Information on Parkinson's Disease and Back Pain

Neck and back pain are common complaints among patients who have Parkinson's disease. While most references list the general symptoms of Parkinson's as being stiffness, slow movement, and poor balance and coordination, few times is pain mentioned as a primary symptom. Yet, according to the Center for Parkinson's Disease and Other Movement Disorders at Columbia University Medical Center, more than half of all patients with Parkinson's disease report experiencing pain.

Causes

• Poor posture, awkward movements, pain from dystonia and nerve pain are often causes of pain associated with Parkinson's disease. Nerve pain is usually the reason for neck or back pain. Even though physicians sometimes find it difficult to determine the cause of pain, patient history and physical exam are probably the most helpful diagnostic tools. Because a doctor must rule out whether arthritis, osteoporosis or scoliosis might be causing a patient's back or neck pain, bone scans and X-rays may be needed. Your doctor may also refer you to see a rheumatologist or an orthopedist for further evaluation.

Musculoskeletal Pain

• Aching muscles and joints are common symptoms in patients with Parkinson's disease. Rigidity in the limbs and trunk, poor standing posture and tight muscles contribute to the musculoskeletal pain reported by many people who have Parkinson's. This type of pain often affects the shoulder, hip, back and neck, and is typically caused by immobility and rigidity. It is easy for a person with Parkinson's to get caught up in a cycle of pain. The disease causes stiffness that reduces a person's range of motion. This in turn causes pain, which makes it even more difficult to move. Many times back pain affects a person's posture. Poor posture then contributes to musculoskeletal pain. Treatment generally requires physical therapy to improve range of motion.

Dystonia

• Dystonic muscle spasms can be quite painful for the Parkinson's patient. These muscle spasms are characterized by twisting movements that can affect the face, neck, limbs and trunk. It may also feel like cramping. Frequently, muscle spasms cause the feet and toes to curl. Sometimes dystonia can be a side effect of medication, in which case dosage is reduced or another drug is substituted.

Sciatica

• A neurologist must assess a patient in order to diagnose nerve or root pain. Sciatica, which is caused by inflammation of the lumbar spine, is a condition that must often be addressed in Parkinson's patients. Affected individuals describe the pain as a sharp, burning sensation that radiates down a limb. This type of lower back pain is normally treated with exercise and physical therapy along with pain medication.

Prevention

• Regular exercise is probably the best way to manage pain due to immobility and stiffness. Talk to your doctor about taking over-the-counter nonsteroidal anti-inflammatory drugs to help relieve minor aches and pains. He or she may want to monitor your use of these medications as long-term use of anti-inflammatories, such as ibuprofen, can increase the risk of developing ulcers, gastrointestinal bleeding or kidney problems.

Other Adverse Effects

• Neck and back pain can cause individuals with Parkinson's disease to sleep poorly or become depressed. Sometimes insomnia is caused by medications used to treat the disease. For some people, involuntary limb movements interrupt sleep. Chronic pain can also cause depression of which insomnia is a common symptom. However, the results of a study published by "ScienceDaily" in February 2004 show that depression may actually be a risk factor for individuals developing severe pain in the neck or lower back. Although many Parkinson's patients suffer from depression after first being diagnosed, many go untreated for depression, which could be causing the pain.