Understanding Parkinson’s pain (and how to get rid of it)

Parkinson’s can be a literal pain in the neck. In fact, it’s one of the most common non-motor symptoms of this disease. Thankfully, there are treatments (including non-drug therapies) that can help.

The medical community spends a lot of time researching and discussing the motor symptoms of Parkinson’s disease, such as tremors, rigidity, bradykinesia (slowness of movement) and walking/gait problems. But what about the non-motor symptoms, or the lesser known side effects of PD, such as chronic pain?

Pain may be one of the earliest symptoms that, when combined with other signs, motivated you to see a doctor. It usually occurs or is worse on the side of your body most affected by Parkinson’s.

There are even musculoskeletal injury sites on the body common to people with PD.

For instance, it’s typical for people with Parkinson’s to have unilateral shoulder pain or “frozen shoulder” that only occurs on one side of the body.

They often experience pain from dystonic reactions (intermittent spasmodic or involuntary contractions of muscles), which manifest as painful curling or bending of the toes or fingers, or the inversion of one foot.

Even if pain wasn’t one of your early signs of having Parkinson’s disease, it may become one as the disease progresses. Chronic pain occurs in between 30 and 85 percent of Parkinson’s cases, and is one of the strongest predictors for low quality of life.

Fortunately, there are myriad treatment options for Parkinson’s-related pain. Some of them you can get at the pharmacy—others are over the counter (OTC). There are even pain-relief options that don’t cost a dime—just a little time and commitment.

Drug therapies for Parkinson’s pain

Dopamine agonists, such as carbidopa/levodopa, are usually your neurologist’s first weapon in the battle against Parkinson’s-related pain.

When dopamine levels are too low, it can worsen the motor symptoms of Parkinson’s, such as rigidity, bradykinesia, or dyskinesia (involuntary movement), which will then cause musculoskeletal pain.

It’s helpful to keep a “pain diary” or a log of events. Mark down what times you eat, take your medicine and when you experience pain throughout the day. You might see a pattern between your dosing and when the pain occurred or was at its most intense.

This could help your doctor determine if they should increase the dosage amount or the frequency of dosing to achieve steadier dopamine levels—and hopefully less pain—throughout the day.

Your doctor also might prescribe analgesics, which are drugs designed specifically to relieve pain. Some pain relief drugs are available OTC, such as acetaminophen (Tylenol); others, specifically opioid analgesics, require a prescription.

Your doctor might even suggest cannabis sativa (medical marijuana) as a pain-relief drug.

Marijuana contains approximately 100 different compounds called cannabinoids. The most commonly known cannabinoid, tetrahydrocannabinol (THC), causes the psychoactive “high” associated with marijuana. The second most common cannabinoid, cannabidiol (CBD), doesn’t make you feel “high” but could have beneficial effects for treating Parkinson’s.

Our bodies make natural cannabinoids that control sleep, appetite, mood and other processes by binding to receptors throughout the body and brain. Because the cannabinoids in marijuana bind to the receptors in our body and brain, researchers are looking at whether these cannabinoids could bind to basal ganglia (a circuit of brain cells that controls movement and is affected in Parkinson’s) to improve symptoms of PD.

Non-drug therapies for Parkinson’s pain

Physical therapy is probably the most common non-drug treatment for Parkinson’s pain relief. Massage, heat and/or ice, stretching and strengthening exercises and aerobic activities are some of the ways that physical therapists can work with you to reduce chronic stiffness pain.

Acupuncture is a pain relief method used in Eastern medicine for centuries. 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.

Exercise is one of the cheapest and most effective ways to battle Parkinson’s pain. Research has found that exercise can activate both dopaminergic and non-dopaminergic inhibitory pain pathways, which may help curb the sensation of pain in PD. Consistent, vigorous aerobic activity promotes neuro-restoration in PD, thus improving motor symptoms and cognition. (Need a little motivation to get moving? Check out our article on workout motivation.)

Yoga and tai chi treat pain in more ways than one. They increase flexibility and reduce muscle stiffness through stretching and gentle movement. They also incorporate breathing exercises that calm the nervous system and facilitate relaxation.

If you really want to show pain who’s boss, join the Power Through Project. This social exercise tool was created exclusively for people with Parkinson’s and their supporters. It lets you track your workouts, find PD-friendly exercise classes and meet others in the community—all while learning how certain types of exercises improve PD symptoms, including pain.

By Kathryn Jones