Pain in Parkinson’s is not one single kind. It differs by cause, and the treatment that helps differs along with it. Figures vary between studies, but 40–80% of people with Parkinson’s are reported to live with chronic pain, and a tendency for women to experience it more often than men has also been confirmed. Even so, pain is counted among the most underestimated symptoms in Parkinson’s — because most people with the condition are over 60, it is hard to tell whether pain comes from the disease or simply from getting older, so it often gets brushed aside.
Musculoskeletal pain — the most common type
Pain that develops as rigidity and changes in posture put continuous strain on the joints, muscles and ligaments. It is the most common type of pain, reported in up to 75% of people with Parkinson’s. Anti-inflammatory painkillers can help, and it is often managed with stretching or physical therapy.
Dystonic pain — when hands and feet lock up as if twisting
Dystonic painPain from muscles twisting or cramping involuntarily and continuously. It commonly shows up as toes curling under or the foot twisting inward, and affects up to half of people with Parkinson's.Learn more is pain that comes from muscles twisting or cramping involuntarily and continuously. It commonly shows up as the toes curling inward or the ankle twisting, and often gets worse at particular times of day — when the medication is wearing off, for instance. Muscle relaxants, botulinum toxin (Botox) injections and deep brain stimulation (DBS)Surgery that places thin electrodes deep in the brain to deliver continuous fine electrical stimulation. It is considered when medication alone no longer controls symptoms well.Learn more can help.
Central pain — pain that is hard to trace
There is also central painPain caused by problems in the pathways of the brain and spinal cord that regulate sensation and pain. It is felt as burning or tingling even though nothing at the site has been injured or pressed.Learn more, which arises because the pathways in the brain and spinal cord that regulate sensation and pain aren’t working properly. It is often felt as burning or tingling without any injury or pressure at a particular spot, so it can take a while to find the cause. Anticonvulsant and antidepressant medications (gabapentin, nortriptyline and others) are known to help with nerve pain and central pain.
Treating depression is part of managing pain
In Parkinson’s, depression has been reported to make pain feel worse. Rather than looking at pain in isolation, checking on your mood as well — and treating it too if needed — can help with pain management.
What you can do now
Because the prescription changes depending on which kind of pain it is, keeping a specific record of when, where and how the pain shows up helps at your appointments. Instead of “it just hurts,” try describing it specifically: “my toes hurt as if they were twisting,” or “it feels like burning.”
This article is not a substitute for medical diagnosis or treatment. If you have pain, please talk with your care team.
