Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education website.

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Am Fam Physician. 2003;68(8):1553

What is essential tremor?

Essential tremor, sometimes called benign or familial tremor, is an uncontrollable shaking of the hands and forearms. You might notice this tremor when your arms are extended in front of your body. Tremor affects each person differently. Some people hardly notice it, but it embarrasses other people.

Who gets essential tremor and why?

No one knows why some people get essential tremor. It seems to run in families. You may be more likely to have a tremor if a parent or other close family member has a tremor. Tremor can start at any age but often happens in the teen years or in the 50s. It can get worse as you get older.

Are there different kinds of tremor?

Yes. Parkinson's disease causes a tremor that might be noticed when your hands are resting in your lap or at the sides of your body. A stroke can cause a tremor that gets worse when you reach for something. Thyroid problems or low blood sugar can cause a mild tremor. Tremor can be caused by some medicines, including heart medicines, decongestants, medicines for breathing problems, and tricyclic antidepressants. Drinks that contain caffeine also may cause tremor.

How can my doctor tell that I have essential tremor?

Tell your doctor if you notice that your head or your hands shake, or if your voice quivers. You may find yourself having trouble eating with a spoon or fork, drinking from a cup, threading a needle, or writing. The tremor may get worse with emotional or physical stress. Your doctor will do an exam to look for possible causes. If everything else is normal, you may be diagnosed with essential tremor.

How is essential tremor treated?

Your doctor will ask you to avoid caffeine, cold pills, and some other medicines if they seem to make your tremor worse. Your doctor may prescribe medicines such as beta blockers or primidone (brand name: Mysoline). Your tremor will not go away with these medicines, but it might be controlled enough to allow you to eat and drink in public without being embarrassed.

Where can I get more information?

Ask your doctor.

International Essential Tremor Foundation

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