Despite the fact that pain affects up to 70% of people with Parkinson’s, it is often an overlooked non-motor symptom. But it shouldn’t be.

There are two types of pain to be aware of: primary and secondary.

Primary Pain

Primary pain is caused by Parkinson’s disease itself, since the disease impacts how the nervous system processes pain.

Recognizing primary PD-related pain can be difficult but important since this can help dictate your correct treatment. Primary symptoms typically appear during off periods and respond to dopaminergic therapy or traditional PD medications. Pain can manifest as rigidity or muscle stiffness in all muscle groups.

Oftentimes, patients are referred to my clinic by an orthopedist with initial symptoms of frozen shoulder and upper limb stiffness. Patients also have painful muscle contractions with posturing, which is called dystonia. Dystonia can affect distal limbs with toe curling, foot/ankle inturning, or torso with side bending/slumping when seated or standing. Rarely, off symptoms can present as tingling or burning sensations.

Secondary Pain

Secondary pain is sometimes easier to identify because it has a physical cause related to Parkinson’s symptoms. It often manifests as exacerbating existing arthritic pain or as low back pain resulting from rigidity or a stooped/tilted posture.

You Can Get Relief

The good news is that pain is not something you simply have to live with. Optimizing Parkinson’s medications, participating in regular exercise and physical therapy, and addressing other contributing conditions can often provide relief.

Be sure to bring this up to your neurologist, since improving pain can lead to better mobility, mood, sleep, and quality of life.