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Essential Tremor


An essential tremor

is uncontrolled muscle shaking that has no known cause. Your healthcare provider can diagnose essential tremor based on your signs and symptoms. Other tests may be used to make sure another condition is not causing the tremors. Essential tremors can happen at any age but are most common after 40 years of age.

Common signs and symptoms of essential tremor:

Signs and symptoms may be mild or severe. You may have tremors when you try to hold still or when you move. Any of the following may get worse slowly, over time:

  • Hands or arms shake, especially when you hold or reach for objects
  • Voice quivers when you speak
  • Legs shake when you stand still
  • Trouble controlling your hands or arms, holding objects, or writing
  • Trouble doing daily activities such as brushing your teeth or shaving
  • Head nodding or shaking you cannot control
  • Shaking brought on or made worse by stress, fatigue, or chemicals such as caffeine
  • A feeling of shaking or trembling inside, even if your body does not shake

Contact your healthcare provider if:

  • You have new or worsening symptoms.
  • You have questions or concerns about your condition or care.


may not be needed. If your tremors are severe or keep you from doing daily activities, the following may help:

  • Medicines may be given to control tremors so you can do your normal activities more easily. Medicines will not completely control or stop the tremors, but they may help.
  • Deep brain stimulation is a procedure used if other treatments do not control your tremors. Electric stimulation is given to parts of the brain that control movement. The stimulation stops those parts of the brain from working.
  • Surgery may be used if your tremors are severe and medicines have not helped. Surgery may be used to destroy part of your thalamus. The thalamus is a part of the brain that control movement and coordination.

Manage your symptoms:

  • Go to occupational therapy as directed. An occupational therapist can help you find new ways to do your daily activities. For example, you may learn to use wrist weights during activities such as brushing your teeth. The weights can help steady your arms and hands.
  • Use assistive devices as directed. Weighted utensils can help you control your movements as you eat. Adaptive equipment, such as a trackball mouse, for the computer can help make computers easier to use. It may also help to install voice recognition software on your computer. The software allows you to talk instead of using the keyboard to type. Electric appliances such as can openers and toothbrushes can make daily living activities easier. Ask your healthcare provider or occupational therapist for more information on assistive devices.
  • Wear clothing that is easy to put on and take off. Examples include shoes that do not need laces and shirts without buttons. You can also get a device to help you get buttons through the button holes.
  • Do not have caffeine. Caffeine can make tremors worse.
  • Do not smoke. Nicotine and other chemicals in cigarettes and cigars can make tremors worse. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
  • Manage stress. Stress can trigger tremors or make them worse. Find ways to manage stress, such as deep breathing, listening to music, or getting a massage. Talk to your healthcare provider if you need help to control anxiety.
  • Ask about medicines. Some medicines can make tremors worse. An example is cold medicines. Talk to your healthcare provider about all the medicines you take.
  • Keep a record of your tremors. Include when the tremors happened, and how long they lasted. List anything you think might have triggered the tremors or made them stop. It might be helpful to include any foods or drinks you had that contained caffeine or were unusual for you. Bring the record with you to your follow-up appointments.

Follow up with your healthcare provider as directed:

You may be referred to a neurologist (nerve specialist). Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.