What is essential tremor?
Essential tremor (ET) is a neurological movement disorder that leads to tremors (involuntary shaking) in various parts of the body. While essential tremor most commonly affects the hands and arms, it can also impact other areas such as the head, voice and even the legs or torso.
As ET progresses, it can become more severe, significantly interfering with everyday activities. Tasks that are often taken for granted, like eating, drinking, writing or dressing, can become challenging and frustrating. The tremors can make these activities more difficult and, in some cases, even impossible or unsafe.
In addition to the physical difficulties, essential tremor can also take an emotional toll. Many people with the condition experience feelings of embarrassment or self-consciousness, particularly when their symptoms are noticeable to others. Coping with essential tremor often requires both medical treatment and emotional support to manage the physical and psychological impact of the disorder.
Essential tremor symptoms
The main symptom of essential tremor is shaking, especially in the hands, when you're trying to use them. This shaking can happen in different ways and usually occurs during certain activities.
The most common types of tremors include:
- Action tremor: This happens when you do something with your hands, like reaching for an object or holding something.
- Postural tremor: This occurs when you hold part of your body in a certain position, like keeping your arm outstretched or your hand at a specific height.
Essential tremor usually affects both sides of the body, but one side may be more affected than the other. While shaking in the hands is the most common, tremors can also affect the head, voice, face and trunk.
Although the shaking itself isn’t usually harmful, it can make everyday tasks more difficult as the condition progresses. Over time, you might have trouble doing things like eating with utensils, drinking from a glass, dressing yourself or writing. This can make it harder to maintain your independence and quality of life.
When to see a doctor
See your primary care provider if you develop a new tremor or an existing one worsens. Let your provider know if shaking or other symptoms make it difficult to do your job, complete routine tasks at home or enjoy your hobbies. Your provider may refer you to a neurologist.
Essential tremor causes
The exact cause of essential tremor is unknown, but it involves abnormal activity in certain areas of the brain responsible for movement control.
One thing that is well-established is that essential tremor can run in families. About half of all cases are inherited, meaning genetics play a significant part in its occurrence. Essential tremor is typically passed down in an autosomal dominant pattern, which means that if one of your parents carries the mutated gene associated with the condition, you have a 50% chance of inheriting it as well. This genetic link makes it more likely that people with a family history of essential tremor will develop it themselves.
Essential tremor risk factors
Several factors can increase the chances of developing essential tremor, including:
- Genetics (inherited gene): If you have a family member with essential tremor, your chances of developing it are higher. The inherited form, called familial tremor, is passed down in an autosomal dominant way, meaning that if one parent has the condition, there’s a 50% chance you’ll inherit it as well. Just one parent passing on the altered gene can be enough for the condition to develop.
- Age: Essential tremor is more common in people over 40. As we get older, the chances of developing the condition increase. While it’s usually seen in older adults, it can start earlier in some cases.
If you have a family history of essential tremor or are noticing symptoms, it's a good idea to talk to your healthcare provider. They can help you understand your risk and provide guidance on managing the condition.
How is essential tremor diagnosed?
There is no single test that can directly diagnose essential tremor. Instead, your doctor will gather information from your medical history, conduct a physical exam and order some tests to rule out other conditions that could be causing the shaking. All of this information helps your doctor confirm whether you have essential tremor and create a personalized plan to help manage the condition.
Medical history and exam
Your doctor will begin by asking about your health, including any conditions you have and whether any family members—especially close relatives like parents or siblings—have had essential tremor or other movement disorders.
You will also be asked about your symptoms, including when you first noticed the tremors, which parts of your body are affected, how often they occur and whether anything makes them better or worse. The more details you provide, the more your doctor will be able to understand your condition.
During the physical exam, your doctor will watch for tremor in your hands or any other areas of your body that might be shaking. They may measure how far your hand moves during a tremor (called amplitude) and how often the tremor occurs (known as frequency).
Additionally, a neurological exam might be done to assess your nervous system. Your doctor will check things like your reflexes, posture and walking ability to see how well your nervous system is working.
Blood and urine tests
While there are no specific blood tests to diagnose essential tremor, your doctor may order blood and urine tests to rule out other conditions that can cause similar symptoms, such as an overactive thyroid or other metabolic issues. These tests can help your doctor gather more information and ensure an accurate diagnosis.
Imaging and tests
Your doctor may recommend additional tests to rule out other conditions that might cause similar shaking. These may include:
- Magnetic resonance imaging (MRI) scan: A brain MRI uses magnets and radio waves to create detailed images of your brain. This helps rule out other neurological conditions like multiple sclerosis or brain problems that could be causing the tremors.
- Computed tomography (CT) scan: A CT scan uses X-rays to create images of your brain and head, helping doctors spot things like tumors or other abnormalities that might be causing shaking.
Essential tremor treatment
For some people with essential tremor, treatment may not be necessary if the symptoms are mild and don’t interfere with daily life. However, if your tremors are making it hard to work, take care of yourself or enjoy everyday activities, it's important to talk to your healthcare provider about treatment options. There are different ways to manage ET, and your doctor can help you find the solution that works best for you.
Lifestyle modifications
While lifestyle modifications won’t cure essential tremor, there are steps you can take to make daily life easier and reduce the impact of ET. Many people find that using tools like weighted utensils or pens designed to lessen shaking can help. There are also devices that can stimulate the nerves in your arms or legs to reduce tremors.
Here are some simple lifestyle tips to consider:
- Cut back on caffeine: Caffeine can make tremors worse, so reducing or eliminating it from your diet may help ease the shaking.
- Use cups with straws and lids: These can help prevent spills, making it easier to drink without worrying about your hands shaking.
- Keep your arms close to your body: When using your hands, try to keep your arms close to your body to help reduce tremors.
- Use voice recordings: Instead of writing, use voice memos or recordings to take notes or make lists.
- Manage stress: Stress can make tremors worse, so practicing relaxation techniques like meditation, deep breathing or mindfulness can help you feel calmer and reduce the effects of tremors.
These changes can make a big difference in managing essential tremor and improving your day-to-day life.
Rehabilitation therapy
Several types of rehabilitation therapy can help make living with essential tremor easier by teaching you strategies and exercises to manage tremors in your everyday life. Here’s how different therapies can help:
- Occupational therapy: Occupational therapists can teach you helpful techniques and introduce tools that make daily tasks, like eating, dressing or writing, more manageable. They’ll show you ways to work around tremors, so they don’t get in the way of your independence and daily activities.
- Physical therapy: Physical therapists help improve your strength, balance and coordination. They’ll guide you through exercises that help stabilize your body and make movement easier, which can reduce the impact of tremors. Stronger muscles and better balance can help you feel more stable and confident in your movements.
- Speech therapy: If tremors affect your voice or speech, speech therapists can work with you to improve clarity and control. They’ll teach you techniques to reduce voice tremors, speak more clearly and project your voice better, making communication easier and less frustrating.
These therapies can help you manage essential tremor and improve your daily life, giving you more confidence and independence in everything you do.
Medication
Treatment for essential tremor typically starts with oral medications. While some people find relief with these medications, others may not experience significant improvement. Over time, your doctor may adjust the dosage as your tremors change.
Here are some types of medications that can help manage essential tremor:
- Beta-blockers: These medications are commonly used to treat high blood pressure and anxiety, and they can also help reduce tremors.
- Anti-seizure medications: Certain anti-seizure medications can help reduce tremors, especially for people who don’t respond well to beta-blockers. These medications may include options like primidone, as well as others that can help manage tremors.
- Benzodiazepines: These medications are often used to treat anxiety and muscle tension. They can also help reduce tremors for some people by relaxing the muscles.
- Botulinum toxin injections: These injections temporarily relax the muscles causing tremors. They are commonly used to treat tremors in the head and voice but can also be effective for hand tremors in some cases.
Your doctor will work with you to find the most effective treatment plan for your specific symptoms and may adjust your medications over time based on how you respond.
Surgery
If treatments like medications or lifestyle changes aren't helping to control your tremors, your doctor may talk to you about surgery as an option. Surgery is usually considered when other treatments haven't worked well enough.
- Deep brain stimulation (DBS): In this procedure, a surgeon places a small device in your brain that sends electrical pulses to the area responsible for the tremors. These pulses help block the nerve signals that cause the shaking. The device can be adjusted by your doctor to find the best settings for controlling your tremors. DBS is a well-established treatment that can help many people who don’t get enough relief from medications.
- Focused ultrasound: Focused ultrasound uses sound waves to target and treat the area of your brain causing the tremors. The sound waves are focused on a small part of your brain, where they heat up and break down the tissue, which can help reduce or stop the tremors. This treatment is a less invasive option compared to DBS.
Your doctor will explain the benefits and potential risks of each option so you can make an informed decision about whether surgery is right for you.
Find specialized essential tremor care near you
If you or a loved one is dealing with essential tremors, Baylor Scott & White Health is here to help. With multiple locations across North and Central Texas, we can provide the care you need to regain control and enhance your quality of life. From diagnosis to tailored treatment plans, therapy and advanced surgical options, we’re with you every step of the way, offering comprehensive care to meet your needs.
Baylor Scott & White Dallas Diagnostic Association - Garland (Satellite)
5220 W University Dr POB II, Ste 250, McKinney, TX, 75071
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Neurology - McKinney
5236 W University Dr Ste 3700, McKinney, TX, 75071
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Medical Center - McKinney
5252 W University Dr Highway 380 at Lake Forest Drive, McKinney, TX, 75071
Baylor Scott & White Medical Center - Lake Pointe
6800 Scenic Dr , Rowlett, TX, 75088
Baylor Scott & White Neurology - Lake Pointe
7600 Lakeview Pkwy Ste 150, Rowlett, TX, 75088
- Monday: 8:00 am - 4:00 pm
- Tuesday: 8:00 am - 4:00 pm
- Wednesday: 8:00 am - 4:00 pm
- Thursday: 8:00 am - 4:00 pm
- Friday: 8:00 am - 4:00 pm
Baylor Scott & White Medical Center - Frisco at PGA Parkway
7600 Better Way , Frisco, TX, 75033
Baylor Scott & White Medical Center - Centennial
12505 Lebanon Rd , Frisco, TX, 75035
Baylor Scott & White Dallas Diagnostic Association - Garland
7217 Telecom Pkwy Ste 300, Garland, TX, 75044
- Monday: 8:00 am - 4:30 pm
- Tuesday: 8:00 am - 4:30 pm
- Wednesday: 8:00 am - 4:30 pm
- Thursday: 8:00 am - 4:30 pm
- Friday: 8:00 am - 4:30 pm
- Monday: 8:00 am - 4:15 pm
- Tuesday: 8:00 am - 4:15 pm
- Wednesday: 8:00 am - 4:15 pm
- Thursday: 8:00 am - 4:15 pm
- Friday: 8:00 am - 4:15 pm
Baylor Scott & White Orthopedic Associates of Dallas - Sports Concussion Program at The Star
3800 Gaylord Pkwy Ste 810, Frisco, TX, 75034
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Medical Center - Sunnyvale
231 S Collins Rd , Sunnyvale, TX, 75182
Baylor Scott & White Neurology - Plano
4708 Alliance Blvd Pavilion I, Ste 550, Plano, TX, 75093
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 4:30 pm
Baylor Scott & White - Plano Brain and Spine Center
4708 Alliance Blvd Pavilion I, Ste 810, Plano, TX, 75093
Baylor Scott & White Dallas Diagnostic Association - Plano
4716 Alliance Blvd Pavilion II, Plano, TX, 75093
- Monday: 7:00 am - 5:00 pm
- Tuesday: 7:00 am - 5:00 pm
- Wednesday: 7:00 am - 5:00 pm
- Thursday: 7:00 am - 5:00 pm
- Friday: 7:00 am - 5:00 pm
- Saturday: 8:00 am - 12:00 pm
Baylor Scott & White Medical Center - Plano
4700 Alliance Blvd , Plano, TX, 75093
Baylor Scott & White Neurology Hospitalist Group - Plano
4700 Alliance Blvd , Plano, TX, 75093
The Headache Center at Baylor University Medical Center
9101 N Central Expy Ste 400, Dallas, TX, 75231
Baylor Scott & White Neuroscience Center
9101 N Central Expy Ste 400, Dallas, TX, 75231
Baylor Scott & White Headache Medicine Specialists of North Texas - Dallas
9101 N Central Expy Ste 400, Dallas, TX, 75231
- Monday: 8:00 am - 4:30 pm
- Tuesday: 8:00 am - 4:30 pm
- Wednesday: 8:00 am - 4:30 pm
- Thursday: 8:00 am - 4:30 pm
- Friday: 8:00 am - 4:30 pm
Baylor Scott & White Cognitive and Behavioral Neurology Associates
9101 N Central Expy Ste 230, Dallas, TX, 75231
- Monday: 8:00 am - 4:30 pm
- Tuesday: 8:00 am - 4:30 pm
- Wednesday: 8:00 am - 4:30 pm
- Thursday: 8:00 am - 4:30 pm
- Friday: 8:00 am - 4:30 pm
Baylor Scott & White Institute for Rehabilitation - Dallas
909 N Washington Ave , Dallas, TX, 75246
Baylor University Medical Center, part of Baylor Scott & White Health
3500 Gaston Ave , Dallas, TX, 75246
Baylor Scott & White Neurology - Dallas
3434 Swiss Ave Ste 400, Dallas, TX, 75204
- Monday: 8:00 am - 4:30 pm
- Tuesday: 8:00 am - 4:30 pm
- Wednesday: 8:00 am - 4:30 pm
- Thursday: 8:00 am - 4:30 pm
- Friday: 8:00 am - 2:00 pm
Baylor Scott & White Medical Center - Irving
1901 N MacArthur Blvd , Irving, TX, 75061
Baylor Scott & White Neurology - Irving
2021 N MacArthur Blvd Ste 210, Irving, TX, 75061
- Monday: 8:00 am - 4:30 pm
- Tuesday: 8:00 am - 4:30 pm
- Wednesday: 8:00 am - 4:30 pm
- Thursday: 8:00 am - 4:30 pm
- Friday: 8:00 am - 1:00 pm
Baylor Scott & White Medical Center - Grapevine
1650 W College St , Grapevine, TX, 76051
Baylor Scott & White Medical Center - Waxahachie
2400 N Interstate 35E , Waxahachie, TX, 75165
Baylor Scott & White All Saints Medical Center - Fort Worth
1400 8th Ave , Fort Worth, TX, 76104
Baylor Scott & White Institute for Rehabilitation - Fort Worth
6601 Harris Pkwy , Fort Worth, TX, 76132
Baylor Scott & White Neurosciences Clinic - Waco
50 Hillcrest Medical Blvd Ste 201-A, Waco, TX, 76712
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Medical Center - Hillcrest
100 Hillcrest Medical Blvd , Waco, TX, 76712
Baylor Scott & White Clinic - College Station Rock Prairie
800 Scott and White Dr , College Station, TX, 77845
- Monday: 7:30 am - 5:00 pm
- Tuesday: 7:30 am - 5:00 pm
- Wednesday: 7:30 am - 5:00 pm
- Thursday: 7:30 am - 5:00 pm
- Friday: 7:30 am - 5:00 pm
Baylor Scott & White Medical Center - College Station
700 Scott and White Dr , College Station, TX, 77845
Baylor Scott & White Medical Center - Temple
2401 S 31st St , Temple, TX, 76508
Baylor Scott & White Clinic - Temple
2401 S 31st St , Temple, TX, 76508
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White McLane Children's Medical Center - Temple
1901 SW H K Dodgen Loop , Temple, TX, 76502
Baylor Scott & White McLane Children's Specialty Clinic - Temple
1901 SW H K Dodgen Loop , Temple, TX, 76502
Baylor Scott & White Medical Center - Brenham
700 Medical Pkwy , Brenham, TX, 77833
Baylor Scott & White Specialty Clinic - Killeen Hemingway
2405 S Clear Creek Rd , Killeen, TX, 76549
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Medical Center - Taylor
305 Mallard Ln , Taylor, TX, 76574
Baylor Scott & White Clinic - Round Rock 300 University
300A University Blvd , Round Rock, TX, 78665
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Medical Center - Round Rock
300 University Blvd , Round Rock, TX, 78665
Baylor Scott & White Clinic - Pflugerville Medical Center (Building 1)
2600 E Pflugerville Pkwy Bldg 1, Ste 200, Pflugerville, TX, 78660
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
- Monday: 7:30 am - 4:00 pm
- Tuesday: 7:30 am - 4:00 pm
- Wednesday: 7:30 am - 4:00 pm
- Thursday: 7:30 am - 4:00 pm
- Friday: 7:30 am - 4:00 pm
Baylor Scott & White Clinic - Pflugerville Medical Center Building 2
2600 E Pflugerville Pkwy Building 2, Pflugerville, TX, 78660
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
- Monday: 8:00 am - 4:00 pm
- Tuesday: 8:00 am - 4:00 pm
- Wednesday: 8:00 am - 4:00 pm
- Thursday: 8:00 am - 4:00 pm
- Friday: 8:00 am - 4:00 pm
Baylor Scott & White Clinic - Austin River Place
10815 Ranch Rd 2222 , Austin, TX, 78730
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Institute for Rehabilitation - Lakeway
2000 Medical Dr , Lakeway, TX, 78734
Baylor Scott & White Medical Center - Lakeway
100 Medical Pkwy , Lakeway, TX, 78738
Baylor Scott & White Specialty Clinic - Lakeway
200 Medical Pkwy , Lakeway, TX, 78738
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Clinic - Buda Medical Center
5330 Overpass Rd Ste 100, Buda, TX, 78610
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Specialty Clinic - Marble Falls
800 W State Hwy 71 , Marble Falls, TX, 78654
- Monday: 8:00 am - 5:30 pm
- Tuesday: 8:00 am - 5:30 pm
- Wednesday: 8:00 am - 5:30 pm
- Thursday: 8:00 am - 5:30 pm
- Friday: 8:00 am - 5:30 pm
Baylor Scott & White Medical Center - Marble Falls
810 W State Hwy 71 , Marble Falls, TX, 78654
Frequently asked questions
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Is essential tremor hereditary?
Yes, essential tremor is often hereditary, with about half of cases passed down through families. If a parent has it, there’s a 50% chance their child might get it too. However, some people develop essential tremor without any family history of the condition.
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Does essential tremor get worse?
Yes, essential tremor generally gets worse over time, although it tends to progress slowly. The severity and speed of progression can vary greatly from person to person, so while some people may experience only mild changes, others may notice a more noticeable increase in tremor intensity as time goes on.
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Can essential tremor go away?
Essential tremor doesn't go away and there's no cure, but treatment can help manage the symptoms. Medications, special devices and sometimes surgery can reduce tremors and make daily activities easier. While it might not go away, treatment can help you feel better and improve your quality of life.
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Can essential tremor turn into Parkinson's?
Essential tremor doesn’t turn into Parkinson’s disease (PD), but people with ET have a slightly higher risk of developing PD. While the two conditions are different, some individuals may experience both, a situation known as ET-PD syndrome. Most with ET won’t develop PD, and treatments can manage symptoms.
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How common is essential tremor?
Essential tremor is the most common movement disorder, affecting up to 5% of people around the world. It tends to become more common as people age, especially in those over 60.