Movement Symptoms

Multigenerational family of men with their backs to the camera. Grandfather stands in the middle with his grandson on the left and his son on the right. Son's left hand is placed on his father's back

Parkinson’s disease (PD) is called a movement disorder because of the tremors, slowing and stiffening movements it can cause, and these are the most obvious symptoms of the disease. However, Parkinson’s affects many systems in the body. Its symptoms are different from person to person and usually develop slowly over time.

Read about Non-Movement Symptoms

Primary Movement Symptoms

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

Bradykinesia (slowness of movement)
Tremor
Rigidity

Bradykinesia plus either tremor or rigidity must be present for a PD diagnosis to be considered.

Another movement symptom, postural instability (trouble with balance and falls), is often mentioned as a primary symptom, 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. Though each person's path with PD is unique, active engagement in exercise and wellness is central to maintaining balance and movement for everyone who lives with PD.

Slowness, stiffness and shakiness can impact daily living. Exercise is proven to ease these and other PD symptoms and can slow disease progression. Verified exercise strategies can keep you moving well. A physical therapist with Parkinson’s expertise can help you get started.

Secondary Movement Symptoms

Parkinson’s affects everyone differently and symptoms can change throughout the course of the disease. Only half of all people with PD will experience tremor, for instance. Though Parkinson's is diagnosed based on primary movement symptoms, it can produce many secondary movement symptoms too.

When alpha-synuclein, a common brain protein, misfolds and clumps specific areas of the brain, it diminishes the brain chemical dopamine. Dopamine is vital to smooth, coordinated movements and other body processes. Parkinson's symptoms arise from dopamine declines and affect people who live with the disease differently.

- Decreased arm swing when walking.
- Difficulty turning over in bed and difficulty getting out of bed, a deep chair, or a car seat.
- Dysarthria (slurring of speech) and hypophonia (soft, sometimes breathy and hoarse, voice).
- Dyskinesia, involuntary, erratic writhing movements of the face, arms, legs or trunk.
- Dystonia, sustained or repetitive muscle cramping, twisting or tightening.
- Facial masking (hypomimia), a serious or mad facial "masking" appearance, and decreased blink rate.
- Festination – short, rapid steps during walking, done in attempt to keep the center of gravity in between the feet while the trunk leans forward involuntarily and shifts the center of gravity forward. It increases fall risk and is often linked with freezing.
- Freezing, a sensation of being stuck in place, especially when beginning a step, turning or navigating through doorways or other narrow passages. This can also increase risk of falling.
- Masked face (hypomimia): results from the combination of bradykinesia and rigidity.
- Micrographia: small, crowded handwriting due to bradykinesia.
- Shuffling gait: accompanied by short steps and often a stooped posture.
- Stooped posture, often accompanied by short steps (shuffling gait) and trouble walking.
- Soft speech (hypophonia): soft, sometimes hoarse, voice that can occur in PD.

What causes Parkinson’s movement symptoms?

Dopamine is a chemical messenger (neurotransmitter) 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.

More Information

For more insights on Movement Symptoms, read 10 Early Signs of Parkinson's Disease.

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Staying Active

Exercise — and tools such as PD Health @ Home Fitness Fridays — can minimize movement symptoms. In fact, exercise is as important to living well with Parkinson’s as medications and other therapies. Find an activity you love and work with your doctor to create a plan to stay well.