Pain

50% of people living with PD experience pain at some point during the journey. This can be related to restlessness, nerve pain, muscles and joints, or dystonia which is the most common pain sustained from poor and stooped posture or back spasms. Musculoskeletal pain may be due to rigidity and decrease movement or mobility. Even abdominal pain from bloating or gastrointestinal issues may be experienced.

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Pain is frequent and often under-recognized as a symptom of PD. Pain can be compounded by other factors including age, arthritis, spinal stenosis, and neuropathy. Lifestyle changes, especially exercising and making your home safer, are important steps for pain reduction and management. Other specialists can be helpful, such as a massage therapist, physical therapist, or acupuncturist. Treatments for motor symptoms in Parkinson's (like dopamine medications and deep brain stimulation surgery) can also reduce pain.

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Treatment of pain in PD is challenging. Anti-inflammatories, muscle relaxants, gabapentin, tricyclic anti-depressants are some choices. Opiates should be used only in severe cases. Anti-inflammatory medications include steroids and non-steroidal drugs (NSAIDs). NSAIDS include ibuprofen, naproxen, meloxicam, and diclofenac.

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Muscle relaxants may be used on an as needed bases, but are not recommended for long term solutions. If pain is thought to be related to neuropathy, Gabapentin, Serotonin norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs) or opioid medications may be used. TCAs, such as amitriptyline and nortriptyline may be effective for nerve pain but can have many drug interactions or side effects that include confusion, forgetfulness, hallucinations, light-headedness, blurry vision, urinary retention or dry mouth. Opioid medications should be used as a last resort.