Understanding the most common tremor
Your hands shake when you’re trying to tie your shoelaces or hold a fork at dinner. This is a classic sign of essential tremor, a nervous system disorder that causes involuntary and rhythmic movement. Though most people more readily associate tremors with Parkinson’s disease, this benign essential tremor is actually more common.
Essential tremor isn’t a dangerous disorder, but it can take a toll on your quality of life. You may find it difficult to perform simple tasks, such as writing a letter or shaving. In severe cases, essential tremor can cause disability.
Experts aren’t exactly sure why essential tremor occurs. A large percentage of people diagnosed with essential tremor have a family history of it, suggesting genetics may play a role. Environmental factors are thought to have an impact, as well.
Essential tremor typically is noticed when you use your hands, with the tremor worsening at the end of the action — for example, when your hand finally connects with the glass of water you’re reaching for at the dinner table. Stress, fatigue, caffeine and extreme temperatures can worsen symptoms. Tremors tend to be focused in the hands, voice and head. If your head is affected, you may notice a “yes-yes” or “no-no” motion. Unlike Parkinson’s, essential tremor usually doesn’t cause other health problems. However, some people with essential tremor may develop an unsteady gait.
While there’s no specific test for essential tremor, your doctor may take a history of your symptoms, perform a physical exam, and order blood or urine tests to rule out other conditions. You may be asked to draw a spiral, hold your arms outstretched or take a sip from a glass of water so your doctor can note how your tremor responds.
People with essential tremor don’t always require treatment, particularly if symptoms are mild. But for those with tremors affecting the way they work or live, treatment options include:
■ Medication — Beta blockers, anti-seizure drugs, sedatives and onabotulinumtoxin A (Botox) injections to relieve tremors.
■ Therapy — Physical or occupational therapy to build muscle strength and control.
■ Surgery — Deep brain stimulation, which can short-circuit signals that are causing tremors in people with severe or unresponsive symptoms. Focused ultrasound is a new technique that’s being used to treat essential tremor.
If you have essential tremor, you may be able to change your lifestyle to help control the condition. Strategies can include avoiding caffeine and stimulants, using relaxation techniques such as meditation.