A common secondary symptom in Parkinson’s disease. Although Parkinson’s disease itself does not seem to affect sensory pathways responsible for conveying pain messages to the brain, its neuromuscular symptoms can create awkward postures and limb positions that become uncomfortable. bradykinEsia, in which movement and motor response are slow, causes people with Parkinson’s to feel as though they are working against great resistance for every move. This effect causes muscles to tire and ache, in the same way as they might with vigorous exercise in a healthy person. dystonia, in which a muscle group becomes so rigid as to be immobilized, can cause painful distortions, spasms, and cramps. Early morning and off-time dystonia, which emerges when anti-parkinson’s mEdications are at their lowest levels in the body, commonly affects the feet in later stages of Parkinson’s and can cause considerable pain. restless leg syndrome (RLS), in which painful spasms cause the muscles in the legs to twitch and jerk when lying in bed awake at night (or sometimes while sitting quietly during the day), also emerges when anti-Parkinson’s medication levels are low. In addition to being uncomfortable, RLS causes sleep disturbances.
Other conditions not related to Parkinson’s disease also can cause pain. One of the most common is osteoarthritis, which causes irritation, inflammation, and swelling in the tissues surrounding the joints. The awkward movements and positions that sometimes result from the neuromuscular symptoms of Parkinson’s can exacerbate osteoarthritis. idiopathic pain syndromes occur in people with Parkinson’s as well and seem to be more common in early-onset Parkinson’s. These conditions tend to attract less attention, from the person with Parkinson’s as well as from doctors, because the primary therapeutic focus is on relieving the symptoms of Parkinson’s disease. The person with Parkinson’s may not recognize that some pains and discomforts are unrelated to Parkinson’s disease.
Pain often is worse at night, as a result of several factors. Among the factors are the hormonal cycles of the body, which influence the release of chemicals in the body that affect pain perception such as endorphins, enkephalins, and prostaglandins. The levels of these substances are lowest during sleep, when the body’s physical and mental functions are slowed. As well, the levels of anti-Parkinson’s medications are at their lowest during sleep, when they are needed least. This state can allow symptoms to emerge.
Most people with Parkinson’s disease can take common over-the-counter pain relief medications such as nonsteroidal antiinflammatory drugs (NSAIDs) to relieve intermittent discomforts, aches, and pains. It is a good idea to check with the doctor or pharmacist about possible interactions between the pain reliever and the anti-Parkinson’s medications. Always discuss persistent or sudden pain with the doctor before self-treating. Pain is a message from the body that something is not right, and determining whether that message is an alert to a serious problem is important. Pain that begins suddenly is called acute; pain that is ongoing is called chronic.
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