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Movement Symptoms

Parkinson’s disease (PD) is called a movement disorder because of the tremors Involuntary shaking of the hands, arms, legs, jaw or tongue. The typical Parkinson’s tremor is “pill-rolling” – it looks like holding a pill between thumb and forefinger and continuously rolling it around. Some people report an internal tremor, a shaking sensation inside the chest, abdomen or limbs that cannot be seen. Most Parkinson’s tremor is “resting tremor,” which lessens during sleep and when the body part is actively in use., slowing and stiffening movements it can cause, and these are the most obvious symptoms of the disease. But Parkinson’s affects many systems in the body. Its symptoms are different from person to person and usually develop slowly over time.

There is no single test or scan for Parkinson’s, but there are three telltale symptoms that help doctors make a diagnosis:

  1. Bradykinesia Slowness of movement.
  2. Tremor
  3. Rigidity

Bradykinesia plus either tremor or rigidity In Parkinson’s, stiffness of the arms or legs beyond what would result from normal aging or arthritis. Some people call it “tightness” in their limbs. must be present for a PD diagnosis to be considered.

Another movement symptom, postural instability Impaired balance and the tendency to fall without explanation, usually when pivoting; a common symptom in the later stages of Parkinson’s. (trouble with balance and falls), is often mentioned, but it does not occur until later in the disease progression. In fact, problems with walking, balance and turning around early in the disease are likely a sign of an atypical parkinsonism.

Additional Movement Symptoms

  • Cramping (dystonia A disorder in which muscles contract uncontrollably, causing abnormal movements and postures; can be very painful.): sustained or repetitive twisting or tightening of muscle.
  • Drooling (sialorrhea Drooling or increased salivation.): while not always viewed as a motor symptom, excessive saliva or drooling may result due to a decrease in normally automatic actions such as swallowing.
  • DyskinesiaAbnormal, involuntary body movements that can appear as jerking, fidgeting, twisting and turning movements; frequently caused by dopaminergic medications to treat Parkinson’s.: involuntary, erratic writhing movements of the face, arms, legs or trunk.
  • Festination: short, rapid steps taken during walking. May increase risk of falling and often seen in association with freezing Temporary, involuntary inability to take a step or initiate movement..
  • Freezing: gives the appearance of being stuck in place, especially when initiating a step, turning or navigating through doorways. Potentially serious problem as it may increase risk of falling.
  • Masked face (hypomimiaDecreased facial expression due to rigidity of facial muscles; also called “facial masking.”): results from the combination of bradykinesia and rigidity.
  • Micrographia: small, untidy and cramped handwriting due to bradykinesia.
  • Shuffling gait: accompanied by short steps and often a stooped posture.
  • Soft speech (hypophoniaLow voice volume or muffled speech.): soft, sometimes hoarse, voice that can occur in PD.

What Causes Parkinson’s Movement Symptoms?

Dopamine A chemical messenger (neurotransmitter) that regulates movement and emotions. is a chemical messenger (neurotransmitter A chemical messenger that carries impulses from one nerve cell to another. Dopamine, acetylcholine and norepinephrine are examples.) that is primarily responsible for controlling movement, emotional responses and the ability to feel pleasure and pain. In people with Parkinson’s, the cells that make dopamine are impaired. As Parkinson’s progresses, more dopamine-producing brain cells die. Your brain eventually reaches a point where it stops producing dopamine in any significant amount. This causes increasing problems with movement.

Page reviewed by Dr. Chauncey Spears, Movement Disorders Fellow at the University of Florida, a Parkinson’s Foundation Center of Excellence.

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