The Early Stages of Parkinson's Disease

Parkinson's disease is often difficult to diagnose in its earliest stages because symptoms tend to be mild, making them easy to miss. Many of the symptoms at onset also mimic those of other neurological conditions. When physical symptoms of Parkinson's are not yet noticeable, imaging tests such as MRI, CT or PET scans might be useful. Recognizing the signs in the earliest stages can lead to treatments that are more successful at slowing down the progression of the disease.

Pain

• An aching pain on one side of the body, usually in the arms, shoulders, pelvic region or thighs, is one of the first symptoms of Parkinson's disease. Pain can be mild to severe, widespread or localized. While loss of muscle strength often accompanies the pain, symptoms might be present only on one side of the body. Although surveys show that more than 50 percent of people with Parkinson's suffer muscle pain and stiffness, many do not bring these symptoms to the attention of their physicians. Women with Parkinson's often report neck pain early on in the disease. Once doctors have ruled out other possible causes of persistent neck pain, they might determine that it is an early symptom of Parkinson's disease. Pain can also be the result of stiff and rigid muscles.

Tremor

• Some people with Parkinson's experience tremor even when the body is relaxed. In the beginning, the tremor is slight and involves the arm or leg on one side of the body. Often more obvious when the patient in a relaxed position or at rest, tremors usually improve with voluntary movement of the limb. But a tremor is not always a sign because at least 25 percent of individuals diagnosed with the disease do not have a tremor. For those for whom tremor is a symptom, it might be so subtle that only the thumb or index finger are affected at first.

Motor Skills

• Because Parkinson's disease affects the central nervous system, a person usually begins to notice disturbances in his fine motor skills in the hands. He might have difficulty performing simple, everyday activities such as buttoning a shirt or brushing teeth. Changes in handwriting might occur, with the writing becoming smaller and shakier. Although the exact cause of Parkinson's is unknown, researchers do know that the disease involves the death of brain cells known as neurons. Unfortunately, symptoms do not become obvious until a significant percentage of brain cells were already affected. To complicate matters, symptoms and progression of the disease can differ among individuals. Nonetheless, in many cases, a person's movement slows early on, with steps becoming smaller and more uncertain. Individuals tend to sit down and stand up slowly as well. This is the result of delayed transmission of signals between the brain and muscles.

Constipation

• Some people with Parkinson's experience bladder and bowel problems. This might be because of the effects of the disease on the autonomic nervous system, which regulates smooth muscle contractions, slowing movement through the intestinal tract. Increased inactivity also might be the cause for constipation. However, the results of one long-term study suggest that there is a link between suffering chronic constipation and developing Parkinson's disease later in life. This might be particularly true for men because research indicates that men who suffer constipation are three times more likely to get Parkinson's. The question is whether exposure to something earlier in life leaves men predisposed to developing both conditions.

Fatigue

• According to an article published in the journal Current Treatment Options in Neurology, more than half of all individuals with Parkinson's disease report symptoms of physical and mental fatigue. Although fatigue is sometimes an early symptom of depression, research shows that most individuals with Parkinson's who report feeling fatigued are not depressed. The fatigue associated with the disease is not treatable and appears to worsen for many people as the disease progresses.

Self-Assessment

• Noting certain symptoms can help you determine whether you might be showing early signs of Parkinson's and whether to seek medical advice. Ask yourself whether your posture seems bent over and whether you frequently suffer pain in the neck and shoulders. Assess whether there have been changes in your voice: Decide whether the tone is softer or more monotone or whether your voice sounds more hoarse. Carrying one arm in a bent position when you walk could be another sign. You might actually feel as though you cannot swing your arm as you walk. Your gait might show some obvious symptoms, especially if you shuffle when you walk or carry one leg behind. Hands shaking, even when they are at rest, is another sign. Aside from physical symptoms, there could be mental signs. If you seem to lack motivation, have no desire to do anything or no longer enjoy socialization, there might be reason for concern. If you exhibit more than three of the mentioned symptoms, contact your physician for a thorough assessment.