Parkinson’s Tremors vs. Essential Tremors: What’s the Difference?

Tremors are one of the most recognizable signs of Parkinson’s disease, but not all tremors are the same. In fact, many people experience shaking or trembling and wonder: Is this Parkinson’s, or something else?

One of the most common sources of confusion is the difference between Parkinson’s tremors and essential tremors. While both involve involuntary shaking, they have different causes, symptoms, and treatment paths.

At The Center for Movement Challenges, we work with individuals at all stages of movement disorders, including those seeking answers to early symptoms. This guide will help you understand the key differences and what to do if you're unsure which type of tremor you're dealing with.

What Is a Tremor?

A tremor is an involuntary, rhythmic muscle movement that results in shaking or trembling. Tremors can affect the hands, arms, head, voice, or other parts of the body.

Both Parkinson’s disease and essential tremor involve shaking, but the type, timing, and progression of the tremor are very different.

Let’s explore each one in more detail.

What Is a Parkinson’s Tremor?

A Parkinson’s tremor is usually a resting tremor, meaning it occurs when the muscle is relaxed and not in use.

Key characteristics of a Parkinson’s tremor:

• Typically starts on one side of the body
• Often begins in the hand or fingers
• Known for “pill-rolling” movement (thumb and forefinger rubbing together)
• Occurs when the limb is at rest and may go away during intentional movement
• Becomes more noticeable with stress or fatigue
• Usually associated with other Parkinson’s symptoms like stiffness, slowness, and balance issues

These tremors are caused by changes in the brain due to a loss of dopamine, which affects how the brain controls movement.

What Is an Essential Tremor?

An essential tremor (ET) is a movement-related tremor, meaning it occurs when you're trying to use a muscle or perform an activity.

Key characteristics of essential tremor:

• Often affects both sides of the body (though it may start on one side)
• Most commonly impacts the hands, but can also affect the head and voice
• Tremor is present during movement, such as writing, eating, or holding objects
• Tends to run in families (genetic component)
• Does not come with other Parkinson’s symptoms like stiffness or slow movement
• May improve slightly with alcohol (in some people)

Essential tremor is the most common movement disorder, affecting an estimated 10 million people in the U.S.

Major Differences at a Glance

FeatureParkinson’s TremorEssential TremorWhen it occursAt restDuring movementWhich side is affectedUsually one side firstOften both sidesOther symptomsStiffness, slowness, balance issuesTypically no other motor symptomsBody parts involvedHands, fingers, legsHands, head, voiceCauseNeurological loss of dopamineGenetic or unknownFamily historyLess commonMore common

Understanding these distinctions can help guide proper diagnosis and treatment.

How Are These Tremors Diagnosed?

A neurologist or movement disorder specialist will typically:

• Review your medical and family history
• Observe the tremor during rest and movement
• Conduct a neurological exam
• Use tools like handwriting analysis or movement assessments
• In some cases, order brain imaging to rule out other causes

There is no single test for Parkinson’s or essential tremor. Diagnosis is based on clinical observation, which is why seeing a specialist matters.

At The Center for Movement Challenges, we help people track and understand tremor patterns and provide support no matter where they are in the diagnostic process.

Treatment Options for Parkinson’s and Essential Tremors

While both conditions involve tremors, they are treated differently.

Parkinson’s Tremor Treatments

• Levodopa/Carbidopa (Sinemet): Most effective medication for Parkinson’s symptoms
• Dopamine agonists: Support dopamine receptors in the brain
• Physical therapy: Helps improve motor control and reduce stiffness
• Deep brain stimulation (DBS): A surgical option for advanced cases
• Exercise programs: Target balance, flexibility, and motor function

We incorporate movement therapy into our Parkinson’s-specific classes, available both in person and online.

Essential Tremor Treatments

• Beta-blockers (like propranolol): Help reduce shaking
• Primidone: An anti-seizure medication that can help manage tremor
• Botox injections: May be used for head or voice tremors
• Focused ultrasound or DBS: Used in more severe cases
• Occupational therapy: Helps improve control in daily tasks

While we specialize in Parkinson’s, we also support those living with other movement disorders and provide referrals when needed.

What Should You Do If You’re Unsure?

If you're experiencing hand shaking or tremors and don’t know the cause, the best first step is to see a neurologist or movement disorder specialist.

Meanwhile, you can:

• Keep a symptom log: Note when the tremor happens, how strong it is, and what activities make it better or worse
• Record a video: Show your doctor how your tremor appears during rest and movement
• Stay active: Movement-based therapies benefit both types of tremor

Our team at The Center for Movement Challenges is here to help you identify symptoms and build a movement plan that supports your lifestyle.

Final Thoughts: Knowledge Leads to Confidence

Understanding the difference between Parkinson’s tremors and essential tremors can ease anxiety and lead to faster, more effective care. While they may look similar, their causes and treatments are different, and recognizing the signs is the first step toward clarity.

Key Takeaways:

• Parkinson’s tremors happen at rest and often start on one side
• Essential tremors occur during movement and are more likely to run in families
• Diagnosis is based on a neurological exam and symptom patterns
• Treatments differ but often include medication, movement therapy, and support
• The Center for Movement Challenges offers classes and tools to help you manage tremors and improve daily life

Let’s Take the First Step Together

If you’re unsure about your tremor, we’re here to help. Join one of our online or in-person Parkinson’s classes to get moving in a safe, supportive environment.

Visit www.centerformovementchallenges.org to explore our programs and find the right path forward.

You don’t have to guess. We’ll help you find answers — and strength — one step at a time.

‍