What is Essential Tremors

What is Essential Tremor?

Essential tremor especially tremors of the hands is the most common neurological movement disorder. It affects up to 10 million people in the United States. This nerve disorder is characterized by shaking, trembling or tremors, in different parts of the body and sometimes on different sides of the body.  The most common affected areas are:

  • hands
  • arms
  • head
  • voice
  • tongue
  • chin
  • The lower body is rarely affected by essential tremors.

Other Names for Hand Tremors

Essential tremor has also been known as:

  • Benign Essential Tremor, (a term that is now obsolete as the life changing condition does have a tendency to progress)
  • Familial Essential Tremor,
  • Hereditary Tremor
  • it is known by its initials ET.

ET disorder can have a lot of variations in how it presents and progresses. It can start at almost any age but most commonly in those who are over 40 years old. A lot of us have first experienced essential tremor symptoms in our early teen years.

There are many cases of tremors having affected the hands or arms slowly progressing to affect other areas of the body, most often the head. This progression of tremors is usually quite slow and may not occur at all.

Some people with Essential Tremors have an “internal tremor”, they have described this feeling has shakiness inside of their body. These internal tremors cannot be seen by someone observing.

How Hand Tremors Occur

Tremors occur in different ways and can change as to how fast or slow they tremors move. Tremors may vary from day to day. Some days they might be very noticeable to other days when your tremors may be barely perceptible. Tremors often get worse with movement and will be aggravated by stress, fatigue, and your emotional state…especially a fight or flight response causing a rush of adrenaline. Moments of intense emotion or conflict can make tremors much much worse such as in public speaking, performances, or arguments. Low blood sugar levels and heavy use of caffeine can also affect tremors.

Primary symptoms that are related to essential tremor:

  • Uncontrollable trembling that happens for brief or extended lengths of time
  • Tremors that get worse during times or moments of stress like emotional confrontations, activities that cause an adrenaline rush.
  • Tremors that get worse with skilled or finesse movements like writing, eating, putting on makeup.
  • Uncontrolled nodding or turning of the head
  • Shaky voice
  • Tremors tend to stop when that part of the body is relaxed or at rest

Some of the most common problems related to hand tremors occur when trying to make fine movements that involve a degree of finesse.

Examples of these are:

  • pouring a drink,
  • carrying a cup of liquid, or using various utensils,
  • tying shoelaces,
  • drawing,
  • writing,
  • putting on makeup,
  • eating meals,
  • using the mouse on a computer and using your touchscreen phone with accuracy.
  • There are thousands of examples limited only by the number of daily tasks and life skills that we all need to accomplish.

Other problems associated with hand tremor.

Other problems associated with ET are social and psychological. Because this is a visible shaking it can cause difficulty with normal daily activities and can dramatically affect persons quality of life.

  • The self-conscious awareness of being seen shaking by others can cause someone to avoid social situations due to the anxiety of what others may think
  • There can be frustration with feeling compelled to explain, combined with some personal embarrassment
  •  all of these and more, make hand tremors or essential tremors a problematic issue to deal with in life.

When are hand tremors the worst?

Generally speaking essential tremors only occur when you are trying to do something. When your body or hands and arms are relaxed the tremors subside.

What is essential tremor caused by?

This is where information from the medical community gets kind of foggy. In some cases the tremors start for no apparent reason, they can't be connected to a family history or any particular event in a persons life. In many cases essential tremors run in families. If you have a close relative with essential tremor, you are more than four times as likely to develop a tremor than the rest of the population. But in truth there's really not that much data to be very conclusive. One thing you can be sure of though, if you look at your hands and their shaking for no reason, you may have essential tremors and you should see a doctor to be correctly diagnosed!

For hand tremor treatment options check out this post: Treatment of Hand Tremors

If you want to go way down the rabbit hole on this subject check out the sources below.

Let me know what you think.

I would love to hear from my https://handtremor.com readers! If you or someone you know has hand tremors please leave a comment below. Any questions? I've got a lot of life experience dealing with this issue. I'm not a doctor, (nor have I ever played one on TV;) but I'd be delighted to offer support and encouragement to anyone like me with ET!



Louis ED. Treatment of essential tremor: are there issues we are overlooking? Front Neurol. 2011;[Epub 2012]. http://www.ncbi.nlm.nih.gov/pubmed/22275907

Louis ED, Agnew A, Gillman A, Gerbin M, Viner AS. Estimating annual rate of decline: prospective, longitudinal data on arm tremor severity in two groups of essential tremor cases. J Neurol Neurosurg Psychiatry. 2011;82:761-765. http://www.ncbi.nlm.nih.gov/pubmed/21436230

Abboud H, Ahmed A, Fernandez HH. Essential tremor: choosing the right management plan for your patient. Cleve Clin J Med. 2011;78:821-828. http://www.ncbi.nlm.nih.gov/pubmed/22135272

Benito-Leon J, Louis ED. Update on essential tremor. Minerva Med. 2011;102:417-440. http://www.ncbi.nlm.nih.gov/pubmed/22193375

Zesiewicz TA, Elble RJ, Louis ED, et al. Evidence-based guidelines update: treatment of essential tremor: report of the Quality of Standards subcommittee of the American Academy of Neurology. Neurology. 2011;77-1752-1755. http://www.ncbi.nlm.nih.gov/pubmed/22013182

Crawford P, Zimmerman EE. Differentiation and diagnosis of tremor. Am Fam Physician. 2011;83:697-702. http://www.ncbi.nlm.nih.gov/pubmed/21404980

Louis ED. Essential tremors: a family of neurodegenerative disorders? Arch Neurol. 2009;66:1202-1208. http://www.ncbi.nlm.nih.gov/pubmed/19822775

Lyons KE, Pahwa R. Deep brain stimulation and tremor. Neurotherapeutics. 2008;5:331-338. http://www.ncbi.nlm.nih.gov/pubmed/18394574

Louis ED, Vonsattel JP. The emerging neuropathology of essential tremor. Mov Disord. 2008;23:174-182. http://www.ncbi.nlm.nih.gov/pubmed/17999421

Benito-Leon J, Louis ED. Essential tremor: emerging views of a common disorder. Nat Clin Pract Neurol. 2006;2:666-678. http://www.ncbi.nlm.nih.gov/pubmed/17117170

Johns Hopkins Medicine Movement Disorders Center: "What is Essential Tremor?"

U.S. National Library of Medicine.

McKusick VA., ed. Online Mendelian Inheritance in Man (OMIM). Baltimore. MD: The Johns Hopkins University; Updated 2/11/2016: http://omim.org/entry/190300

McKusick VA., ed. Online Mendelian Inheritance in Man (OMIM). Baltimore. MD: The Johns Hopkins University; Updated: 05/02/2012: http://omim.org/entry/602134

McKusick VA., ed. Online Mendelian Inheritance in Man (OMIM). Baltimore. MD: The Johns Hopkins University; Updated:05/02/2012. http://omim.org/entry/611456


Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this Website. If you think you may have a medical emergency, call your doctor, go to the emergency department, or call 911 immediately.

6 thoughts on “What Is Essential Tremor?”

  1. This is a very informative article. I’m so glad you chose to research and share this information. It would be great if everyone could read it, then the world would be more understanding. My hands used to shake all the time, especially under stress. My doctor told me to quit eating wheat. No more tremors, except for extreme stress. Not everyone can just make a diet change. Thank you for covering this valuable subject.

    1. Thank you Cathy for sharing your experience, and for your very kind words! I’m so glad you found a solution that works. I’m sure there are a lot of different “medical” problems that can be corrected by eating the right food. It’s so good that your doctor actually recommended “stop eating wheat”. Most doctors I’ve seen have very little desire to recommend a non-drug solution. You’ve got a good doctor!

  2. Very interesting and well researched. I was wondering if you go see a doctor and he diagnoses you, what will he advice to do? Is there a treatment? As you describe very clearly, tremors are not only making it difficult to do things, they also might make you socially awkward and avoid social relationships which might in the end weaken your psycological situation and even worsen the tremors. Is there any hope?
    Thank you so much, Jana

    1. Hi Jana and thanks for the comments and questions! Last question first, yes there is always hope, but this is an individual choice in my opinion. There are some emerging treatments but generally only for the most severe cases. When someone is diagnosed with tremors, they have already begun to feel the strained social awkwardness that comes with them, and yes the anxiety produced can worsen the tremor. I personally had to start recognizing just how many people have other handicaps that they deal with cheerfully everyday and that are much more debilitating than tremors. Having a positive perspective on things really helps insulate your mind from depression and pity parties.

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