Essential Tremor

Physical/Psychological Measures/Lifestyle Changes

Physical and psychological measures as well as certain lifestyle changes may be helpful in managing mild tremor. Physical measures may include the application of weights to affected limbs to decrease tremor amplitude. For example, strapping 1- to 2-pound weights to the wrist may promote hand stability. In addition, some patients have experienced limited benefits with biofeedback, relaxation methods, and other behavioral techniques through alleviation of anxiety or stress that may exacerbate tremor.

Lifestyle changes may include restricting caffeine intake or other stimulants that may augment symptoms. In addition, as discussed previously, alcohol consumption may lead to transient improvement for many with ET. For example, in one multicenter study of 678 ET patients, alcohol consumption was reported to alleviate tremor in 74% of those who were aware of the effect of alcohol on tremor. The onset of tremor suppression is typically reported at about 10 to 15 minutes, with effects lasting approximately 3 hours.

The potential risk of alcohol dependence and abuse among ET patients who drink alcohol to control symptoms remains controversial. Although a number of investigations have indicated that ET generally does not increase alcohol consumption nor lead to an increased frequency of chronic alcoholism, it is possible that consuming alcohol during stressful situations to alleviate tremor symptoms could lead to alcohol abuse. Simply stated, when alcohol is recommended for symptomatic management of ET, the medical and ethical ramifications must be considered.