6 Proven Ways to Treat Essential Tremor

Are you among the 7 million Americans who have essential tremor? If your hand shakes involuntarily, or another part of your body trembles, you may have essential tremor.

Essential tremor (ET) can be confused with Parkinson’s disease, but ET is different and much more common. A health care clinician can tell the difference between the two conditions.

Both women and men of any age can be affected by ET, but it’s more common in middle age and later in life. The tremors can affect your arms, legs, trunk, head and even your voice.

We don’t have a definitive cure for essential tremor. If the symptoms are mild, you may not even need a treatment.

If the symptoms affect your daily activities, work or your quality of life, discuss your concerns with your health care clinician.

How Is Essential Tremor Treated?

If the tremors are mild, some simple lifestyle changes may help:

1. Follow an appropriate sleep schedule. For some people, physical exhaustion can cause tremors.

2. Try relaxation techniques. This can work well for tremors brought on by stress or heightened emotions.

If the condition is more problematic, your clinician may do some tests to find the underlying cause. Depending on the cause, additional treatment options may be available:

3. Employ occupational therapy. An occupational therapist can help you adjust to living with the tremors. Some simple changes can make life easier. Use eating utensils with larger handles. Wearing wrist weights to stabilize the hand. Select clothes that are easy on and off — no buttons!

4. Avoid aggravating substances. Medications (like certain antidepressants, antiepileptics or inhalers) or foods (caffeine, energy drinks) can worsen tremor. Ask your doctor if any of your medications could be the source of your problems.

5. Take prescribed medications. Based on the underlying cause, we’ll recommend a good option. A good result with medication would be reduction in tremor by about 50%.

• Propranolol. This is a beta blocker. These meds are commonly used to treat high blood pressure. Don’t use beta blockers if you have asthma or a heart problem. Side effects can include fatigue and lightheadedness.
• Primidone. This anti-seizure drug is typically used to treat epileptic seizures. Side effects can include short-term drowsiness, concentration problems or nausea.
• Botox. This injectable drug is an accepted treatment for conditions such as migraine, bladder dysfunction and excessive sweating. It can also be used to treat hand, head or voice tremors. When used for hand tremors, you may notice finger or wrist weakness. When used for voice tremors, Botox can cause a raspy voice or swallowing difficulties.
• Various other medications can be tried including clonazepam, gabapentin, topiramate, zonisamide although these are generally less effective.

6. Utilize surgical treatments. These methods are used for bothersome or disabling tremor that is not adequately managed on medication. A good result with surgery would be elimination or near elimination of tremor.

• Deep Brain Stimulation. This is the most effective and most proven tremor therapy and frequently can result in tremor freedom.  A thin wire is surgically implanted into a deep region of the brain that is involved in generating tremor.  Electrical stimulation delivered at the tip of the wire is adjusted by your doctor and powered by a battery pack placed in the chest.  Deep Brain Stimulation offers the ability to treat tremor on both sides and can be adjusted over time.  There are risks of bleeding, infection, speech or balance issues with the surgery.
• Focused X-rays or Ultrasound. During stereotactic radiosurgery, the surgeon directs X-rays or Ultrasound at the specific part of the brain that’s the source of the tremors. Special imaging technology helps direct the X-rays to the precise target.  These techniques are limited to only treating one arm rather than both arms and cannot be adjusted after they are done.

If you have additional questions about essential tremor, make an appointment with your health care clinician online.