Susan Collins lived with a tremor for nearly three decades on Capitol Hill without publicly discussing it. Now, at 73 and seeking a sixth Senate term, the Maine Republican has finally opened up about it.

Collins disclosed the diagnosis in May. The disclosure followed questions about visible shaking in her hands, head and voice during recent public appearances.

What Is the Condition?

Essential tremor is one of the most common movement disorders, according to the National Institutes of Health. It may occur when nerve signals fail to properly reach certain muscles.

This causes involuntary shaking. According to the Mayo Clinic, the condition mostly affects the hands, though it can also involve the head and voice.

Symptoms typically worsen with movement. They may also intensify under stress, fatigue or after caffeine intake.

At least half of all cases are inherited, meaning the tremor can run in families. Risk also increases with age, particularly after 40.

Unlike Parkinson's disease, essential tremor is not generally associated with the same pattern of neurological decline. The Mayo Clinic notes it is not a dangerous condition, though symptoms often become more pronounced over time.

Viral Video Fuelled Backlash

Public scrutiny of Collins' health intensified after a video of her opening a box of shoes while announcing her re-election bid went viral. The clip added fuel to a wider debate over age limits for elected officials.

In the comments, some viewers questioned Collins' decision to seek another term, with one writing that she 'needs to retire'.

Nurse Marie King, 46, told The Mirror said she believes fitness tests should be required for lawmakers regardless of age, since age alone does not determine capability. Her husband, Aaron, said he would support an age cap of 65 for officeholders.

Senator Says It Is Manageable

Collins said she has lived with the tremor for her entire Senate tenure, which began in 1997. She described it as 'inconvenient at times' but insisted it has not affected her performance.

'It has absolutely no impact on my ability to do my job or on how I feel each day,' she said. She pointed to her voting record as proof of her stamina.

Her office says she has never missed a Senate vote, a streak now exceeding 10,000. That is reported to be the second-longest such record in the chamber's history.

Dr Rees Cosgrove, chief of the Division of Functional Neurosurgery at Mass General Brigham, said the tremor is not tied to cognitive decline. He noted it is distinct from conditions such as Parkinson's or Alzheimer's.

He added that it does tend to worsen gradually with age. Still, he said, it carries no impairment to a person's mental sharpness.

Health and age have become recurring themes this election cycle. Collins is seeking a sixth term in a race widely viewed as one of the most competitive in the country.

Treatment Options Available

Essential tremor cannot be prevented, but it can often be managed. Treatment ranges from lifestyle adjustments to medication, depending on severity.

Behavioural strategies, such as reducing stress and limiting caffeine, are sometimes enough for milder cases. Physical therapy and weighted utensils may also help with everyday tasks.

When symptoms are more disruptive, doctors may prescribe medications such as propranolol or primidone. These are considered standard options for long-term control.

Other drugs, including certain anti-seizure medications, may be used when first-line treatments fall short. In severe, treatment-resistant cases, surgical options exist.

These include thalamotomy or deep brain stimulation, procedures aimed at reducing tremor activity in the brain. Both are typically reserved for the most disruptive cases.

Despite the diagnosis, Collins has indicated she does not plan to slow down. She said she remains open to seeking re-election again in future years, despite an earlier pledge to limit her time in office.

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