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The name “essential tremor” can be misleading because it makes people think essential tremor is a condition they must learn to live with, rather than a treatable condition.
If you are experiencing the symptoms of essential tremor, a movement disorders specialist can help confirm your diagnosis and provide customized treatment.
There are a variety of treatments available for addressing essential tremor and non-invasive options are always considered first.
Living with a movement disorder brings everyday activities into sharp focus. Getting dressed, brushing your teeth and pouring a cup of coffee become challenges rather than routines. People living with these life-altering conditions often share a common goal: regaining control of their movements so they can feel confident taking on each new day.
The most common movement disorder is essential tremor, a progressive disease that causes tremors in the hands and head and occasionally affects the voice. It impacts many of the activities we take for granted, like writing, drinking, eating and working with tools. And it can potentially rob people of their livelihood. An estimated 7 million Americans live with varying degrees of essential tremor.
To better understand essential tremor and its causes, symptoms and treatments, we spoke with Dr. Pravin Khemani, the medical director of the movement disorders program at the Swedish Neuroscience Institute.
What is essential tremor?
“There is a lot of misinformation about essential tremor, partly because the name does not do it any justice,” says Dr. Khemani. “These tremors are not ‘essential’ at all — we call them ‘essential’ because the tremor is the primary concern unlike, for example, Parkinson disease, where patients may have a multitude of both motor and non-motor symptoms in addition to the tremor.”
Dr. Khemani adds that many people are under the impression that essential tremor is an ordinary sign of aging and think it is just something they have to put up with. And while there is no cure for essential tremor, there are very effective treatments that can help patients living with it.
How to identify essential tremor symptoms
Essential tremor causes shaking in different areas of the body, but it primarily affects the hands and arms. Essential tremor can mimic the tremor caused by Parkinson’s disease and it can be exacerbated by caffeine, heightened emotions, stress and tiredness.
Signs of essential tremor include:
- Rhythmic shaking in the arms, hands, legs or midsection of the body that begins gradually and can intensify with movement or stress.
- Shaking of the head that results in a repeated “yes” or “no” motion.
- A shaky voice caused by a tremor in the voice box that makes your speech quiver.
- Hand tremors that make it difficult to do things like eat, drink, write, drive, hold tools or play musical instruments.
Essential tremor symptoms often get worse with age, which is one reason it is incorrectly attributed to a natural consequence of aging.
Dr. Khemani emphasizes that patients who are experiencing any kind of tremor should seek an evaluation with either a general neurologist or a movement disorders specialist.
“We can help patients with undefined or progressive tremors, as well as patients whose tremors are not responding to medicine, ensure they get the correct diagnosis and a treatment plan which works for them,” he says.
Patient education is step number one
Patients in the Swedish Movement Disorders program can expect treatment that is fully focused on improving their quality of life, no matter where they are in their journey with essential tremor.
“The first thing we do with all new patients is to listen carefully and thoroughly review their medical history to understand their experience prior to seeing us,” says Dr. Khemani. “We want to cover everything — how long they’ve had symptoms, what medications they are taking, if those medications are streamlined and optimized, and if their primary care is up-to-date.”
“As movement disorder specialists, we want to demystify the condition for patients,” he adds. “We can make sure their diagnosis is accurate, and that they understand their condition and all of their treatment options so they can make informed choices and participate in their own health care.”
How movement disorder specialists treat essential tremor
The program’s collaborative model includes working with other Swedish services such as neurosurgery, physical therapy, rehabilitation, neuropsychiatry, neuropsychology, palliative care, hospice and cognitive specialists to provide multidisciplinary treatment for essential tremor.
“Very mild tremors that do not interfere with daily tasks may only need annual or biannual monitoring,” says Dr. Khemani. “But once the tremor becomes bothersome, it’s time to consider treatment options and make sure you have all the information you need to make an informed decision.”
Treatment for essential tremor is always customized for each patient to make sure it is aligned with their lifestyle and any other conditions they may have. Options include:
- Medications including beta blockers, anti-seizure medications, anti-anxiety medications and Botox injections in selected cases
- Cala Trio therapy, an FDA-approved, wearable electrical device that stimulates the hand to diminish the tremor
- Surgical treatments, including deep brain stimulation and MRI-guided focused ultrasound, which are done in collaboration with Swedish neurosurgeons
Surgery is only considered if the tremor is not responding to medication or therapy.
Care that improves quality of life
“There is a lot that can be done for essential tremor,” says Dr. Khemani. “We’ll always do everything to make sure you understand your options and feel confident in your decisions, so you can get timely intervention that is critical to restoring your quality of life.”
Learn more and find a provider
If you have questions about essential tremor or other movement disorders, contact the Swedish Movement Disorders program. We can accommodate both in-person and virtual appointments.
Join our Patient and Family Advisory Council.
This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.