Essential tremor is a nervous system condition, also known as a neurological condition, that causes involuntary and rhythmic shaking. It can affect almost any part of the body, but the trembling occurs most often in the hands, especially when doing simple tasks, such as drinking from a glass or tying shoelaces.

Essential tremor is usually not a dangerous condition, but it typically worsens over time and can be severe in some people. Other conditions don't cause essential tremor, although essential tremor is sometimes confused with Parkinson's disease.

Essential tremor can occur at any age but is most common in people age 40 and older.


Essential tremor symptoms:

  • Begin gradually, and usually are more noticeable on one side of the body.
  • Worsen with movement.
  • Usually occur in the hands first, affecting one hand or both hands.
  • Can include a "yes-yes" or "no-no" motion of the head.
  • May be aggravated by emotional stress, fatigue, caffeine or temperature extremes.

Essential tremor vs. Parkinson's disease

Many people associate tremors with Parkinson's disease, but the two conditions differ in key ways:

  • Timing of tremors. Essential tremor of the hands usually occurs when using the hands. Tremors from Parkinson's disease are most noticeable when the hands are at the sides of the body or resting in the lap.
  • Associated conditions. Essential tremor doesn't cause other health problems, but Parkinson's disease is associated with stooped posture, slow movement and dragging the feet when walking. However, people with essential tremor sometimes develop other neurological signs and symptoms, such as an unsteady walk.
  • Parts of the body affected. Essential tremor mainly involves the hands, head and voice. Parkinson's disease tremors usually start in the hands, and can affect the legs, chin and other parts of the body.

From Mayo Clinic to your inbox

Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Click here for an email preview.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.


About half the people with essential tremor appear to have an altered gene. This form is referred to as familial tremor. It isn't clear what causes essential tremor in people who don't have familial tremor.

Risk factors

Known risk factors for essential tremor include:

  • Altered gene. The inherited variety of essential tremor, known as familial tremor, is an autosomal dominant disorder. An altered gene from just one parent is needed to pass on the condition.

    Anyone who has a parent with an altered gene for essential tremor has a 50% chance of developing the condition.

  • Age. Essential tremor is more common in people age 40 and older.


Essential tremor isn't life-threatening, but symptoms often worsen over time. If the tremors become severe, it might be difficult to:

  • Hold a cup or glass without spilling.
  • Eat without shaking.
  • Put on makeup or shave.
  • Talk, if the voice box or tongue is affected.
  • Write legibly.

March 29, 2023
  1. Essential tremor. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/health-information/disorders/essential-tremor. Accessed Feb. 8, 2023.
  2. The facts about essential tremor. International Essential Tremor Foundation. https://essentialtremor.org/resource/the-facts-about-essential-tremor/. Accessed Dec. 7, 2021.
  3. Chou KL, et al. Surgical treatment of essential tremor. https://www.uptodate.com/contents/search. Accessed Feb. 9, 2023.
  4. Spindler MA, et al. Overview of tremor. https://www.uptodate.com/contents/search. Accessed Feb. 9, 2023.
  5. Ferri FF. Essential tremor. In: Ferri's Clinical Advisor 2023. Elsevier; 2023. https://www.clinicalkey.com. Accessed Feb. 9, 2023.
  6. Jankovic J, et al., eds. Parkinson disease and other movement disorders. In: Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed Dec. 7, 2021.
  7. Giordano M, et al. Comparison between deep brain stimulation and magnetic resonance-guided focused ultrasound in the treatment of essential tremor: A systematic review and pooled analysis of functional outcomes. Journal of Neurology, Neurosurgery and Psychiatry. 2020; doi:10.1136/jnnp-2020-323216.
  8. Coping tips for everyday living. International Essential Tremor Foundation. https://essentialtremor.org/resource/coping-tips-for-everyday-living/. Accessed Dec. 7, 2021.
  9. AskMayoExpert. Essential tremor (adult). Mayo Clinic; 2022.
  10. Karamesinis A, et al. Wearable peripheral electrical stimulation devices for the reduction of essential tremor: A review. IEEE Access. 2021; doi:10.1109/access.2021.3084819.
  11. Ami T. Allscripts EPSi. Mayo Clinic. Jan. 10, 2023.
  12. Reis C, et al. Essential tremor amplitude modulation by median nerve stimulation. Scientific Reports. 2021; doi:10.1038/s41598-021-96660-6.