Essential tremor

Essential tremor (ET) is a neurological movement disorder that is most commonly characterised by a rhythmic trembling of the hands, although it can also affect the head, voice, trunk and legs.

It is sometimes confused with Parkinson’s disease, but it is 8–10 times more common than Parkinson’s. Essential tremor affects over one million people in the UK.

For people with essential tremor, doing simple, everyday tasks such as drinking, eating, writing or even using a touchscreen phone can become extremely difficult and frustrating.

What is essential tremor?

Essential tremor is a chronic condition affecting the nervous system. Anyone of any gender, age or race can get essential tremor, although it is more commonly diagnosed in older adults over 40. 

There are many different types of tremor, but essential tremor is the most common of the  movement disorders.

Essential tremor is characterised by involuntary, rhythmic shaking that is more pronounced when the individual is more active. This is called ‘kinetic tremor’ because the person experiences the tremor while performing any movement. ‘Postural tremor’ is also common. This is involuntary shaking while trying to maintain a still position (such as stretching out your arm). 

Essential tremor is a chronic, progressive condition. This means there is no known cure, and it can get progressively worse over time, although the rate of progression is often slow. The condition is highly variable, with some individuals only experiencing a mild tremor that can be managed with medication, whereas others might have a moderate to severe tremor that requires more intensive treatment. 

Although it is not life-threatening, essential tremor can have a debilitating impact on your quality of life. If you or your loved one might have essential tremor, it is important to seek treatment from a neurologist to get a correct diagnosis and learn more about your treatment and management options. 

Essential tremor symptoms

If you have essential tremor, you might experience some of the following signs and symptoms:

  • You might find that your tremor begins gradually, often in one or both hands
  • Your tremor is more noticeable when you are moving
  • Both sides of your body are not affected by tremor in the same way
  • You might have uncontrollable head nodding or shaking 
  • You may experience a shaking or trembling voice
  • Certain medications, caffeine, fatigue, anxiety or stress can worsen your tremor
  • A small amount of alcohol consumption can improve your tremor

Less commonly, you may find that you have tremors in your legs and feet.

Essential tremor causes

It is not entirely known what causes essential tremor, but we do know it runs in families. 

If your parent has essential tremor, you have a 50% chance of developing the disorder regardless of your sex. In familial cases (those where essential tremor is hereditary), the onset of the condition tends to occur earlier. 

Essential tremor can affect anyone of any age, sex, race or ethnicity. However, it is more commonly diagnosed in older people over 40.

Essential tremor vs Parkinson's disease: what’s the difference?

Although there is a much higher awareness of Parkinson’s disease (PD) among the general public, essential tremor is 8–10 times more likely than Parkinson’s. 

Both are characterised by involuntary tremors, but there are key differences between these two neurological movement disorders. 


Essential tremor (ET) Parkinson’s disease (PD)
Tremors are primarily experienced during action (kinetic and postural tremor). Tremors are mostly experienced while at rest (rest tremor).
Tremors largely affect the hands, head, voice and, less commonly, the legs. Tremors affect the arms, legs, chin and jaw. The voice and head are rarely affected.
ET affects both sides of the body, although not in the same manner. PD tends to affect the body asymmetrically. It typically starts on one side and progresses to the other.
A family history of ET is common. A family history of PD is present in less than 10% of cases.
Onset typically occurs after 40, but it can occur in individuals of all ages, even in infancy. The average onset is between 55–65.
The level of disability varies among individuals. Some might experience an unsteady walk, but this is less common. PD can cause general slowness, stiffness, difficulty walking and poor balance.
The condition can be worsened by stress or anxiety. The condition can be worsened by stress or anxiety.


There are no tests that definitively test for either essential tremor or Parkinson’s disease, so the two are frequently confused. However, a neurologist (preferably an expert in movement disorders) should be able to accurately diagnose a patient based on their symptoms, family history, medication history and a comprehensive neurological exam.

Download our helpful guide and symptom diary to aid in your conversation with your neurologist.  

Essential tremor treatment

There is no cure for essential tremor, but there are various treatments that can help manage symptoms. Because ET affects people differently, your treatment plan should be personalised to you.

Coping with essential tremor

Essential tremor is a life-altering condition that can be both frustrating and embarrassing. In a 2020 survey of people living with essential tremor, 46% of respondents reported that they require help from others to eat and drink, and 57% said that ET has a negative effect on their mental health.

If the effects of essential tremor have gotten in your way of doing simple, everyday tasks, you might be a candidate for MR-guided focused ultrasound — a newly approved, safe and non-invasive treatment for essential tremor. 

Learn more about how MR-guided focused ultrasound has given many people with essential tremor the ability to regain control of their lives.

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