More people know and understand Parkinson's disease today than at any time in its history. It was first characterized in 1817 by British physician James Parkinson. Seven to 10 million people worldwide have Parkinson's disease. One million of these live in the United States.
Awareness campaigns and the public courage of many people, including actor Michael J. Fox and boxer Muhammad Ali, have exposed many of us to the outward signs of the disease. Commons signs include trembling, body stiffness, slow movements, weakened balance and lack of coordination.
What many people don't know is that more than half of those who have Parkinson's also experience pain, an often-overlooked symptom. Diagnosing pain associated with Parkinson's can be a challenge. It is often treatable when identified.
What is the nature of Parkinson's-related pain?
Parkinson's symptoms often begin on one side of the body. Pain may develop on that same side. People may experience it as cramping or aching sensations in the muscles and joints. Many people with Parkinson's develop a stiff or "frozen" shoulder. Hip, back and neck pain can also be common.
Pain may be related to:
- Prolonged, forceful muscle contractions, called dystonia, that twist the affected body part. This can affect muscles throughout the body from the feet to the face.
- Central pain syndrome, a brain dysfunction that can cause spontaneous, unprovoked sensations, such as stabbing or burning pain.
- Nerve pain, most commonly caused by an extreme, inner restlessness, called akathisia.
- The cycle of medications used to treat Parkinson's. For example, some observe that when their medications are at peak effectiveness, they experience less pain than when their medications are in the "off" state.
Working with your doctor
If you or a loved one is diagnosed with Parkinson's, speak up about any pain or discomfort. The more information you can provide about your pain, the better your doctor will be able to diagnose and treat it. Be as honest and direct as you can be when your doctor asks questions like these:
- How would you describe the characteristics of your pain?
- When do you feel pain? Does your Parkinson's medicine seem to make the pain better or worse?
- Where in the body is your pain?
- Does the pain feel hot or cold, stabbing or burning?
- How is pain impacting your daily activities, such as walking or sleeping?
- Are you depressed? Depression occurs in about 40 percent of people with Parkinson's. It is even more likely if you are in pain.
How is Parkinson's pain treated?
The treatment for pain related to Parkinson's starts with a determination by your treating team about the source of your pain. Managing pain with Parkinson's can include medications and non-drug options. A combination of both may offer the best pain control. A person with Parkinson's disease may see a neurologist, orthopedist, physical therapist and primary care physician. Having all of the patient's specialists aware of each other and working together can lead to the best results. Some treatment options for pain include:
- Physical therapy
- Nutrition management and exercise
- Acupuncture or acupressure
It can take some time to find the right combination of medications and actions to treat the pain of Parkinson's. You and your medical team will need to work together to pinpoint the cause of pain and to find the right treatment. Expect that you will need to try different medications, different doses and different treatments. The goal is not only for you to move more freely, but to be pain-free.
Created on 11/17/2008
Updated on 07/29/2013
- National Institute of Neurological Disorders and Stroke. Parkinson’s disease.
- Michael J. Fox Foundation for Parkinson’s Research.
- Parkinson's Disease Foundation. Understanding pain in Parkinson’s.