In Parkinson’s Disease (PD) pain is one of the most common and perhaps unexpected symptoms. Up to 75 percent of PD victims suffer from pain ranging from the intensity of slight discomfort to stinging pain. But this symptom is also one of the most under-recognized and therefore undertreated of all.
Understanding Pain In Parkinson’s Disease
Due to extensive study on the aspects of Parkinson’s Disease, it is found that 10% of people suffer from pain in the very onset of Parkinson’s disease. A major factor that causes pain also results in certain movement disruptions. Parkinson’s disease patients tend to change their body posture which is resulted by pain in keeping the normal posture. That is why; the pain occurring in the patients suffering from Parkinson’s Disease is largely termed as pain alongside Parkinson’s instead of related to it.
The challenge that many medical professionals face while diagnosing the symptoms of Parkinson’s Disease is the confusion of a misdiagnosis of any other underlying illness. As there is no defined pain related to Parkinson disease, the diagnosis becomes difficult to differentiate from other diseases. Given the impact of pain is too high in both intensity and quantity of patients suffering from Parkinson’s disease, an informal survey was conducted by APDA (American Parkinson Disease Association) National Young Onset Center and according to the results, observations were made as stated below:
Overall the survey stated that a vast majority of respondents (82%) experienced pain after the onset of their illness and the pain was severe. The younger set of survey audience (below the age of 60) cited frequent pain in certain areas like shoulder (65%) and foot (53%) respectively. For the elder patients (Above the age of 60), the pain was either in the neck or in the whole back. 50% of the elder respondents reported pain in both neck and back.
List of Causes of Pain in Parkinson’s Disease Patients:
Muscle Stiffness
Motor symptoms of Parkinson’s disease include rigidity and slowness of movement (Bradykinesia) due to which the muscles of the body tend to get stiff. This stiffness often causes aches which result in decrease in movement leading increase in the stiffness of the muscles. Pain while stretching the ligaments or back also occurs due to muscle stiffness.
Dystonia
The change in posture is due to Dystonia (involuntary contraction of muscles). Abnormal posture results in pressure on one side of the body and often a stinging pain, foot cramps or curling under the toes. Dystonia occurs mostly in the morning time or during the “off” period (Off medication phase) or even when the medications stop showing effects and the symptoms start coming back.
Dyskinesia
With long term use of Levodopa, comes Dyskinesia. It involves abnormal, involuntary movement of body parts like foot, toes, arms or fingers. Dyskinesia generally occurs during the “on” time (when the symptoms are under control with the help of medication). It includes movements like writhing, wriggling and fidgeting type motion.
Central Pain
Central pain is a syndrome which occurs when the central part of the brain that processes sensations and pain stops working correctly. The symptoms of central pain vary from person to person. The pain may be in a small portion of the body or wide-spread to the whole body. Intensity of pain may also vary from every person depending on how the malfunctioning of the central brain nerves affects the sensations.
Abdominal Pain
Patients suffering from Parkinson’s Disease commonly face issues related to digestion. They may experience upset stomach or constipation to the extents that start aches in the abdominal art of the body. The condition varies from mild ache to bloating and severe discomfort. But these symptoms are largely neglected as the medications of Parkinson’s Disease often cause this side effect.
Musculoskeletal Pain
All the symptoms related to changes in the muscles movements, posture or contractions result in pain in the musculoskeletal regions. Another factor that causes pain is injury due to the symptoms which result in such. Fractures, joint ruptures, muscle spasms and back strains are common in people suffering from Parkinson’s Disease.
Joint Pain
The survey revealed that 65% of the people suffering from Parkinson’s Disease also suffer from back and joint related chronic diseases like Arthritis, Sciatica and other joint pains. Joint pain also occurs in Parkinson’s disease patients due to Vitamin B and Vitamin D deficiency.
Neuropathy Pain
Another kind of pain caused due to the damage of sensory nerves going to the arms, fingers and other ligaments is tingling, burning or numbness. It can be caused by a number of factors that come along with Parkinson’s disease but mainly due to the medications’ side effects, and mineral and Vitamin B deficiency.
Pain Management In Parkinson’s Disease
Pain in the people suffering from Parkinson’s Disease can fluctuate and also include non-motor pain a times. But the chance of such is negligible and only 12% of the survey respondents suffered from it. So, it is mandatory to consult your doctor or medical professional if any kind of pain occurs after the onset of your Parkinson’s Disease. If motor symptoms cause pain, then contact your movement disorder professional immediately as it can be an emergency or symptom of any other underlying illness.
It is known that Parkinson’s disease is incurable and only the symptoms can be treated to slow down the progression or reduce pain and other motor movements. If the motor movements are not controlled, then pain related to them will also be not controlled and can even worsen over time. So, when you experience pain during your “off” time, the pain must be treated otherwise may result in a severe injury. Lack of sleep and depression also cause severe headaches, prostate pain and fatigue. So, another advice for the beloved ones is to keep the sleep cycle of the Parkinson’s disease patient balanced and their emotional stress at least.
Millions of people suffering from Parkinson’s Disease are fighting it in their unique way but also follow adequate medical measure to control, reduce and regulate the progression of the disease. Researchers are looking into the objective measures to find the exact cause of pain arising in PD to effectively address it but right now it can be done only with a subjective approach for every individual by noting down the frequency, intensity and duration of pain.
