What are the Symptoms of Essential Tremor?

Essential tremor (ET), which is also known as familial or benign essential tremor, is a common neurological disorder that affects about 10 million people in the United States¹ and is defined by shaking in the hands and arms, the head, torso and voice. The tremors typically present during activities like writing.

While many people have different kinds of tremors, for those with noticeable or disruptive tremors, it’s important to receive the right diagnosis. While essential tremor is a specific type of tremor, it’s also the most common. In addition, it’s often confused with Parkinson’s disease, even though they progress differently and have different symptoms. The good news is that knowing the symptoms of essential tremor can help you be more prepared for discussions with your healthcare provider.

Defining Symptoms of Essential Tremor

There are two parts of essential tremor: the first part is shaking, which is called a tremor because it’s both unwanted and uncontrollable. The second part is the “essential” -  which is a medical term that means it has an unknown cause. In addition, there are other common aspects of essential tremor, which include:

• Tremors that are mostly in the hands and arms
• Tremors that are more pronounced on one side of the body
• Head tremors that cause a “yes-yes” or “no-no” motion, or a shaky voice
• Difficulty with tasks involving the hands, such as writing or using tools
• More pronounced tremors with body movement
• Difficulty with walking or balance

Essential tremor symptoms can worsen with caffeine, fatigue, or high stress levels. Certain foods can also aggravate symptoms.

Contacting Your Healthcare Provider

While essential tremor is a fairly common condition which can make daily tasks more difficult and cause embarrassment, it’s not life-threatening. If you experience tremors on a continual basis or if tremor impacts your ability to complete tasks in your daily life, you should reach out to a qualified healthcare professional, ideally a movement disorder neurologist, to provide you the best assessment of your condition as well as treatment options. Your primary care physician can provide a referral.

Be as specific as you can about where, when, and how you experience tremors when speaking to your healthcare team. This will help your doctor better understand your neurological condition and increase the likelihood of a correct essential tremor diagnosis. This is incredibly important, as different conditions associated with tremors often have different treatment options.

Essential Tremor vs. Parkinson’s Disease

Essential tremor is often confused with Parkinson’s disease, which also involves uncontrollable tremors and shaking. The two conditions, however, are very different, as are their treatment paths.

The biggest difference comes down to when tremors are most obvious. For people with essential tremor, tremors are usually most noticeable when actively using their hands or arms. Parkinson’s disease tremors, on the other hand, are noticeable at rest.

Parkinson’s disease is a neuro-degenerative condition that progresses and leads to other motor problems, including deteriorated posture, slower movement, and foot dragging. In contrast, essential tremor is not degenerative and does not directly cause other motor issues. Essential tremor symptoms, however, can progress in severity and, in more severe cases, it can impact movement, causing an unsteady gait.

In both conditions, tremors usually start in the hands. In essential tremor, tremors are typically most pronounced in the hands, arms, and head. In Parkinson’s disease, tremors spread to other parts of the body, including the legs. In contrast, shaking legs is considered rare with essential tremor.

Causes of Essential Tremor

While the initial cause of essential tremor is currently unknown, it is known that there is a significant genetic factor, and those who have a parent with essential tremor have about a 50% chance of developing the condition themselves². While ET can start at any age, it typically presents in your 40s, although it can start earlier if inherited from a parent. While much has been learned about ET, there is more to learn, as researchers continue to investigate the root cause.