Essential Tremor

Essential tremor is a common, progressive movement disorder that causes shaking in the limbs, typically the hands and arms. It is an action tremor, meaning it occurs when you are trying to perform a task with movement such as writing, picking something up, or pouring a drink. As symptoms worsen over time, many activities of daily life can become difficult to perform without assistance. This might include simple things like getting dressed, holding a glass of water without spilling or using a spoon.

Essential tremor can also affect speech, making it harder to hold a conversation, and can cause balance problems that make walking more difficult. While essential tremor is generally not dangerous, it can have significant impacts on an individual’s independence, mental health and social life.

At first, impacts to daily life may be minimal. Over time, as symptoms progress, essential tremor can cause shaking that affects:

• Eating and drinking
• Getting dressed
• Shaving
• Applying makeup
• Writing
• Fixing small things
• Using a computer, phone or electronic device
• Talking
• And many more activities

Taken together, these symptoms can make it harder to live independently and could affect your professional life. You may feel a sense of self-consciousness or embarrassment. If so, you’re not alone. Many people with essential tremor experience anxiety, depression and loneliness. Talking openly with your healthcare team, family members and other people in your life can help them understand what you’re going through. This can also help your healthcare team recommend more effective strategies for managing your condition.

Researchers don’t yet fully understand the causes of essential tremor. An estimated 50-70% of all people with essential tremor have a family history of the condition.⁶ However, experts are still working to understand the mechanisms of essential tremor, including for individuals without a family history.

Age is a risk factor for essential tremor. Essential tremor becomes increasingly common with each decade of life, especially after the age of 50⁵ (but can also occur younger than that).If you have a family history of essential tremor, you are more likely to develop it. You may be also more likely to develop essential tremor at a younger age if a family member has the condition.⁶

There are no known ways of reducing your risk of developing essential tremor.

Essential tremor affects an estimated 25-60 million people globally. While rare among younger people, it is increasingly common with age. Nearly 75% of cases occur in individuals over the age of 50. Approximately 3% of individuals 80 years or older have essential tremor. ⁴

Diagnosing essential tremor can be challenging, but is crucial for getting effective treatment. There is no specific medical test for essential tremor. Instead, a diagnosis is based on your symptoms. This requires ruling out other conditions with similar symptoms, including other tremor and movement disorders like Parkinson’s disease and dystonia. Some individuals with essential tremor are initially misdiagnosed because of the challenge of telling essential tremor apart from these other conditions.

To make an accurate diagnosis, your healthcare provider may order a series of tests and exams, including blood and urine tests, neurological exams, genetic testing, and physical tests to check your movement, balance and coordination. Or they may send you to a specialist (a neurologist or a movement disorder specialist) for diagnosis and treatment.

Essential tremor is sometimes confused with Parkinson’s disease. While both conditions have overlapping symptoms, there are some differences. Essential tremor is more likely to:

• Affect the body part (e.g., hands, arms) when trying to perform an activity
• Occur on both sides of your body

Research suggests an association between essential tremor and Parkinson’s disease, although researchers are still working to understand what this relationship is. For instance, some people have essential tremor in combination with Parkinson’s disease. In some cases you may develop Parkinson’s years after your essential tremor symptoms begin. Having a family history of Parkinson’s disease may also be correlated with a higher risk of developing essential tremor.⁵

Researchers are continuously investigating potential new and more effective treatments. For guidance on the best treatment options for you—and to determine if you may qualify for a clinical trial—please speak with your healthcare provider.