Table of Contents
Parkinson’s Pain
Parkinson’s pain can have a devasting impact on the quality of life for a person living with Parkinson’s Disease. In fact, according to the Parkinson’s Foundation, chronic pain affects about 80% of people living with Parkinson’s.
Imagine the toll that pain can take on your daily life, your mood and overall, well-being. Pain can limit a person’s daily activities, social interactions and hobbies & interest.
Parkinson’s Pain doesn’t have to restrict your quality of life. This article shares 5 proven strategies as well as practical tips for actually overcoming Parkinson’s pain so you can participate in the activities you enjoy and lead your best life with Parkinson’s.
Types of Parkinson’s Pain
Chronic pain is very common in people living with Parkinson’s Disease. In fact, according to the article Pain in Parkinson’s Disease, by the Parkinson’s Foundation they state:
“Chronic Pain is twice as common among people with PD as in people without it. 80% of people with PD report experiencing pain and many say it is their most troubling non-motor symptom.”
While chronic pain is common in Parkinson’s, the source or cause of the pain can be different. So, let’s examine he types of pain in more detail to help us understand not only where pain is occurring but what are the underlying causes and source of the pain.
Musculoskeletal Pain
Musculoskeletal pain in Parkinson’s can be caused by muscle stiffness, joint problems and changes in posture that occur as part of Parkinson’s Disease progression.
According to the Parkinson’s Foundation, musculoskeletal pain is experienced by up to 75% of people living with Parkinson’s.
Musculoskeletal pain is related to some of the symptoms that accompany Parkinson’s Disease including rigidity, limited movement, and while not necessarily a Parkinson’s symptom, arthritis.
Common symptoms of musculoskeletal pain include but are not limited to:
- Joint Pain
- Muscle cramps
- Tightness in the neck spine an arms
- Muscle stiffness or achiness
Parkinson’s is one of the risk factors for a condition known as “Adhesive Capsulitis” or Frozen Shoulder.
What is Frozen Shoulder? According to the Mayo Clinic article Frozen Shoulder, they note that frozen shoulder “involves stiffness and pain in the shoulder joint. Signs and symptoms typically begin slowly, then get worse. Over time, symptoms get better, usually within 1 to 3 years.“
The Mayo Clinic Article notes that symptoms of frozen shoulder involve 3 stages:
- Freezing
- The person experiences pain in the shoulder when moving the shoulder
- The mobility of the shoulder because limited during this stage.
- Typically last from between 2 months to 9 months according to published data.
- Frozen
- The amount and duration of pain may be less compared to the Freezing Stage.
- People often experience stiffness and/or tightness in the shoulder causing limited mobility.
- This stage typically last up to 12 months.
- Thawing
- Mobility in the shoulder slowly begins to return allowing for more range of motion.
- Can last between 0.5 and 2 years
Treatment of frozen should typically include, medications, typically ibuprofen and sometimes, corticosteroids to help reduce inflammation and manage pain. Physical therapy is also a good option for working on range of motion.
I want to share a quick story om my personal experience with Frozen should and Parkinson’s’ pain.
“I’ve experience should pain for as long as I can remember, at least 20 years or more, partly because of my days playing high school and college football then with Parkinson’s. While I was always able to manage the shoulder pain, I started having mobility issues with my right shoulder. I have a lot of difficulty raising my arms from the side and if you ask me to reach behind my back and lock my fingers, that’s out of the question.
I went through 2 rounds of corticosteroid injections, the latest being June of 2024 when I received a shot in my AC joint and my rotator cuff. I then participated in Physical Therapy of 6 weeks where I worked on mobility and range of motion exercises with my shoulder.
After the injections and the Physical Therapy, I was able to get a lot of my mobility and range of motion back into the “normal” range. While my frozen shoulder is in the Thawing stages, I am pleased with the progress I’ve made. I’ve experienced improved range of motion, reduction in stiffness and pain.”
Subscribe to the FREE Live Parkinson’s Monthly Newsletter for our Spotlight Topic of the Month, What’s New in Clinical Research, New Parkinson’s Medications, Success Stories and More.
Dystonic Pain
Are you like me and get painful curling of your foot, toes or hands? Then you’ve experienced a type of Parkinson’s pain known as Dystonic pain.
Dystonic pain is a painful muscle spasm in the foot, toes or hand. According to the Parkinson’s Foundation, “up to 50% of people with PD experience dystonic pain at some stage of the disease.
In their article, Pain in Parkinson’s, the Parkinson’s Foundation states that:
- “Foot dystonia is one of the most common sources of dystonia pain in early PD”.
- “Severe and painful spasms can also occur in the neck, face or throat muscles”.
- “Dystonia may occur spontaneously or may be triggered by certain movements but is often experienced in the early morning and may also be related to fluctuations in PD Medications”.
Source: Pain in Parkinson’s, Parkinson’s Foundation
I want to share my personal story with dystonia to give you my personal perspective on this type of Parkinson’s pain.
I participate in two different group fitness classes at the fitness center I attend. to help me with my flexibility and balance – Soul Fusion TM and BarreTM.
In both classes we were doing exercises working on leg strength and balance. As part of the exercise, we were instructed to flex our toes and then point our toes.
For some unknown reason, every time I would point my toes, I would get a painful cramp in the arch of my foot which caused my foot to curl and arch. Most of the time, I was able to massage the muscle, and the painful cramping and foot arch would dissipate.
However, one day, I had dystonia after pointing my toes and my right foot immediately curled, and I had a painful muscle cramp and spasms. I spent 15-20 minutes massaging my foot until the pain and spasm went away, and I was able to put my shoes on and walk on it to further stretch the muscle.
Did this incident cause me to quit taking these classes? No, because they provided dramatic improvements in my flexibility and balance. However, I am cognizant that pointing my toes can lead to dystonia and am leery of pointing my toes too far and causing this type of Parkinson’s pain.
For information on tracking your Parkinson’s symptoms, including dystonia to help you prepare for your next doctor visit read my article:
Parkinson’s Symptom Tracker: 4 Actionable Steps to Improve Communication with Your Doctor
Neuropathic Pain
Neuropathic pain, also known as nerve pain, occurs when there is damage or dysfunction in the nervous system. It can be caused by diseases like Parkinson’s.
According to published data 5-30% of people with {D experience neuropathic pain. So, what are the symptoms and what does this type of pain in parkinsons disease feel like?
People with Neuropathic pain often experience
- Burning or Shooting Pain
- Tingling or Numbness
- Increased Sensitivity to Touch (allodynia)
- Pain from normally non-painful stimuli (Hyperalgesia)
so, how do healthcare providers help you to manage neuropathic Parkinson’s Pain? Mangement of the pain often requires a combination of treatments including:
- Medications– Antidepressants, anticonvulsants and pain relievers
- Physical Therapy – to improve strength and mobility.
- Psychological Counseling – to help cope with chronic pain.
- Lifestyle Changes – including exercise and eating a healthy diet.
Now that we understand the types of Parkinson’s pain that individuals living with Parkinson’s can experience, Let’s discuss five specific strategies for managing pain.
Having a positive attitude and being optimistic can also help to manage Parkinson’s pain. Form more information on positivity and optimism and the benefits it provides, read my article:
The 5 Powerful Benefits of a Positive, Happy Attitude
5 Proven Strategies to Manage Parkinson’s Pain
Managing Chronic Parkinson’s Pain often requires a multi-faceted treatment approach. In fact, your doctor may not only recommend medications to treat pain but may also refer you to Physical and Occupational Therapy and counseling.
Let’s look at 5 specific proven strategies that can help you overcome the challenges that Parkinson’s pain poses.
Medical Interventions
Disclaimer: I am not a medical professional, the information on medications to manage pain is based on my research and personal experience taking these medications to manage Parkinson’s pain. The information provided is for informational purposes only. If you experience Parkinson’s pain, please contact your healthcare professional and they can develop a treatment plan that addresses your specific health needs.
Pain medications for Parkison’s Disease can target specific sources or types of Parkinson’s pain. Some common medications include:
- Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
- Ibuprofen and Diclofenac
- Opioids and Opioid-Like Medications
- Oxycodone, morphine, tramadol and codeine may be used to treat chronic pain
- Anticonvulsants
- Gabapentin, Pregabalin, Carbamazepine and tricyclic antidepressants are used to treat chromic pain.
- Other Medications
- Other medications that may help with PD-related pain include Safinamide, Cannaboids, COMT Inhibitors and Dopaminergic Agents.
The Parkinson’s Foundation article Pain in Parkinson’s Disease makes an important point that I feel is worth noting. the article states:
“Build a team that includes a PD doctor, nurse, physical therapist, occupational therapist, pain management specialist and in some cases, an orthopedic specialist.”
Exercise
Exercise can be a great option for managing Parkinson’s pain. Exercise can help reduce pain perception through increased activity and the release of neurotransmitters.
During and after exercise, several neurotransmitters are released, contributing to positive feelings and potentially reducing pain perception. Here are some key neurotransmitters involved:
- Endorphins: These natural painkillers are produced by the brain’s hypothalamus and pituitary gland in response to exercise-induced stress.
- Dopamine: Exercise increases dopamine levels, which play a crucial role in mood regulation, mental alertness, and focus.
- “Dopamine plays an important role in how you feel pleasure. It’s also responsible for other processes in your body, such as regulating heart rate, sleep cycles, mood, attention, motivation, working memory, learning, and pain processing.” Exercise and the Brain: The Mental Health Benefits of Exercise, Healthline.com, Daniel Preiato and Ryan Collins, May 10, 2023
- Serotonin: Regular physical activity boosts serotonin levels. Serotonin is essential for maintaining mood balance, reducing symptoms of depression and anxiety, and promoting overall well-being.
Some exercises that may help manage Parkinson’s pain include:
- Stretching & Flexibility exercrises
- Endurance training
- Muscle Activation & Relaxation
- Balance Training
- Dancing
- Mind Body Exercises – Yoga, Tai Chi and Gigong
For additional information on the benefits of exercise and Parkinson’s, Read my articles:
4 Proven Benefits of Exercise On Parkinson’s Disease
Parkinson’s and Exercise – 7 Reliable Exercises for Awesome Results
Move Your Body, Fight Parkinson’s: 5 Best Parkinson’s Exercises to Improve Strength & Balance
Massage
Massage which involves the Kneading, rubbing, tapping and stroking the body’s soft tissues can help to relieve stress and reduce pain and may also help you to relax.
I personally get a massage every other month and as a person living with Parkinson’s myself and the muscle stiffness, rigidity and the Parkinson’s pain that that goes with it, I highly recommend a massage. It helps to alleviate muscle stiffness and is very relaxing.
Acupuncture
I know, you are probably thinking, no thank you, I am not being stuck with a bunch of needles. Let me give you my personal experience to ho help alleviate some of your concerns with Acupuncture.
I was having facial pain from Lyme’s Disease and the doctor recommended Acupuncture. I agreed to try it, although I was honestly a bit skeptical that it would provide and pain relief. I found the experience to be very relaxing and non-painful. The needles they use are very thin and I barely noticed them being inserted. I had acupuncture done over a number of weeks and felt it did help in alleviating a lot of my facial pain.
So, if you are experiencing Parkinson’s pain, I highly recommend giving it a try. Consult your healthcare professional for a referral. For more information on Acupuncture visit the American Society of Acupuncturists
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy is a process that involves the use of strategies that help you to train your thoughts and behaviors to help you overcome negative thought patterns that may be causing fear and destructive or disturbing thoughts that have a negative impact on your emotions and quality of life.
CBT can be a good tool for helping you manage chronic Parkinson’s pain and the associated anxiety and depression that may accompany it.
I’ve personally used CBT to help me overcome issues with anxiety and panic attacks and can highly recommend it as a means to overcome emotional challenges you may be facing.
In my particular situation using CBT to overcome anxiety and panic attacks, I used a two-part process that involved CBT and exposure therapy or training. Using CBT I was able to re-train my brain and thought patterns to overcome FEAR (False Evidence Appearing Real) by reframing my thinking. In addition, I slowly exposed myself to the thing I was fearful of in my case heights and was able to overcome my anxiety and fears and live a much better quality of life.
Here’s how it works:
- Focus on Thoughts, Feelings, and Behaviors: CBT examines the connections between thoughts, feelings, and behaviors. It helps individuals recognize negative thought patterns and behaviors related to uncomfortable feelings like depression or anxiety.
- Active Collaboration: Unlike some other talk therapies, CBT is highly instructive and involves active collaboration between the person with Parkinson’s and the therapist. Sessions are structured, and specific techniques and coping skills are explained.
- Tailored Approach: CBT is tailored to each person’s unique goals. Individuals are encouraged to practice coping skills between sessions to work toward their objectives.
- Brief and Time-Limited: CBT is generally a brief treatment (three to six months), but the number of sessions varies based on individual needs.
It’s important to remember you need to practice it on a consistent basis to get the best results.
Pain and Parkinson’s Summary
Living with Parkinson’s and managing the debilitating Parkinson’s pain that may be associated with it is undoubtedly a challenge. But remember, you are not alone.
By understanding the different type of Parkinson’s pain, exploring the 5 strategies for managing pain and seeking professional guidance you can take significant steps towards improving your quality of life.
Remember, every individuals experience with Parkinson’s is unique. What works for one person managing Parkinson’s pain might not work for another.
It is essential to find what works best for you through trial and error, patience and open communication with your health care provider.
Here are specific calls to action to help you on your journey for managing Parkinson’s pain.
- Consult your health care professional if you are experiencing pain. They can develop treatment plans and suggest therapies that are specific to your needs.
- Explore Pain Management Options – research different pain management strategies and find what works for you.
- Join a Support Group – Connect with others who understand your challenges and can offer support.
- Continue Learning – Stay informed about the latest research & treatment advancements.
By taking proactive steps to manage Parkinson’s pain, you can reclaim your life and enjoy a better quality of life with Parkinson’s. Remember, you are stronger than you think.
Chris Kustanbauter – Liveparkinsons.com 8/22/2024