Essential tremors

Also called familial tremor, benign essential tremor or hereditary tremor.

Key points

  1. Essential tremor is a term used to describe the uncontrolled trembling or shaking movements in parts of your body. The term 'essential' means that there is no associated disease that causes the tremor.
  2. It is quite common, affecting between 1–5% of the adult population in New Zealand (which means about 1 to 5 in every 100 adult New Zealanders are affected).
  3. Essential tremor can occur at any age but is most common in people age 40 years and older, and it is equally common in men and women.
  4. It is also called familial tremor because it tends to occur in families.
  5. Many people confuse tremors with Parkinson's disease, but the two conditions are quite different.

What is essential tremor?

Essential tremor is a term used to describe the uncontrolled trembling or shaking movements in parts of your body.

  • It can affect almost any part of your body, but the trembling occurs most often in your hands, especially when you try to do simple tasks, such as holding a cup, tying shoelaces, writing or shaving.
  • Sometimes essential tremor may also affect your voice, head, arms or legs.

What causes essential tremor?

The term 'essential' means that there is no associated disease that causes the tremor.

  • Essential tremor is also called familial tremor because it tends to occur in families.
  • At least 5 to 7 out of 10 people with essential tremor have other members of the family with the same condition.

What are the symptoms of essential tremor?

The only symptom in essential tremor is tremor.

  • In most cases the tremor is mild and non-progressive (which means it does not usually get worse over time).
  • However, in some cases the tremors may slowly worsen over time. In severe cases it can be quite disabling and can affect a person’s quality of life by hampering daily activities.
  • The tremors usually begin slowly and at first, it may not be present all the time, but the movements are likely to worsen over time.  
  • In some cases, the tremor may be worsened by:
    • emotional stress
    • fatigue (tiredness)
    • caffeine
    • extremes of temperature (if it's too hot or too cold).

How is essential tremor diagnosed?

There is no test to diagnose essential tremor. Determining the diagnosis is often a matter of ruling out other conditions that could be causing your symptoms such as thyroid disease, Parkinson's disease or it may be a side-effect of some prescribed medicines. To do this, your doctor will assess your symptoms, review your medical history, and your family history and conduct a physical examination.

What is the treatment for essential tremor?

Essential tremor cannot be cured.  

  • If your symptoms are mild, you may not require treatment.
  • However, if your are having difficulty doing daily activities because of worsening tremor, your doctor may start you on medication, such as beta-blockers (for example, propranolol) or anti-epilepsy medication such as primidone or gabapentin.
  • In severe cases, where medicines are not effective, your doctor may discuss the option of surgery. There are two main surgical procedures that may be considered called thalamotomy and thalamic deep brain stimulation. They both involve the thalamus, which is a part of the brain that organizes messages travelling between the body and brain.

Self-care

In some people with mild symptoms, the following self care measures may help to ease tremor:

  • Avoiding food and drinks containing caffeine.
  • Quit smoking.
  • Avoiding excessive alcohol.
  • Managing stress. 
  • Alternative therapies such as yoga, acupuncture, and tai-chi may be useful in relieving tremors caused by stress.
  • Getting adequate amounts of rest in order to reduce fatigue.

Learn more

The following links provide further information on essential tremor. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.

About essential tremor NZ Essential Tremor Support Group
Essential tremor Patient Info, UK
Treatments for essential tremor American Academy of Neurology

Credits: Sandra Ponen, Pharmacist. Reviewed By: Dr J Bycroft. Health Navigator NZ Last reviewed: 07 Oct 2015