Essential tremor is a nervous system (neurological) disorder that causes involuntary and rhythmic shaking. It can affect almost any part of your body, but the trembling occurs most often in your hands — especially when you do 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 signs and symptoms:
- Begin gradually, usually more prominently 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 you use your hands. Tremors from Parkinson's disease are most prominent when your hands are at your sides or resting in your 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 your hands, head and voice. Parkinson's disease tremors usually start in your hands, and can affect your legs, chin and other parts of your body.
From Mayo Clinic to your inbox
Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Click here for an email preview.
ErrorEmail field is required
ErrorInclude a valid email address
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.
Thank you for subscribing!
You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox.
Sorry something went wrong with your subscription
Please, try again in a couple of minutes
About half of essential tremor cases appear to result from altered DNA. This form is referred to as familial tremor. It isn't clear what causes essential tremor in people who don't have familial tremor.
Autosomal dominant inheritance pattern
Autosomal dominant inheritance pattern
In an autosomal dominant disorder, the altered gene is a dominant gene located on one of the nonsex chromosomes, called autosomes. You need only one altered gene to be affected by this type of disorder. A person with an autosomal dominant disorder — in this case, the father — has a 50% chance of having an affected child with one altered gene. The altered gene is known as the dominant gene. The person has a 50% chance of having an unaffected child with two typical genes, known as recessive genes.
Known risk factors for essential tremor include:
Altered gene. The inherited variety of essential tremor (familial tremor) is an autosomal dominant disorder. An altered gene from just one parent is needed to pass on the condition.
If you have a parent with an altered gene for essential tremor, you have a 50% chance of developing the disorder yourself.
- 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, you might find it difficult to:
- Hold a cup or glass without spilling
- Eat without shaking
- Put on makeup or shave
- Talk, if your voice box or tongue is affected
- Write legibly
Essential tremor care at Mayo Clinic
May 04, 2022
- Essential tremor information page. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/All-Disorders/Essential-Tremor-Information-Page. Accessed Dec. 7, 2021.
- The facts about essential tremor. International Essential Tremor Foundation. https://essentialtremor.org/resource/the-facts-about-essential-tremor/. Accessed Dec. 7, 2021.
- Chou KL, et al. Surgical treatment of essential tremor. https://www.uptodate.com/contents/search. Accessed Dec. 7, 2021.
- Spindler MA, et al. Overview of tremor. https://www.uptodate.com/contents/search. Accessed Dec. 7, 2021.
- Ferri FF. Essential tremor. In: Ferri's Clinical Advisor 2022. Elsevier; 2022. https://www.clinicalkey.com. Accessed Dec. 7, 2021.
- 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.
- 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.
- Coping tips for everyday living. International Essential Tremor Foundation. https://essentialtremor.org/resource/coping-tips-for-everyday-living/. Accessed Dec. 7, 2021.
- AskMayoExpert. Essential tremor (adult). Mayo Clinic; 2021.
- Essential tremor. National Organization for Rare Disorders. https://rarediseases.org/rare-diseases/essential-tremor/. Accessed Dec. 7, 2021.
- Braswell Pickering EA. Allscripts EPSi. Mayo Clinic. Dec. 20, 2021.
- Reis C, et al. Essential tremor amplitude modulation by median nerve stimulation. Scientific Reports. 2021; doi:10.1038/s41598-021-96660-6.
- 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.