigarettes and tobacco
Health experts say that taking actions to avoid these behaviors or conditions may help improve the severity of your
essential tremor symptoms. Stress reduction has also been observed to notably reduce the symptoms of essential
tremor.
Articles on ET Causes:
Understanding Cognitive Impairment Issues Due to Essential Tremor
Gait & Balance Problems Associated with Tremors
Guide to post surgery tremor
What are Tremors? (Types, Causes, Symptoms & Treatment)
Anxiety Tremors and Shaky Hands
Overactive Brain Waves & Essential Tremor (Newfound Link & Treatments)
Diagnosis
If you believe you have essential tremor, or you’re dealing with new unexplained, involuntary shaking, please
consult your doctor for an essential tremor evaluation. Your primary care provider will likely refer you to a
neurologist with specialized training in brain and nervous system conditions for a complete diagnosis. There are no
definitive tests to diagnose essential tremor. However, your doctor or neurologist may begin your diagnosis by
running tests to rule out other conditions that may be causing your symptoms. Potential tests may include
neurological, lab, and performance-based options.
Neurological Tests
Your health care professional may perform a series of neurological tests in order to rule out other disorders.
During your neurological examination, your doctor may test your:
- Ability to feel certain sensations
- Tendon reflexes
- Muscle strength and tone
- Posture
- Gait
- Coordination
These tests may help rule out other movement conditions such as Parkinson’s Disease, and help your doctor understand
the extent of your symptoms.
Laboratory Tests
To rule out other possible ailments, your doctor may run laboratory tests on both blood and urine for the following
conditions:
- Thyroid disease
- Metabolic problems
- Drug reactions
- Chemical imbalances
Performance Tests
To analyze the presence and severity of the tremor, your doctor may ask you to perform the following
tasks:
- Drink from a glass
- Hold your arms outstretched
- Write
- Draw a spiral
These tasks will allow your health care provider to examine the extent and severity of your symptoms, and may help
them further rule out underlying causes.
Articles on ET Diagnosis:
Non-Surgical Therapy
Groundbreaking new technologies have given those with essential tremor new treatment options. Cala Trio offers
personalized therapy for hand tremor by delivering electrical stimulation to nerves in the wrist. These nerves
project from the wrist to central brain networks that are responsible for generating hand tremor in essential
tremor.
Stimulation of the nerves in the wrist is thought to disrupt the network activity causing hand tremor. This
disruption can provide temporary and meaningful tremor reduction in the hand that undergoes treatment. The wristband
is calibrated to your unique tremor pattern. Learn more about Cala Trio by reading this essential tremor therapy
information for healthcare patients.
Essential tremor affects every person differently. Our individualized approach to treatment and therapy can help you
address the source of your tremor. If you’re interested in incorporating Cala Trio™ therapy into your essential
tremor treatment plan, get started with essential tremor therapy. Our wristband is available by prescription only,
so reach out to your doctor today.
If you are in the medical field and interested in offering Cala Trio* to your patients, check out this essential
tremor therapy information for healthcare professionals.
Lifestyle Changes
Certain lifestyle factors have been observed to increase the severity of tremors. Taking steps to form healthy
habits and avoid negative lifestyle factors can help decrease the symptoms of tremors.
What to avoid:
- Avoid caffeine, tobacco, and excessive alcohol intake: These substances have been observed to increase the
severity of essential tremor symptoms.
- Avoid stressful situations: Stress has also been observed to have a significant impact on the severity of
essential tremor. In order to mitigate your symptoms, avoid placing yourself in stressful situations.
What to adopt:
- Practice relaxation techniques: Techniques such as deep breathing can help control the effects of stress, which
may in turn mitigate the severity of your essential tremor symptoms.
- Consider timing: If you find your tremors are worse at particular parts of the day, try to finish necessary tasks
during other windows of time.
- Assistive devices: Therapists may suggest that those with essential tremor use assistive devices such as heavy
glasses and utensils, wrist weights, and heavy pens to reduce the effect of tremors on daily activities.
Medication
When essential tremor significantly interferes with an individual’s daily activities, doctors may prescribe drug
treatment. The drugs most commonly prescribed for essential tremor include:
Beta-blockers: This is the most commonly prescribed type of medication for
essential tremor. Generally used to treat high blood pressure, beta-blockers such as propranolol have been shown to
relieve tremors in some individuals; however, they are not a good option for those with heart problems or asthma,
and can come with significant side effects.
Anti-seizure medication: These drugs are designed to treat epilepsy, and
have been prescribed to individuals with essential tremor who don’t experience relief from beta-blockers. As with
any medication, these can come with significant side effects.
Tranquilizers: Individuals who experience worsened tremors as a result of
tension or anxiety may be prescribed benzodiazepine drugs. These medications are habit-forming and can cause side
effects including sedation and fatigue.
Botox injections: Those who suffer from severe head and voice tremors may be
prescribed onabotulinumtoxinA (Botox), as it may improve tremors for a few months at a time. However, depending on
injection placement, use of Botox for tremors has been observed to cause weakness in the fingers and may affect your
voice.
Medication is not always the optimal solution, and its efficacy varies by individual. These drugs work systemically,
not tailored to essential tremor. Beyond their inherent side effects, these drugs can interact with existing
medications.
Physical Therapy
Some health care professionals may suggest physical therapy to help individuals improve their coordination, build
muscle strength, and enhance control. Generally, physical therapy for essential tremor is focused on resistance
training. This resistance training is typically performed on the upper extremity in order to build strength and
coordination.
Surgery
If your tremor proves to be significantly disabling, and your symptoms are unresponsive to other treatment types,
you may qualify for surgery. However, surgical procedures come with heightened risk and are typically only
recommended in the most severe instances of essential tremor.
Currently, there are two main types of surgical procedures used to treat essential tremor:
Deep Brain Stimulation (DBS):
This minimally invasive surgical procedure uses a neurostimulation device to deliver electrical pulses to specific
locations in the brain that are thought to be the cause of the tremor. These electrical pulses block abnormal
activity in the brain, allowing the brain to function more normally. The device is placed under the collarbone, and
connected to a wire implanted under the skin that runs up into the scalp — it is then guided to the brain through a
small hole made in the skull. It is the tip of this wire that sends the electrical impulses.
This procedure is completed in two phases:
- First stage: the electrode is placed into the brain while the patient is awake or asleep. Correct placement of the
electrode is ensured by monitoring brain activity or by using a portable computed tomography machine.
- Second stage: the patient is put under anesthesia, and the neurotransmitters are placed under the
collarbone.
This surgery does come with risks, which include:
- Brain hemorrhage, including stroke
- Infection
- Device malfunction
- Lack of benefit for essential tremor symptoms
- Headache
- Worsening mental or emotional status
Focused Ultrasound:
Introduced in 2016, this focused ultrasound procedure uses magnetic resonance imaging (MRI) to designate the exact
location in the brain where tremors originate. Doctors then use MRI guidance to focus ultrasound waves on that
location. The patient is kept awake throughout the procedure and fitted with a helmet that passes ultrasound waves
into the brain. The device measures temperature throughout the brain, ensuring that only the perfect amount of
energy hits the target in the brain, eliminating or reducing the tremor.
Because this procedure uses ultrasound energy, there aren’t radiation-related risks. However, this procedure creates
a lesion that can result in permanent changes to brain function, which may result in:
- Muscle weakness
- Unsteadiness
- Sensory loss
- Numbness or tingling in extremities
Surgery is only advised for patients that meet specific criteria, and non-invasive therapies are typically preferred
before pursuing these treatment options.
Support Groups for Essential Tremor
Essential tremor can make daily life challenging, and it’s important to feel supported when dealing with this
sometimes debilitating condition. As with any neurological condition, essential tremor can have a significant social
and psychological impact on individuals. However, you’re not alone — and it’s important to seek out support when
needed. There are essential tremor support groups in communities across the country that can help those with ET deal
with the stress and daily toll of this neurological condition.
Articles on ET Treatment:
Symptoms of Essential Tremor
Essential tremor is characterized by involuntary shaking. While essential tremor can affect almost any part of the body, trembling is most often present in the hands. Learn more about the full range of symptoms of essential tremor.
Involuntary Shaking
The most commonly observed symptom of essential tremor is a rhythmic, involuntary shaking. The symptoms of essential tremor generally appear gradually, and in some individuals, may be more prominent on one side of the body. Many who are diagnosed with essential tremor notice symptoms in the hands first, but a slight shaking motion of the head may be noticed as well. Ultimately, this shaking may affect an individual’s hands, arms, legs, torso, or head.
Difficulty with Daily Tasks
The involuntary shaking associated with essential tremor can make it difficult for individuals to complete daily tasks, such as eating with utensils or drinking from a cup. Writing, drawing, and computer work can also be difficult. In addition, those with essential tremor may experience a shaky voice, as this condition can affect the voice box.
Essential Tremor Vs. Parkinson’s Disease
Essential tremor is often confused with Parkinson’s disease, but essential tremor is actually eight times more common than Parkinson’s Disease, affecting an estimated 7 million people in the U.S. While both essential tremor and Parkinson’s disease are movement disorders, meaning both interfere with an individual’s movement, there are key differences:
Essential tremor:
Essential tremor is characterized by a rhythmic, involuntary shaking, which affect the hands, head, torso and legs. Essential Tremor can also be known as postural or action tremor, whichreferstotremorthat occurs when someone holds up a part of the body against the force of gravity, for example, holdinganarmoutinfront of the body. Most types of tremor are considered action tremor.
Parkinson’s Disease:
Unlike essential tremor, Parkinson's disease is also associated with numerous problems such as poor balance, difficulty swallowing, and stooped posture. Those with Parkinson's disease may experiencerestingtremor or action tremor. Resting tremor refers to a tremor that occurs when the body part is at rest. For example,restingtremor can be seen in a hand while someone is seated and the hand is resting on the thigh. Patients with both Essential Tremor and Parkinson’s disease often present with tremors during muscle contractions, including during intentional activities such as outstretched hands (postural tremors) and when hands are in motion during tasks (kinetic tremors).
Articles on ET Symptoms:
Causes of Essential Tremor
The cause of essential tremor is not known, and this neurological disorder is not associated with any particular
disease. However, some medical experts speculate that the following factors may contribute to this condition:
Hereditary Factors
Essential tremor can be passed through generations in families, which is why essential tremor is sometimes called
familial tremor. While the inheritance pattern for essential tremor can vary, if you have a parent with a genetic
mutation for essential tremor, you have a 50% chance of developing the disorder yourself.
Essential tremor is not limited to those with family history, however. Some individuals who begin to show symptoms
of this neurological disorder have no known previous family history of the disorder. In these instances, essential
tremor appears to occur spontaneously for unknown reasons.
Age
Essential tremor is more common in people aged 40 and older, but essential tremor may affect anyone of any age,
including children. Also, if the essential tremor is inherited, its effects may appear earlier in life. Age is also
related to the progression of this disorder. In general, as an individual ages, tremor frequency (the speed of the
tremor shakes) may be reduced; however, the severity of the tremor will actually increase.
Lifestyle Factors
There are many lifestyle factors that health experts have found can worsen essential tremors. These factors
include:
Physical and mental stress
Fatigue
Hunger
Extreme temperatures
Caffeinated drinks
Excessive alcohol intake
Cigarettes and tobacco
Health experts say that taking actions to avoid these behaviors or conditions may help improve the severity of your
essential tremor symptoms. Stress reduction has also been observed to notably reduce the symptoms of essential
tremor.
Articles on ET Causes:
Understanding Cognitive Impairment Issues Due to Essential Tremor
Gait & Balance Problems Associated with Tremors
Guide to post surgery tremor
What are Tremors? (Types, Causes, Symptoms & Treatment)
Anxiety Tremors and Shaky Hands
Overactive Brain Waves & Essential Tremor (Newfound Link & Treatments)
Diagnosis
If you believe you have essential tremor, or you’re dealing with new unexplained, involuntary shaking, please
consult your doctor for an essential tremor evaluation. Your primary care provider will likely refer you to a
neurologist with specialized training in brain and nervous system conditions for a complete diagnosis. There are no
definitive tests to diagnose essential tremor. However, your doctor or neurologist may begin your diagnosis by
running tests to rule out other conditions that may be causing your symptoms. Potential tests may include
neurological, lab, and performance-based options.
Neurological Tests
Your health care professional may perform a series of neurological tests in order to rule out other disorders.
During your neurological examination, your doctor may test your:
- Ability to feel certain sensations
- Tendon reflexes
- Muscle strength and tone
- Posture
- Gait
- Coordination
These tests may help rule out other movement conditions such as Parkinson’s Disease, and help your doctor understand
the extent of your symptoms.
Laboratory Tests
To rule out other possible ailments, your doctor may run laboratory tests on both blood and urine for the following
conditions:
- Thyroid disease
- Metabolic problems
- Drug reactions
- Chemical imbalances
Performance Tests
To analyze the presence and severity of the tremor, your doctor may ask you to perform the following
tasks:
- Drink from a glass
- Hold your arms outstretched
- Write
- Draw a spiral
These tasks will allow your health care provider to examine the extent and severity of your symptoms, and may help
them further rule out underlying causes.
Articles on ET Diagnosis:
Non-Surgical Therapy
Groundbreaking new technologies have given those with essential tremor new treatment options. Cala Trio offers
personalized therapy for hand tremor by delivering electrical stimulation to nerves in the wrist. These nerves
project from the wrist to central brain networks that are responsible for generating hand tremor in essential
tremor.
Stimulation of the nerves in the wrist is thought to disrupt the network activity causing hand tremor. This
disruption can provide temporary and meaningful tremor reduction in the hand that undergoes treatment. The wristband
is calibrated to your unique tremor pattern. Learn more about Cala Trio by reading this essential tremor therapy
information for healthcare patients.
Essential tremor affects every person differently. Our individualized approach to treatment and therapy can help you
address the source of your tremor. If you’re interested in incorporating Cala Trio™ therapy into your essential
tremor treatment plan, get started with essential tremor therapy. Our wristband is available by prescription only,
so reach out to your doctor today.
If you are in the medical field and interested in offering Cala Trio* to your patients, check out this essential
tremor therapy information for healthcare professionals.
Lifestyle Changes
Certain lifestyle factors have been observed to increase the severity of tremors. Taking steps to form healthy
habits and avoid negative lifestyle factors can help decrease the symptoms of tremors.
What to avoid:
- Avoid caffeine, tobacco, and excessive alcohol intake: These substances have been observed to increase the
severity of essential tremor symptoms.
- Avoid stressful situations: Stress has also been observed to have a significant impact on the severity of
essential tremor. In order to mitigate your symptoms, avoid placing yourself in stressful situations.
What to adopt:
- Practice relaxation techniques: Techniques such as deep breathing can help control the effects of stress, which
may in turn mitigate the severity of your essential tremor symptoms.
- Consider timing: If you find your tremors are worse at particular parts of the day, try to finish necessary tasks
during other windows of time.
- Assistive devices: Therapists may suggest that those with essential tremor use assistive devices such as heavy
glasses and utensils, wrist weights, and heavy pens to reduce the effect of tremors on daily activities.
Medication
When essential tremor significantly interferes with an individual’s daily activities, doctors may prescribe drug
treatment. The drugs most commonly prescribed for essential tremor include:
Beta-blockers: This is the most commonly prescribed type of medication for
essential tremor. Generally used to treat high blood pressure, beta-blockers such as propranolol have been shown to
relieve tremors in some individuals; however, they are not a good option for those with heart problems or asthma,
and can come with significant side effects.
Anti-seizure medication: These drugs are designed to treat epilepsy, and
have been prescribed to individuals with essential tremor who don’t experience relief from beta-blockers. As with
any medication, these can come with significant side effects.
Tranquilizers: Individuals who experience worsened tremors as a result of
tension or anxiety may be prescribed benzodiazepine drugs. These medications are habit-forming and can cause side
effects including sedation and fatigue.
Botox injections: Those who suffer from severe head and voice tremors may be
prescribed onabotulinumtoxinA (Botox), as it may improve tremors for a few months at a time. However, depending on
injection placement, use of Botox for tremors has been observed to cause weakness in the fingers and may affect your
voice.
Medication is not always the optimal solution, and its efficacy varies by individual. These drugs work systemically,
not tailored to essential tremor. Beyond their inherent side effects, these drugs can interact with existing
medications.
Physical Therapy
Some health care professionals may suggest physical therapy to help individuals improve their coordination, build
muscle strength, and enhance control. Generally, physical therapy for essential tremor is focused on resistance
training. This resistance training is typically performed on the upper extremity in order to build strength and
coordination.
Surgery
If your tremor proves to be significantly disabling, and your symptoms are unresponsive to other treatment types,
you may qualify for surgery. However, surgical procedures come with heightened risk and are typically only
recommended in the most severe instances of essential tremor.
Currently, there are two main types of surgical procedures used to treat essential tremor:
Deep Brain Stimulation (DBS):
This minimally invasive surgical procedure uses a neurostimulation device to deliver electrical pulses to specific
locations in the brain that are thought to be the cause of the tremor. These electrical pulses block abnormal
activity in the brain, allowing the brain to function more normally. The device is placed under the collarbone, and
connected to a wire implanted under the skin that runs up into the scalp — it is then guided to the brain through a
small hole made in the skull. It is the tip of this wire that sends the electrical impulses.
This procedure is completed in two phases:
- First stage: the electrode is placed into the brain while the patient is awake or asleep. Correct placement of the
electrode is ensured by monitoring brain activity or by using a portable computed tomography machine.
- Second stage: the patient is put under anesthesia, and the neurotransmitters are placed under the
collarbone.
This surgery does come with risks, which include:
- Brain hemorrhage, including stroke
- Infection
- Device malfunction
- Lack of benefit for essential tremor symptoms
- Headache
- Worsening mental or emotional status
Focused Ultrasound:
Introduced in 2016, this focused ultrasound procedure uses magnetic resonance imaging (MRI) to designate the exact
location in the brain where tremors originate. Doctors then use MRI guidance to focus ultrasound waves on that
location. The patient is kept awake throughout the procedure and fitted with a helmet that passes ultrasound waves
into the brain. The device measures temperature throughout the brain, ensuring that only the perfect amount of
energy hits the target in the brain, eliminating or reducing the tremor.
Because this procedure uses ultrasound energy, there aren’t radiation-related risks. However, this procedure creates
a lesion that can result in permanent changes to brain function, which may result in:
- Muscle weakness
- Unsteadiness
- Sensory loss
- Numbness or tingling in extremities
Surgery is only advised for patients that meet specific criteria, and non-invasive therapies are typically preferred
before pursuing these treatment options.
Support Groups for Essential Tremor
Essential tremor can make daily life challenging, and it’s important to feel supported when dealing with this
sometimes debilitating condition. As with any neurological condition, essential tremor can have a significant social
and psychological impact on individuals. However, you’re not alone — and it’s important to seek out support when
needed. There are essential tremor support groups in communities across the country that can help those with ET deal
with the stress and daily toll of this neurological condition.
Articles on ET Treatment:
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