symptoms of parkinsons disease : Pain in Parkinson's Disease

For most people with Parkinson's disease (PD), the most serious concern is with the motor system: stiffness, slowness of movement, impaired handwriting and coordination, poor mobility and balance. Descriptions of PD do not generally include the mention of pain. And yet, when carefully questioned, more than half of all people with Parkinson's disease say that they have experienced painful symptoms and various forms of physical discomfort. Most people experience aching, stiffness, numbness and tingling at some point in the course of the illness. For a few of them, pain and discomfort are so severe that they overshadow the other problems caused by the disease. This article will address these overlooked painful symptoms of PD, and describe an approach to diagnosing and treating the various pain syndromes that may occur.

Pain is described in textbooks as an unpleasant experience associated with physical injury or tissue damage. Pain can arise from anywhere in the body, of course. It goes without saying that people with Parkinson's are subject to all of the painful conditions - cardiac, gastroenterological, rheumatological, among others - that can affect people without PD. This discussion will focus on pain that is directly related to PD itself.

Pain syndromes and discomfort in Parkinson's usually arise from one of five causes: (1) a musculoskeletal problem related to poor posture, awkward mechanical function or physical wear and tear; (2) nerve or root pain, often related to neck or back arthritis; (3) pain from dystonia, the sustained twisting or posturing of a muscle group or body part; (4) discomfort due to extreme restlessness and (5) a rare pain syndrome known as "primary" or "central" pain, arising from the brain.

It takes diagnostic skill and clinical experience to determine the cause of pain in someone with PD. The most important diagnostic tool is the patient's history. Where is the pain? What does it feel like? Does it radiate? When does it occur during the day? Does it occur in relation to any particular activity or medication? Perhaps the most important task for people with Parkinson's who experience pain is to describe as accurately as they can whether their medications induce, aggravate or relieve their pain. To help your physician in diagnosing pain,

© 2005 The Parkinson’s Disease Foundation