Essential tremor occurs when parts of your body begin to shake against your control, usually the hands, though the head or voice may be affected. This is the "tremor" part – the "essential" part basically means this is not linked to a serious disease or any medical condition such as Parkinson's disease. It's a neurological condition that occurs out of the blue and begins with signals in the brain leading to the nervous system.
Essential tremors usually affect both hands from the beginning and become more pronounced with movement. With the hand, it's more obvious when you carry out simple tasks like carrying a drink or writing something down. They typically get worse over time, and for some people, it can really affect their day-to-day activities.
Essential tremors can be caused by a genetic mutation and can be inherited from one of your parents. It's more common in those over the age of 40. Stress and tiredness can make the symptoms worse, and alcohol can improve things (use this more as a diagnostic tool than a treatment).
Many people worry about Parkinson's disease, but they are very different diseases with different outcomes. Essential tremor is much more common than Parkinson's disease, there's usually a family history, and it typically starts around the age of 40, rather than in the 60s like Parkinson's.
We know that certain things provoke or magnify a tremor, such as stress, coffee, or tiredness. For this reason, addressing any of these is a good place to start.
It's a good idea to find things that relax or calm you down when you are in a stressful situation. Some people find talking to other people who also suffer from the same disease is helpful. If you suffer from stress or anxiety, talking to a therapist about your emotional or mental burden may bring on a feeling of being calm and in control.
Caffeine is a stimulant, which – along with any other stimulants – can exacerbate a tremor. It's a good idea to avoid it. Because alcohol is typically a depressant, it can make the situation better in the short term – you may have noticed this yourself. But it has the opposite effect in the longer term, as tolerance levels build and once the alcohol wears off, the tremor may be worse.
A physiotherapist may provide exercises to improve your strength and build up the coordination of your muscles.
This is a lifelong condition, so it's good to start managing it early on and making any changes you can to reduce symptoms.
Many people feel very self-conscious with a tremor when out in public – if this is causing you great difficulty, this is a reason to seek medical help. If you're finding it hard to get everyday tasks done or to do your job to your best ability, this is another reason to book a routine appointment with your doctor.
Many people worry that a tremor may be the start of Parkinson's disease. You should book an appointment with your doctor if this is playing on your mind, or if you have any other symptoms, such as a change to how you're walking, speaking, or writing. Your doctor can usually tell the two apart from examining you, as essential tremor occurs on movement and Parkinson's tremor occurs at rest, among other signs.
Your doctor will ask about your symptoms, your family history, and any medications you have started. They will then examine your nervous system and ask you to carry out certain movements. They may do some blood tests to rule out other causes, but there are no medical tests that can diagnose essential tremor.
Your doctor may consider prescribing medication to ease symptoms. Beta-blockers, normally used to treat high blood pressure or anxiety, as well as some anti-epileptic or sedative medication, may prove helpful for you, but it's a trial of treatment. Surgery is occasionally considered if problems are severe, but other methods are tried first.
If your symptoms affect your day-to-day activity, they may affect your ability to work. It may be worthwhile speaking to your doctor to consider some work-based adjustments or taking time off until you are able to manage your symptoms better.
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