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Neurosciences and Behavioral Health Center

Essential Tremor

Essential tremor (ET) is a movement disorder that presents itself as shaking in the hands. It occurs in about 5 percent of older adults. It may also cause shaking of the head, voice, arms and trunk. It occurs less often in the legs and feet. Two types of tremor are common with ET:

  • Postural tremor — shaking in certain positions only, such as with arms outstretched
  • Kinetic or action tremor — shaking that gets worse during activities, such as eating or shaving

For some people, ET is caused by a genetic mutation. For others, the cause is not clear. The condition may occur at any age, but it’s more likely to occur in teens and people older than 50.

Symptoms of Essential Tremor 

ET is generally not serious, but its severity may vary and worsen over time. Symptoms may include:

  • Tremor that occurs when standing or moving the limbs, but not usually at rest
  • Uncontrollable, rhythmic movement
  • Shaking is most common in hands, arms, head or voice
  • Shaking only in certain positions or during activity
  • Trouble with fine motor skills such as drawing, sewing or playing an instrument
  • Shaking that gets worse from caffeine, stress, fatigue or heat
  • Shaking that may decrease when using alcohol
  • Problems with social, functional or job-related abilities in more severe cases

Tremors must not be related to other health conditions in order for someone to have the ET diagnosis.

Treating Essential Tremor

Most people with ET do not require treatment. Mild tremors may be relieved or even eliminated by simple measures, including:

  • Staying well-rested
  • Avoiding caffeine
  • Avoiding stimulants often found in over-the-counter medications, like cold remedies
  • Avoiding temperature extremes

Your doctor may prescribe certain medications to help you function. 

Surgical Alternatives & Innovation

Surgery may be an option in rare cases where tremors are disabling and medications don’t help. Options include:

  • Deep brain stimulation (DBS) — sends painless electrical pulses to the brain, interrupting faulty signals
  • Thalamotomy — destroys a tiny part of the brain (less commonly performed than DBS)
  • Focused ultrasound — ultrasound beams offer precision and fast recovery without surgery


Call our Parkinson's Disease and Movement Disorders Clinic.


Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.

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