Pain is a common, yet often under-recognized symptom of Parkinson’s disease (PD). It affects approximately 40-80% of patients and can significantly impact quality of life. Effective pain management in PD requires a comprehensive and individualized approach due to the variety of pain types associated with the disease, including musculoskeletal, neuropathic, and dystonic pain.
Musculoskeletal pain, often due to muscle stiffness and rigidity, is managed through physical therapy, stretching, and exercise, which help maintain mobility and relieve discomfort. Analgesics like nonsteroidal anti-inflammatory drugs (NSAIDs) may provide relief, but should be used cautiously due to potential side effects, particularly in older adults.
Neuropathic pain involves nerve damage and may present as burning or tingling sensations. Treatment includes medications like gabapentin or pregabalin, which are commonly used to treat nerve-related pain. These medications modulate abnormal pain signals in the nervous system.
Dystonic pain is caused by involuntary muscle contractions, often related to PD medication cycles. Adjusting dopaminergic medications, such as levodopa, may reduce these painful episodes. Botulinum toxin injections are another option, offering localized relief by relaxing overactive muscles.
Multidisciplinary care, involving neurologists, physical therapists, and pain specialists, is essential. Non-pharmacological treatments like massage therapy, acupuncture, and mindfulness-based therapies can complement medical treatment and help address chronic pain in PD.
Proper pain management improves not only physical function but also mental health, as untreated pain in Parkinson’s can lead to increased anxiety, depression, and decreased mobility.
References:
Broen, M. P., et al. (2012). "Prevalence of pain in Parkinson's disease: A systematic review using the international association for the study of pain definitions." Movement Disorders, 27(4), 480-484.
Ford, B. (2010). "Pain in Parkinson's disease." Movement Disorders, 25(S1), S98-S103.
Martinez-Martin, P., et al. (2018). "Pain as a nonmotor symptom of Parkinson disease." Neurology, 91(8), S8-S14. Assessed and Endorsed by the MedReport Medical Review Board