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 Patrick McNamara, PhD, is an associate professor of neurology and the director of the Evolutionary Neurobehavior Laboratory. Learn about our editorial process Updated on March 22, 2022 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Diana Apetauerova, MD Medically reviewed by Diana Apetauerova, MD 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 University. Learn about our Medical Expert Board Fact checked Verywell Health content is rigorously reviewed by a team of qualified and experienced fact checkers. Fact checkers review articles for factual accuracy, relevance, and timeliness. We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Content is fact checked after it has been edited and before publication. Learn more. by Angela Underwood Fact checked by Angela Underwood LinkedIn Angela Underwood's extensive local, state, and federal healthcare and environmental news coverage includes 911 first-responder compensation policy to the Ciba-Geigy water contamination case in Toms River, NJ. Her additional health-related coverage includes death and dying, skin care, and autism spectrum disorder. Learn about our editorial process 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 healthcare provider) 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 healthcare provider will base your diagnosis on your signs and symptoms. Your healthcare provider will test you for cogwheeling during your diagnostic assessment for Parkinson's disease. To perform this test, your medical professional will ask you to relax and then will move the joints of your wrist, arm, or leg. If your healthcare provider 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 healthcare provider 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 medical professional 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. 10 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. Nies YH, Mohamad Najib NH, Lim WL, Kamaruzzaman MA, Yahaya MF, Teoh SL. Microrna dysregulation in parkinson’s disease: a narrative review. Front Neurosci. 2021;15:660379. doi: 10.3389/fnins.2021.660379 Silva TV de A, Sobral A do V, Silva RM da, Almeida VL dos S, Coriolano M das GW de S, Lins CC dos SA. Pain, click and crepitation as factors associated with temporomandibular dysfunction in Parkinson’s disease. Brazilian Journal Of Pain. 2018;1(3). doi: DOI 10.5935/2595-0118.20180048 UpToDate. Diagnosis and differential diagnosis of Parkinson disease. American Parkinson Disease Association. There is no test to diagnose Parkinson’s Disease. National Institute of Neurological Disorders and Stroke. Tremor Fact Sheet. UpToDate. Patient education: Parkinson disease treatment options - medications (Beyond the Basics). U.S. National Library of Medicine. Deep Brain Stimulation (DBS) for the Treatment of Parkinson's Disease (INTREPID). Oliveira de Carvalho A, Filho ASS, Murillo-Rodriguez E, Rocha NB, Carta MG, Machado S. Physical exercise for parkinson’s disease: clinical and experimental evidence. Clinical Practice and Epidemiology in Mental Health. 2018;14(1). doi; 10.2174/1745017901814010089 Gisbert R, Schenkman M. Physical therapist interventions for parkinson disease. Physical Therapy. 2015;95(3):299-305. doi: https://doi.org/10.2522/ptj.20130334 Bek J, Groves M, Leventhal D, Poliakoff E. Dance at home for people with parkinson’s during covid-19 and beyond: participation, perceptions, and prospects. Front Neurol. 2021;12:678124. doi: 10.3389/fneur.2021.678124 By Patrick McNamara, PhD Patrick McNamara, PhD, is an associate professor of neurology and the director of the Evolutionary Neurobehavior Laboratory. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! 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