Article written by Jackie Hunt Christensen.
If you are like most people who have Parkinson’s, one of your major complaints is probably pain. Fortunately, there are steps you can take to reduce its impact on your life. Existing treatment options, including both pharmacological and non-pharmacological, can prevent it from interfering with your daily activities.
While many family doctors and even some neurologists will tell you that Parkinson’s disease does not hurt, most people with the disease will probably disagree. In fact, pain might have been one of the early symptoms that, when combined with other signs, first compelled you to see a doctor. Chances are, if you did not experience pain as an early symptom, it will show up later, as your disease progresses. Usually, it occurs or is worse on the side of your body that is most affected by Parkinson’s.
In Parkinson’s, the type of pain and its location vary from person to person. But because there are many reasons you may experience pain, you will first need to determine whether your pain is associated with Parkinson’s or some other condition such as arthritis. Here are four questions and answers about pain in Parkinson’s disease.
What type of pain occurs with Parkinson’s disease?
The types of pain associated with Parkinson’s include: aching or burning pain from muscles or skeleton, sharp pain from a nerve or nerve root, numbness or “pins and needles” pain also radiating from a nerve or nerve root, pulsing or aching pain that results from tightness or ongoing twisting and writhing movements (dyskinesia), restlessness caused from akathisia, and sudden, sharp burning pain that occurs for no known reason.
What drug treatments are commonly prescribed for pain?
Dopamine agonists are often the neurologist’s first weapon to alleviate Parkinson’s-related pain. Levodopa is used to treat many types of pain due to Parkinson’s because it treats the motor symptoms such as rigidity and dystonia that are causing them. Other medicines called analgesics can also be used to treat pain. When talking with your doctor, it is critical to let her know about all of the medications you are taking– including over the counter drugs, herbs, vitamins and mineral supplements. Without complete information, your doctor may prescribe a drug that could have serious adverse effects.
What non-drug therapies are used to treat pain?
Physical therapy is probably the most common non-drug treatment. Massage, therapeutic ultrasound, heat and/or ice, stretching and strengthening exercises and aerobic activities are some of the methods used to reduce pain by a therapist. Ideally, you should work with an experienced licensed physical therapist (LPT).
Acupuncture has been shown to relieve pain. The procedure involves the insertion of fine needles into various points on the body to treat physical and mental conditions. As with physical therapy, it is a good idea to pursue a skilled and qualified practitioner.
Tai chi and yoga treat pain in two ways. Both help to increase flexibility and reduce muscle stiffness through poses and postures. Also, both therapies incorporate breathing exercises, which facilitate relaxation. Many hospitals, clinics or care centers offer modified classes geared toward people with Parkinson’s.
Exercise. An appropriate exercise regimen can strengthen bones and muscles, increase flexibility and improve mood.
Here are a few things to consider before getting started:
- Work with your healthcare providers to develop a plan that suits your individual health needs and preferences.
- Realize that you will have to take part in these therapies more than once before you see any benefit.
- None of these therapies is a cure-all. Each person’s journey with Parkinson’s is unique, and so is his or her experience with pain. Thus, everyone’s treatment plan will be unique.
I’m in pain, but I don’t want to take carbidopa/levodopa yet because my doctor says it will only work for five years. Any advice?
It is true that as time passes and your disease progresses, you will have to take higher doses to replace the dopamine your body can no longer produce. However, the rate of dopamine loss is different for everyone. What your doctor may be telling you is that after taking carbidopa/levodopa for some time, you may begin to experience side effects like dyskinesia. It is important to understand that while you may experience this unwanted side effect, for example, you still benefit from the carbidopa/levodopa. If you believe your pain is Parkinson’s-related, and you have already tried other medications and complementary therapies without relief, it is probably time to try carbidopa/levodopa.