Noticeable shaking when you write, drink, or hold a cup? That’s often essential tremor (ET). It's one of the most common movement disorders and usually shows up as a rhythmic shake during movement or when maintaining a position. ET can be mild or so strong it gets in the way of everyday tasks. The good news: there are real options to reduce shaking and regain control.
ET typically affects the hands, head, or voice. Shaking happens when you try to use a muscle (an action tremor) or hold your arms out. Unlike Parkinson's, ET usually doesn't cause slowness or stiffness. Family history matters — many people inherit it. Things that make tremor worse include stress, caffeine, lack of sleep, and some medicines. Doctors often diagnose ET from how you move and a short exam. Simple tests like thyroid checks or a medication review help rule out other causes.
Onset can happen at any age, but symptoms often get worse with time. For most people, ET is not life-threatening. Still, it can be frustrating or embarrassing, and some people need treatment because it interferes with work, cooking, or personal care.
First-line medicines that doctors commonly try are propranolol (a beta-blocker) and primidone (an anti-seizure drug). Both reduce tremor for many people, but side effects can occur, so your doctor will tailor the choice. If medications don’t help enough, options include botulinum toxin injections for head or voice tremors, or advanced procedures like deep brain stimulation (DBS) and MR-guided focused ultrasound for severe cases. These can give big improvements but come with trade-offs and require specialist care.
There are also quick practical fixes you can use today: cut back on caffeine, try weighted utensils or wrist weights, and work with an occupational therapist to learn adaptive tools and techniques. Alcohol can briefly reduce tremor for some, but it’s not a safe long-term strategy. Regular sleep, stress management, and light strength training often help overall control.
See a doctor if tremor starts suddenly, gets worse fast, or comes with other symptoms like slowed movement, numbness, or balance problems. Ask about medication interactions if you already take drugs for blood pressure, mood, or seizures. If you need help deciding between treatments, a neurologist who specializes in movement disorders can walk you through the risks and benefits.
Living with essential tremor means combining medical options with hands-on tools and small lifestyle changes. Many people find substantial improvement by mixing a medicine that suits them with practical supports at home and work. If shaking is holding you back, reach out for a focused evaluation — better control is often within reach.
