Someone with essential tremor is troubled by erratic shaking of their arms and hands, which can prevent them doing everyday tasks easily.

Essential tremor

Essential tremor is different to a natural tremor. Almost everyone exhibits a tremor, particularly as they get older. It is usually not very noticeable, except when we are under stress. As we grow older, tremor becomes more pronounced as muscles and bones grow a little weaker. When shaking becomes more difficult to control and obvious to others, it may be that essential tremor, a recognised medical condition, is starting to develop.

Around 6% of us develop essential tremor and it occurs with equal frequency in men and women. Some people first develop symptoms between the ages of 35 and 45 but it becomes more common with old age. If you haven’t developed the symptoms of essential tremor by the age of 65, it is unlikely you ever will. However, cases have been diagnosed in newborn infants and symptoms do occasionally appear in teenagers.

We don’t fully understand why essential tremor develops but a genetic link has been identified; 50–70% of cases run in families. This means that children with parents who develop essential tremor are more likely to develop it themselves, later in life.

Types of essential tremor

The shaking that happens in someone with essential tremor can be kinetic or postural. Kinetic essential tremor affects someone when they are trying to move.

Postural tremor is more obvious when they are just trying to maintain their position against gravity – when they are trying to stand still in a queue, for example.  It tends to be much less of a problem when they are relaxed and at rest and is usually completely absent during sleep, or when really concentrating on a difficult task.

The symptoms of essential tremor affect the hands and arms, which shake in small, rapid movements more than five times per second. Tremor can also occur in:

  • The head: this happens in about a third of people who are affected, causing either a repetitive nodding action, or an obvious side-to-side head shake
  • The voice box: this makes the voice tremble and can cause great self-consciousness
  • The tongue and palate: this makes it difficult to speak and get words out properly

Does essential tremor get worse?

It can do: essential tremor is often progressive. It may begin as an intermittent tremor in one hand, eventually becoming constant and also then affects the other hand and arm. If you have it very badly, your symptoms can also start to affect your legs and even your whole body will shake. This doesn’t always happen – some people find that their symptoms remain mild and never get any worse.

Essential tremor can be more pronounced on some days than others; getting hungry, feeling tired and being too hot or too cold can all make it worse. Some people find that avoiding drinking coffee and alcohol, and stopping smoking can help as stimulants also tend to exacerbate the tremor.

The symptoms of essential tremor can also lead to a great deal of frustration over not being able to perform simple tasks. It’s perhaps not surprising that people with essential tremor have an increased risk of depression.