Brain & Nervous System Parkinson's Disease Cogwheeling in Parkinson's Disease When Your Arms or Legs Feel Like a Ratchet Wrench By Patrick McNamara, PhD Patrick McNamara, PhD, is an associate professor of neurology and the director of the Evolutionary Neurobehavior Laboratory. Learn about our editorial process Patrick McNamara, PhD Medically reviewed by Medically reviewed by Diana Apetauerova, MD on September 11, 2020 linkedin Diana Apetauerova, MD, is board-certified in neurology with a subspecialty in movement disorders. She is an associate clinical professor of neurology at Tufts School of Medicine. Learn about our Medical Review Board Diana Apetauerova, MD Updated on April 08, 2021 Print Cogwheeling is one of the symptoms of Parkinson's disease. It is a jerky feeling in your arm or leg that you (or your doctor) can sense when moving or rotating your affected limb or joint. It is an early effect of Parkinson's disease. Daisy Daisy / Getty Images What Is Cogwheeling? The movement of cogwheeling can be described as similar to a ratchet wrench that hesitates before "clicking" forward into its next position. Cogwheeling was named for the cogwheel, a toothed wheel or gear that clicks forward and back, rather than running smoothly. You may feel it in your elbow, wrist, ankle, knee, or other joints. It can affect both sides of your body, but it doesn't have to be symmetrical—cogwheeling can affect one side of your body, but not necessarily the other. Testing for Cogwheeling in Parkinson's Cogwheeeling is a common effect of Parkinson's disease. Many people with the condition can feel the cogwheeling in their joints or limbs. Some people describe it as an almost audible "click" as the joint moves forward a notch. The affected limb can feel stiff as you move it. It shouldn't be associated with pain, and you will still continue to be able to move your joints even if you have cogwheeling. And you should rest assured that movement will not damage your joint that is affected by cogwheeling. Physical Examination Parkinson's disease is a clinical diagnosis. There is no blood test or imaging test that can confirm it. Your doctor will base your diagnosis on your signs and symptoms. Your doctor will test you for cogwheeling during your diagnostic assessment for Parkinson's disease. To perform this test, your doctor will ask you to relax and then will move the joints of your wrist, arm, or leg. If your doctor encounters choppy resistance while moving your joint limb, then you might be diagnosed with Parkinson's disease. If the cogwheeling isn't immediately obvious, your doctor may ask you to move your limb or joint on the opposite side of your body—for example, you may be asked to raise and lower your left arm while your doctor is checking your right side for cogwheeling. This action can help to tease out the cogwheeling effect, especially if it's subtle. Cogwheeling usually progresses along with tremors and rigidity, which are primary motor symptoms of Parkinson's disease. In Parkinson's disease, rigidity is a type of stiffness that feels like resistance to any type of movement. Parkinson's disease tremor is a rhythmic shaking movement that occurs at rest, with tensing and relaxation of the affected muscles. How to Control Cogwheeling The symptom of cogwheeling can be reduced with the treatments that are normally used for managing Parkinson's disease. Parkinson's disease is treated with drugs that include levodopa and dopamine agonists. Medications often help control the symptoms, especially at the early stages of the disease. However, these medications can cause side effects and they may become less effective over time as your disease progresses. If the symptoms of Parkinson's disease become difficult to manage with medication, some people may have interventional treatments, such as deep brain stimulation (DBS). Regular exercise can also be valuable for you if you have Parkinson's disease, and it may lessen the cogwheeling effect. You may also be referred to physical therapy. A physical therapist can help guide you in creating an exercise plan that is best for your Parkinson's disease. Dancing to music is also considered an activity that may help reduce stiffness and other symptoms of Parkinson's disease. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Parkinson Disease Association. There is no test to diagnose Parkinson’s Disease.