Medical Reviewer: Dhira Khosla D.O.
Essential tremor and Parkinson’s disease are both adult-onset tremor disorders that can be characterized by shaking that affects daily life. If you have one of these conditions, you may find it difficult to hold onto items, struggle to write normally, and notice your hands shaking uncontrollably. However, beyond that, there are many key differences.
If you believe you may suffer from one of these conditions, this guide can help you better understand the signs that you may have Parkinson’s disease or essential tremor, how each is diagnosed, and what the treatment process entails. If you have questions about a certain aspect of these conditions, use the links below to navigate to its specific section:
Defining the Condition: Parkinson’s vs. Essential Tremor
Parkinson’s Disease: According to the Parkinson’s Foundation, Parkinson’s disease is a “neurodegenerative disorder that affects predominantly dopamine-producing (“dopaminergic”) neurons in a specific area of the brain called substantia nigra”. Parkinson’s itself is not a fatal disease, however, it can have serious complications that can be.
- At what age does Parkinson’s usually manifest? Typically Parkinson’s typically manifests in individuals 50 years or older. However, Young Onset Parkinson’s (YOD), affects 2% to 10% of individuals in the U.S. with Parkinson’s.
- What is the prevalence of Parkinson’s disease? According to Nih.gov, approximately 1.8% of adults 65 and older suffer from Parkinson’s disease.
Essential Tremor: As defined by John Hopkins Medicine, essential tremor disorder is a neurological condition that causes your hands, head, trunk, voice, or legs to shake rhythmically. Generally, these tremors are worse when moving than when at rest. However, tremors can be severe enough to interfere with regular daily activities such as eating, speaking, and even using the restroom independently. Essential tremor is considered benign, or non-life-threatening.
- At what age does essential tremor usually manifest? Essential tremor typically affects individuals over the age of 65, however, it can develop at any age.
- What is the prevalence of essential tremor? According to Nih.gov, approximately 4.67% of adults 65 and older suffer from essential tremor.
Both of these conditions are progressive, meaning they typically develop slowly and worsen over time.
Causes: Parkinson’s vs. Essential Tremor
The cause is largely unknown for both Parkinson’s and essential tremor. However, there are theories about what may cause these conditions.
In regards to essential tremor, John Hopkins Medicine notes that there is a theory that the condition may be caused by miscommunication between the cerebellum (which controls motor coordination) and other parts of the brain. There is also believed to be a genetic predisposition for developing essential tremor. You may be 50% more likely to develop essential tremor if your parent has the condition.
It is also important to note that certain factors can also cause other types of tremors. For example, according to the National Institute of Neurological Disorders and Stroke, certain medications, thyroid overactivity, and toxins like lead and mercury can produce tremors that might be confused with this condition.
In regards to what causes Parkinson’s disease, the direct cause as to why specific individuals develop Parkinson’s is unknown. However, what happens within the body that causes Parkinson’s symptoms to manifest, is the gradual loss of brain cells that are responsible for producing dopamine. When this happens, it can interfere with normal body movement, leading to patients to exhibit the common symptoms of Parkinson’s.
Signs & Symptoms: Is It Essential Tremor or Parkinson’s?
In order to start managing your condition and receive the treatment you need, you should be aware of the most common signs and symptoms as well as the key differences between essential tremor andParkinson’s. After all, the first step in getting care as early on as possible is self-awareness that you might be suffering from one of these conditions.
Essential Tremor Symptoms
The most prominent symptom of essential tremor disorder is shaking. The fact that this shaking is worse when in action, known as a moving tremor, is a key difference between essential tremor and Parkinson’s. However, there are other symptoms that someone with essential tremor may display, including:
- Difficulty controlling hands when trying to complete tasks
- Head nodding (this is not typically exhibited by those with Parkinson’s)
- Quivering voice
In fewer cases, some essential tremor sufferers may also experience tremors in their legs and feet. One thing to note that might help you distinguish whether you’re suffering from essential tremor vs. Parkinson’s is that drinking alcohol may temporarily subdue the shaking associated with essential tremor. That said, alcohol consumption should not be treated as a solution for essential tremor, but noticing this change while drinking alcohol may aid in diagnosis.
Parkinson’s Disease Symptoms
According to Stanford Medicine, some of the most noticeable symptoms of Parkinson’s disease include:
- Stooped posture
- Short gait, characterized by shuffling feet
- Tremors in hands and legs
- Forward tilting of the upper body
- Limited arm movement
- Balance issues (which is not typically exhibited by patients with essential tremor)
One symptom of Parkinson’s disease is tremors at rest. However, it’s important to note that not every patient exhibits this symptom, which can make identification more difficult. Although not as common, patients with Parkinson’s disease can also experience action tremor. The Parkinson’s Foundation also notes that other, non-motor-related symptoms that commonly affect Parkinson’s sufferers include depression, sleep disorders, and constipation.
Diagnosing Parkinson’s vs. Essential Tremor
The difference between essential tremor and Parkinson’s can be so slight that it can be difficult for doctors to diagnose these conditions correctly. In fact, they are often mistaken for one another, which can be frustrating for physicians and patients alike. Specialty physicians that diagnose and treat these conditions are Movement Disorder Neurologists.
While there are no official tests for either condition, there are several diagnostic techniques that physicians employ to attempt properly diagnose essential tremor vs. Parkinson’s, including:
- Physical examination: During a physical examination, a physician evaluates the patient’s motor skills to help in their determination of whether they suffer from essential tremor vs. Parkinson’s.
- DaTscan: During a DaTscan, a radioactive tracer is injected, which makes its way into the brain, where it attaches to dopamine transporters. Special imaging scans are then conducted to see whether the dopamine system is healthy. If it is irregular, it may help diagnose your condition as Parkinson’s.
- Handwriting sample evaluation: A doctor may be able to differentiate Parkinson’s vs. essential tremor using a handwriting sample because those with Parkinson’s typically exhibit exceptionally small handwriting, whereas those with ET exhibit larger, shaky handwriting.
Getting Treatment: Essential Tremor vs. Parkinson’s Disease
There is currently no cure for essential tremor or Parkinson’s. However, that does not mean you have no control over your condition. As doctors learn more about these conditions, developments in treatment and disease management continue to help patients preserve their quality of life as much as possible.
Treatments for Essential Tremor
According to Harvard.edu, there are several actions that can be taken to help manage your essential tremor and minimize how they impact your daily life. First, let’s cover treatment options:
- Oral Medications: Propranolol (Inderal) and primidone (Mysoline) are considered to be the most effective treatments for essential tremor, reducing tremors as much as 50%. Propranolol is a beta-blocker and primidone is an anti-seizure medication.
- Surgical Treatment: In cases where essential tremor does not respond to medication, surgery may be recommended. There are invasive techniques, such as deep brain stimulation, that can be used to help reduce tremors. However, brain surgery is not without it’s serious risks.
- Non-Invasive Therapy with Cala Trio™: Cala Trio is a wrist-worn non-invasive therapy device that is calibrated to relieve hand tremors. It works by delivering surface stimulation at your wrist, which is believed to disrupt the central tremor network in your brain. In one clinical study, 64% of patients reported tremor relief and the average reported time was 94 minutes. Available only by prescription, the Cala Trio wrist-worn device provides on-demand tremor relief.
As each patient is different, you and your doctor will need to decide what the best course of action is for you. You must weigh the pros and cons of each treatment option based on your lifestyle and how you think they’ll impact your quality of life.
In addition to formal treatment methods, some of the ways you can manage your daily symptoms include:
- Holding your elbows close to your body to help minimize hand tremors
- Turning your head to the side to help with head tremors
- Avoiding caffeine when possible
- Using voice notes to record memos (this can also be an alternative to texting)
If you want to avoid medications or surgery, you can try implementing tactics like the management techniques above and Cala Trio’s non-invasive therapy device. Get started by scheduling a consultation with your doctor so they can help you determine what is the best solution for you.
Treatments for Parkinson’s Disease
While currently available Parkinson’s treatments cannot slow or halt the disease, they can help manage symptoms. According to the American Parkinson Disease Association, here are some of the most common treatment options:
- Oral Medications: As far as medications for Parkinson’s disease are concerned, Carbidopa/Levodopa are considered to be the most effective. However, it can also be used in combination with other medications as recommended by your doctor.
- Surgery: Similarly to essential tremor, deep brain stimulation is also a surgical treatment option for patients with Parkinson’s.
- Physical and Speech Therapy: In addition to medications, physical and speech therapy can help those with Parkinson’s maintain better control over their movements, voice level, and ability to speak clearly.
There are also lifestyle changes that you can make to help with your Parkinson’s symptoms, including:
- Practicing strength training to help with movement
- Stretching to help with rigidity
- Getting massages to relieve muscle stiffness and stress
- Eating a healthier diet to help with lethargy
While these are the most commonly recommended treatment options for Parkinson’s disease right now, there is a lot of effort and financial support toward finding new solutions, including clinical trials of medications.
Next Steps: Getting Care for Parkinson’s and Essential Tremor
If you believe you have Parkinson’s disease or essential tremor, don’t hesitate to seek professional care. Your doctor can help you diagnose your condition, find the right treatment plan for you, and manage your symptoms so you can enjoy the best quality of life possible. While suffering from a condition like essential tremor or Parkinson’s can be frightening, you don’t have to face it on your own.
MKG-1123 Rev A Feb 2021