The Correlation of Pain and Parkinson's Disease

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Pain is known to be the most widely sought out reason for patients to visit physicians. Treating pain can be difficult because it’s a subjective concept that is hard to depict. Parkinson’s disease is a disease of the nervous system and is associated with tremor, muscular rigidity, and delayed mobility. It is primarily due to the deterioration of the basal ganglia and a shortage of dopamine. When it comes to people diagnosed with Parkinson’s Disease, pain is one of the major objections, though it often goes unnoticed and untreated. More often than not, people with undiagnosed Parkinson’s disease often experience pain early on. Thus, it is important to learn how to manage pain that comes with Parkinson’s.

Manifestations of Parkinson's Disease and Pain

Most nociceptive pain is due to tremors, muscle rigidity, dystonia, and musculoskeletal injuries that are a result of a fall, a common occurrence with patients dealing with Parkinson’s Disease. This specific type of pain tends to be more localized as opposed to radiating though this often affected by medication. The most common places pain stems from in Parkinson’s patients are the neck and the upper back.  When there is painful twisting, cramping, or posturing of a body part, a patient can be diagnosed for dystonia.

Info on Pain Receptors and Parkinson’s Disease

Reasons for pain associated with this disease is due to the separation of the pain receptors from the nerves in the tissue. Nociceptive pain, the most common type, is due to tissue damage which disturbs the pain receptors in the skin or bones. Neuropathic pain is due to the nerves. It is also common to have a mix of both of these pains. Classification of your pain will help your physician better cater to your treatment for you.

With Parkinson’s neuropathic pain is not as common as nociceptive pain. Signs of neuropathic pain are burning, numbness, tingling, sharpness, and or shocks. It is usually related to shingles, diabetic neuropathy, cancer pain, and carpal tunnel syndrome.

Pain and Parkinson’s

The pain derived from Parkinson’s disease can be categorized into pain from the muscles or skeleton, pain from the nerves or spinal roots, pain related to long-term twisting, discomfort from akathisia and pain due to brain damage caused by Parkinson’s.

Pain management is critical because unmanageable pain is an obstacle that can affect mood, sleep, and day-to-day activities. In the long run, pain can result in malnutrition, social withdrawal, insomnia, depression​, and anxiety.

Perception of pain varies depending on the patient and their emotional state. People diagnosed with Parkinson’s are often affected by depression or anxiety which can subsequently affect one’s perception of pain.

Assessing pain will likely be done via a clinical interview and a neurological examination. Along with this, you will be asked to characterize your pain, using numbers and sensory words.

Treatment options for pain include medications, physical therapy, massage therapy, exercises, injections, acupuncture and mental therapy. Physical therapy and massage therapy can help loosen any rigidity that is caused by the disease and allow for a more comfortable mobility and a wider range of motion. Exercise and massage therapy can do something similar and can also be used to relieve stress and anxiety from the patient.

Many Parkinson’s patients are already on medication for the disease. Dopaminergic medications such as levodopa alter perceptions of pain. Thus, using levodopa medication will likely help Parkinson patients better deal with pain. Dealing with Parkinson’s disease and managing the pain correlated with it is a bit of a challenge. However, it can be overcome. So it is important to be motivated or support your loved one when it comes down to it. Talk with your physician to find the right solutions for you and your family.

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