Parkinson’s disease is a movement disorder that usually occurs in older adults. Rigidity and other movement problems that characterize Parkinson’s disease may cause pain. Treatment side effects can also sometimes contribute to pain.

With Parkinson’s disease, a specific part of the brain called the substantia nigra deteriorates, causing slow movements, tremors, and muscle rigidity.

This article explores pain related to Parkinson’s disease. It also describes ways of managing pain and overall Parkinson’s treatment.

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People living with Parkinson’s disease may experience pain, which can be an overlooked symptom. According to experts, chronic pain is the most common symptom not related to movement in Parkinson’s.

People with pain due to Parkinson’s usually have musculoskeletal pain. However, other types of pain people with the condition may experience include:

  • pain from dystonia
  • central pain
  • shooting pain
  • dyskinetic pain
  • muscle cramps
  • restless legs syndrome
  • akinetic crisis

Visit our dedicated hub to learn more about Parkinson’s disease.

The most common type of pain in Parkinson’s disease is musculoskeletal pain. Experts suggest muscle pain occurs in about 45–90% of people living with Parkinson’s. Musculoskeletal pain can be acute or chronic.

People may develop muscle and joint pain from changes in posture because of Parkinson’s disease. Muscle rigidity can occur and cause painful conditions such as stiff shoulders and lower back pain.

To treat musculoskeletal pain, doctors may recommend over-the-counter painkillers such as acetaminophen (Tylenol) or nonsteroidal anti-inflammatory medications such as ibuprofen (Advil).

Prescription opioids, such as Targinact (oxycodone/naloxone), are also effective pain relievers. However, because they can be habit-forming and affect a person’s mental status, doctors rarely prescribe them for Parkinson’s-related pain.

Regular exercise and physical therapy may also help relieve this type of pain.

Read more about how physical therapy may help musculoskeletal pain here.

Dystonia is an involuntary, sometimes painful, muscle contraction that causes atypical positioning of the hands and feet. A person with dystonia may temporarily be unable to walk, put on their shoes, or use their hands.

Approximately 15–40% of people with Parkinson’s experience dystonia, which experts suggest is mostly an effect of a common Parkinson’s medication called levodopa. Taking this medication long-term can cause muscular side effects.

Treating dystonia may involve other medications, such as sublingual apomorphine (Apokyn) and botulinum toxin injections. Deep brain stimulation (DBS) is a drug-free strategy to reduce dystonia and pain that involves surgical placement of a device in the brain, providing electrical stimulation that doctors can adjust with external control.

DBS of a part of the brain called the subthalamic nucleus might stabilize brain signals and reduce pain.

Read more about dystonia here.

Central and peripheral pain are two types of nerve pain people with Parkinson’s disease may experience. Central pain comes from the brain.

Aching and soreness are features of peripheral pain. These types of pain can dramatically affect a person’s quality of life. Management strategies include prescription medications, surgery, and nonsurgical interventions.

Over time, Parkinson’s disease medication may cause dyskinesia, which involves involuntary and uncontrolled movements. As Parkinson’s progresses and treatment requires higher doses of medication, dyskinesia may worsen, which can be painful.

To manage this, doctors need to adjust the doses of medications such as levodopa, which replaces missing dopamine. Dopamine is a chemical that sends nerve signals in the body. Certain treatments, such as amantadine (Gocovri), can help relieve dyskinesia and related pain.

Read more about dyskinesia here.

Shooting or radicular pain is a sharp, tingling, or numbing sensation that travels down the limbs or extremities.

Shooting pain occurs in Parkinson’s disease due to changes in posture. With these changes, nerves coming from the spinal cord may experience compression and fire uncomfortable sensations in the body. Dyskinesia is another cause of shooting pain in Parkinson’s disease.

Treatment for shooting pain involves painkillers and regular physical activity adapted to the person’s abilities. Compression of nerves in the spinal cord may require surgery in some situations.

Severe muscle cramps can occur with dystonia. Contractions causing muscle cramps can occur in the following areas:

  • toes
  • fingers
  • hands
  • arms
  • lower legs

As well as being painful, these muscle cramps can affect posture and the positioning of toes and fingers.

Treatment for muscle cramps and dystonia is the same. Adjusting the dose of Parkinson’s disease medications can help relieve pain from muscle cramps.

Restless legs syndrome (RLS) is another pain syndrome that causes leg discomfort when the legs are not moving. It is common among those with Parkinson’s disease. People can relieve pain from RLS by moving their legs.

Experts suggest that people with Parkinson’s disease may also develop leg motor restlessness (LMR). With LMR, movement does not relieve pain, and pain is not worse when the legs are still.

Psychomotor restlessness pain is another similar pain syndrome that people with Parkinson’s disease may experience. Pain from restlessness can be diffuse or local. Local pain may occur around the mouth, abdomen, or pelvis. Restlessness can shift from one area to the next in a short period.

People experiencing restlessness pain with Parkinson’s disease usually have complications from levodopa and other medications. Therefore, treatment may involve adjusting medication.

Read more about RLS here.

An akinetic crisis is a rare, life threatening complication related to Parkinson’s disease in which motor symptoms worsen, leaving a person unable to move the muscles.

In an akinetic crisis, people may have trouble swallowing and inhale liquid into their lungs. This can be fatal.

Autonomic dysfunction is another characteristic of akinetic crisis. This happens when the autonomic nervous system, which controls functions related to the body’s well-being and balance, does not work as it should.

Some experts suggest pain from akinetic crises is the most painful form of dyskinesia.

Other emergency features of an akinetic crisis include:

  • an altered mental state
  • the inability to start a movement
  • an abnormally high body temperature

Akinesia may occur when the medications used to treat Parkinson’s disease wear off. Treatment for akinesia involves adjusting medication dosing to avoid “off” periods, such as by using longer-lasting levodopa treatments. However, akinetic crises require emergency medical attention.

Pain may be challenging for doctors to assess, as the feeling of pain varies between people and there is a lack of objective diagnostic tools available to classify it.

When assessing pain, doctors will generally determine if the sensation is acute or chronic. Acute pain lasts for a short time. People with Parkinson’s disease can experience acute pain after an injury or due to sudden changes in posture.

Doctors can detect pain syndromes with a thorough assessment of a person’s medical history and an extensive physical exam. These assessments help doctors choose the best treatment for pain management with Parkinson’s disease.

Read more about ways to manage chronic pain here.

According to a 2020 article, people with pain from Parkinson’s disease may benefit from alternative therapies such as massage therapy and yoga.

It suggests that rehabilitation and physical therapy may be the most effective strategy for temporarily lowering muscle and joint pain.

Yoga is another pain-reducing strategy that may help treat various conditions involving the brain.

Read more about treatment options for Parkinson’s disease, including alternative therapies.

Parkinson’s disease can cause significant changes to a person’s quality of life.

According to a 2020 article, chronic pain is an often underrecognized and undertreated symptom of Parkinson’s, despite being the most commonly reported nonmotor symptom.

This article also suggests that having Parkinson’s may increase a person’s perception of pain, making symptoms worse. However, according to its authors, healthcare professionals may not adequately recognize and treat pain related to Parkinson’s due to a lack of awareness of the wide variety of pain types and levels of severity that can occur among people with the condition.

Various medications and interventions can help treat Parkinson’s-related pain. However, effective treatment strategies require a personalized approach since each person will have a different experience.

Parkinson’s disease can cause pain. Musculoskeletal pain can occur due to posture changes related to Parkinson’s. Pain can also occur due to dystonia, a common side effect of the medications that doctors prescribe for treating Parkinson’s disease.

The varying causes and types of pain in people with Parkinson’s disease may challenge doctors to test different pain-relieving strategies. Various medications and surgical and nonsurgical options may help treat pain from Parkinson’s disease.