For some people, pain can be the main symptom of their condition, although not everyone will experience this problem. Uncontrollable muscle contractions (dystonia) and rigidity can be a problem in Parkinson’s. This is very painful, like bad cramp, and hurts most when Parkinson’s drugs are ‘wearing off’ or when someone is taking their medication less frequently.
The most effective way to treat pain in Parkinson’s is to find the cause of the pain. It is best for the person with Parkinson’s to speak to their GP, specialist or Parkinson’s nurse. Usually, the GP will be able to manage the more common types of pain, such as musculoskeletal shoulder pains and headaches. However, other types of pain, such as dyskinetic pain or a burning mouth, may need a referral to a specialist. The main types of pain associated with Parkinson’s are discussed below.
Muscle (musculoskeletal) pain
This is the most common type of pain experienced by people with Parkinson’s. It comes from the muscles and bones, and is usually felt as an ache around joints, arms or legs. The pain stays in one area and doesn’t move around the body, or shoot down the limbs.
Simple painkillers, such as anti-inflammatory medications, and exercise can help.
Muscle cramps associated with Parkinson’s can happen at night or during the day. At night they may cause pain in the legs and calf muscles as well as restlessness, which leads to disrupted sleep.
Cramps can be soothed by stretching and massaging the affected muscle.
Dystonia is an involuntary muscle contraction that can make the affected part of the body go into spasm.
In Parkinson’s this is most common on feet, legs, head and neck. Dystonia can cause the feet to turn inwards, or toes to curl downwards.
Medication can help – if dystonia is a problem then anyone who has it should see their specialist or Parkinson’s nurse.
Find out more in the Parkinson’s UK information on muscle cramps and dystonia [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] .
This is a sharp, often shock-like shooting pain that travels down the leg or arm and may involve fingers and toes. Tingling and numbness, or a burning feeling in the toes and/or fingers is also common in people with Parkinson’s.
Radicular pain is usually the result of a trapped nerve within the spinal cord around the neck or lower back region.
Simple painkillers and gentle exercise may help. They may need some tests, such as an MRI scan of the spine, to rule out compression of the nerve roots at the spinal cord.
This sort of pain is not limited to any body part and can be described as a deep, aching sensation. It can occur because of involuntary movements (dyskinesia) that some people with Parkinson’s experience. It can happen before, during or after movement.
Adjusting Parkinson’s medication can help. If dyskinesia is a problem, anyone with it should see their specialist or Parkinson’s nurse.
Restless legs syndrome
This can cause symptoms such as pins and needles, painful sensations, or a feeling of burning in the legs. Some people may feel an irresistible urge to move their legs while relaxing, such as while sitting watching TV or getting to sleep. Medication can help.
Other types of pain associated with Parkinson’s
There are other types of pain associated with Parkinson’s that are less common. These can include shoulder or limb pain, pain in the mouth and jaw, and headaches.
‘I also experience muscle stiffness and inflexibility, which cause me pain due to over-exertion. This happens if I don't take regular breaks throughout the day’
Some people may also experience akinetic crisis and pain, which usually only occurs in the advanced stages of Parkinson’s. The symptoms include severe stiffness, fever, pain in muscles and joints, headache and, sometimes, whole-body pain.
Some people occasionally experience this type of pain if their Parkinson’s symptoms suddenly get worse. This can be brought about by abrupt withdrawal of Parkinson’s medication or by infections. Severe stiffness in the muscles may also be the cause.
If you think your client is experiencing pain, always recommend they seek advice from their GP, specialist or Parkinson’s nurse.
Actions to take
- People with Parkinson’s might take pain relief as part of their drugs regime. If they’re not happy with what they take, or if pain relief needs to be added to their regime, they may need a review of their medication with their specialist or Parkinson’s nurse.
Find out more in the Parkinson’s UK information sheet on pain.
2.13 Care planning