Essential tremor often begins gradually. In a few cases it appears during adolescence, then goes into remission only to resurface later. More often, though, symptoms begin in mid- to late-life. The most common symptom is a trembling, up-and-down movement of your hands, although your arms, head and even your tongue and voice box (larynx) may also be affected. In general, you'll have tremors in both hands, but a small percentage of people have tremors in only one hand.
Tremors usually occur only when you engage in a voluntary movement, such as drinking a glass of water, writing or threading a needle. Actions requiring fine motor skills — using utensils or small tools, for example — may be especially difficult. Fatigue, anxiety and temperature extremes make symptoms worse, but tremors usually disappear when you're asleep or at rest.
Some people have relatively mild symptoms throughout their lives, while others develop more severe tremors and increased disability over time. Effects of worsening tremors may include:
- Difficulty holding a cup or glass without spilling
- Eating normally
- Putting on makeup or shaving
- Talking, if your voice box or tongue is affected
- Difficulty writing — handwriting may become increasingly large, shaky and illegible
- The inability to perform actions requiring fine motor skills, such as playing an instrument or
drawing
Essential tremor vs. Parkinson's disease
Many people associate tremors with Parkinson's disease, a serious movement disorder. But essential tremor and Parkinson's disease aren't related, and the two conditions differ in three key ways:
- Essential tremor of the hands typically occurs when your hands are in use. Tremor from
Parkinson's is most prominent when your hands are at your sides or resting in your lap.
- Essential tremor doesn't cause other health problems. Parkinson's, on the other hand, is
associated with a stooped posture, reduced swinging of the arms when walking, rigid limbs, slow
movement, speech problems other than tremor, and sometimes memory loss.
- Essential tremor can involve your hands, head and voice. Tremor from Parkinson's typically
affects your hands, but not your head or voice.
Genes are information centers in your cells that control your body's growth, development and function. Although the exact number is still in dispute, it's likely you have at least 30,000 genes. A mutation in just one of these genes can drastically alter the way your body works.
The following suggestions can sometimes help reduce or relieve tremors:
- Avoid caffeine. Caffeine can cause your body to produce more adrenaline, which may make
your tremors worse.
- Use alcohol sparingly. Some people notice that their tremors improve for up to an hour
after they drink alcohol, but drinking isn't a good solution for people with essential tremor. That's
because tremors tend to worsen once the effects of alcohol wear off. What's more, larger amounts of
alcohol eventually are needed to relieve tremors, which can lead to chronic alcoholism. If you have
essential tremor, it's best to drink sparingly or not at all.
- Perform special exercises. Your doctor may recommend working with a specialist to learn
exercises to promote more stability in your hands and wrists. These usually involve using 1- to
2-pound weights strapped to your wrists. You can continue doing these exercises at home.
- Consider joining a support group. For many people, essential tremor can have serious social
and psychological consequences. One study found that 60 percent of people with the disorder didn't
dine out, 30 percent didn't shop or use public transportation and 20 percent took early retirement. If
the effects of essential tremor are making it hard to live your life as fully as you once did,
consider joining a support group for people with the disorder. Support groups aren't for everyone, but
you may find it helpful to have the encouragement of people who understand what you're going through.
Or you might want to consider seeing a counselor or social worker who can help you meet the challenges
of living with essential tremor.
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November 1, 2002 —
