Treatment guide
There is no cure yet, and no current treatment changes how the condition progresses. But several treatments can reduce tremor a lot. Here is each one, who offers it and what it costs.
Step 1
Many people notice their tremor gets worse with stress, poor sleep, caffeine and some medications. Keeping track of your own triggers is free and can help on hard days.
Weighted utensils, stabilizing gloves and wrist braces can make eating, drinking and writing easier. Our product guide rates each one by the evidence behind it. An occupational therapist can help you choose.
Step 2
The usual first medicines are propranolol (a blood-pressure medicine) and primidone (an anti-seizure medicine). A primary care doctor or neurologist can prescribe them. They don't work for everyone, and side effects are common, so tell your doctor how they're working for you.
Step 3
Several wrist-worn devices are now cleared by the FDA for essential tremor. They are worn like a watch and gently stimulate nerves or deliver vibration to calm hand tremor for a period of time. They need a prescription.
| Device | How it works | FDA status | Coverage |
|---|---|---|---|
| Cala kIQ (Cala Health) | Stimulates wrist nerves, tuned to your tremor | Cleared 2022 | Medicare covers it for essential tremor in the dominant hand; some private plans and the VA |
| Felix NeuroAI wristband (Fasikl) | Stimulates three wrist nerves, adjusted by an algorithm | Cleared July 2025 | Medicare covers it for essential tremor in the dominant hand; private coverage varies |
| Encora X1 (Encora Therapeutics) | Senses tremor and delivers custom vibration | Cleared 2026 | Prescription only; ask your insurer |
Source: Practical Neurology, Sept/Oct 2026.
Step 4
When medication doesn't control the tremor well enough, two procedures can bring large improvements. Both are done by specialized teams, usually at major hospitals.
MRI-guided sound waves treat a tiny spot in the brain that drives the tremor. No incision and no implant. Medicare covers it in all 50 states for essential tremor that hasn't responded to medication.
A surgeon places a thin wire in the thalamus, connected to a small device under the skin of the chest. It sends pulses that calm the tremor and can be adjusted over time.
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