Wednesday, December 7, 2022
Wednesday, December 7, 2022
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Can Parkinson’s Cause Pain

Mechanisms That Contribute To Persistent Pain In Pd

Pain and Parkinson’s

As the field progresses psychophysical testing has the potential to advance our understanding of persistent pain in PD by elucidating the mechanisms which underlie pain in PD, and in doing so, identifying subgroups of patients with susceptibility to developing persistent pain while assisting in the development and monitoring of personalised pain management strategies for these patients.

How Is Parkinsons Disease Treated

There is no cure for Parkinsons disease. However, medications and other treatments can help relieve some of your symptoms. Exercise can help your Parkinsons symptoms significantly. In addition, physical therapy, occupational therapy and speech-language therapy can help with walking and balance problems, eating and swallowing challenges and speech problems. Surgery is an option for some patients.

What Are The Symptoms

The best-known symptoms of Parkinson’s disease involve loss of muscle control. However, experts now know that muscle control-related issues aren’t the only possible symptoms of Parkinson’s disease.

Motor-related symptoms

Motor symptoms which means movement-related symptoms of Parkinsons disease include the following:

Additional motor symptoms can include:

  • Blinking less often than usual. This is also a symptom of reduced control of facial muscles.
  • Cramped or small handwriting. Known as micrographia, this happens because of muscle control problems.
  • Drooling. Another symptom that happens because of loss of facial muscle control.
  • Mask-like facial expression. Known as hypomimia, this means facial expressions change very little or not at all.
  • Trouble swallowing . This happens with reduced throat muscle control. It increases the risk of problems like pneumonia or choking.
  • Unusually soft speaking voice . This happens because of reduced muscle control in the throat and chest.

Non-motor symptoms

Several symptoms are possible that aren’t connected to movement and muscle control. In years past, experts believed non-motor symptoms were risk factors for this disease when seen before motor symptoms. However, theres a growing amount of evidence that these symptoms can appear in the earliest stages of the disease. That means these symptoms might be warning signs that start years or even decades before motor symptoms.

Non-motor symptoms include:

Stages of Parkinsons disease

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Pain Management In Patients With Parkinsons Disease: Challenges And Solutions

This review focuses on the diagnosis and management of Parkinson-related pain. It reviews the incidence and prevalence of PD, general pain and PD-related pain, the pathophysiological pathways of pain in PD, physiological pathways of pain relief, measurements of pain, clinical diagnosis of PD-related pain, and treatment strategies.

Hand And Finger Stimulation Exercises

Parkinsons Paralysis Treatment By Dr. Vigil

I have done a lot of hand/finger stimulation and experimented to optimize such exercises, in the spirit of Curiosity and Play. I’ve personally found significant benefit in pursuing this line of research. Indeed, I have managed to recover a lot of my independence and quality of life through hand and finger therapy, and I know just how much of a major part it has played in my own progressive symptom reduction.

I therefore encourage everyone with PD to do as much hand and finger stimulation as possible, through games and play and self-discovery. By doing nothing, the only thing that will happen is that out situation will rapidly become worse, because we will lose the use of our hands quicker and consign ourselves to increased suffering. By applying neuroplasticity techniques , we can delay the worse ravishes of the disease or even, like in my own case, continuously push the symptoms back and recover some independence. I feel this is an important message for those newly diagnosed, in particular.

Here are some suggestions of the type of stimulatory exercises and games which can help, more ideas which I have personally found beneficial will be provided in forthcoming articles.

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Potentials Ways To Reduce Fatigue

  • Exercise. It may seem counterintuitive get moving if youre feeling fatigued however, the right kind and the right amount of exercise can significantly reduce fatigue. Experiment. Sometimes just getting out the door for a walk in the fresh air can reduce fatigue.
  • Talk to your doctor if you think you may be depressed. Its possible that an anti-depressant could reduce fatigue.
  • Plan your time. Identify when you tend to have the most energy throughout the day and plan to get your most important jobs done then.
  • Be realistic, but still do something. If youre feeling extra exhausted on a certain day, dont put pressure on yourself to accomplish everything you planned. Do somethingbecause accomplishing something will give you an energy boost but be realistic about what youre capable of doing.
  • Delegate. Its not easy. You may have concerns about being a burden to others. Most people will be thrilled to help. Let them.
  • Organize and declutter. Opening up spacephysically, emotionally, mentally and logisticallycan help you reduce stress and as a result reduce feelings of fatigue.
  • Connect with others. We know that when you feel wiped out that the last thing you want to do is attend a support group meeting or event, but connecting with others in a positive way has the potential to not only make you feel supported and encouraged and loved, but it may very well give you the exact bump in energy that you need.

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Negative Impact Of Severity Of Pain On Mood Social Life And General Activity In Parkinson’s Disease

This case control study designed for clinicians and rehabilitation specialists to effectively identify pain from the patient’s point of view determined that PD patients had significantly higher pain severity scores compared to controls. PD patients with depressive symptoms had significantly higher pain severity and pain interference scores than controls without depressive symptoms. PD patients reported greater scores on Global BPI pain interference and all components of the pain interference subscale. Therefore, PD and depression seem to be correlated with higher perceived pain, severity and interference. A report on this study, by Jose Marques Lopes, PhD., was published in Parkinson’s News Today, September 21, 2018.

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Types Of Parkinsons Pain

Most of the time, discomfort in muscles and joints is secondary to the motor features of Parkinsons lack of spontaneous movement, rigidity, and abnormalities of posture what is known as musculoskeletal pain. The most commonly painful sites are the back, legs, and shoulders and it is usually more predominant on the side more affected by parkinsonism.

But there are many other categories of pain associated with Parkinsons disease. Radicular or neuropathic pain is experienced as a sharp pain that can start in the neck or lower back with radiation to arm or leg respectively and is often associated with numbness or tingling, or a sensation of coolness in the affected limb. It is usually secondary to a pinched nerve due to something like a slipped disc.

Dystonia related pain occurs as its name suggests, at times of dystonia most often experienced in the foot, neck or face and arm at different points in the dosing schedule, particularly the off phase when there is not enough dopamine replacement but can uncommonly also occur at peak-dose times. It can be one of the most painful symptoms those with Parkinsons can face.

Akathisia pain is experienced as restlessness, a subjective inner urge to move, an inability to stay still and the inherent feelings of discomfort that it brings. It is primarily experienced in the lower limbs and can often be relieved by walking around.

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Fluctuations Of Pain Experiences In Pd

Ask the MD: Pain and Parkinson’s

Patterns of NMS fluctuations are heterogeneous and complex. Psychic NMS seem to fluctuate more frequently and severely than nonpsychic symptoms. A recent study of ten frequent NMS in advanced PD using VAS rating scales in motor-defined on- and off-states, as well as self-ratings at home, confirmed previous suspicions that increased pain in off-states and pain fluctuations correlate with a low health-related quality of life. Pain as NMS was more frequent in the off-state more precisely, it was three to four times more common during the off-state than during the on-state.

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Stooping Or Hunched Posture

People who have Parkinsons disease may notice changes in their posture due to other symptoms of the disease, such as muscle rigidity.

People naturally stand so that their weight is evenly distributed over their feet. However, people who have Parkinsons disease may start bending forward, making them appear hunched or stooped over.

Hip Pain Caused By Cancer

There are several types of cancer that can give rise to the symptom of hip pain. These types of cancer include primary bone cancer, chondrosarcoma, metastatic cancer, and leukemia.

The good news is hip pain caused by cancer is quite rare, but its definitely still worth noting. If youre experiencing hip pain that is severe, getting worse, or not getting better, its time to see your doctor.

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Which Type Of Hip Replacement Should I Have

Your surgeon will discuss this with you. It will depend on who you are. In other words, how old you are, whether you have any other medical conditions and what you want to be able to do once you have had your hip replaced. It will also depend on what types of hip replacements your surgeon is used to performing and which ones are used in their hospital. In the UK the National Institute for Health and Care Excellence only recommends devices that are known to last at least 10 years in 95 out of every 100 people who have that type fitted.

All hip replacements can be divided into either cemented or uncemented.

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These Symptoms Can Interfere With Daily Activities

Dystonia

Poston notes that the numbness in your hands could be so severe that it can make you unable to sense an object in your hand, which could result in difficulty eating, getting dressed, and holding objects. OBrien also says that people who suffer from these symptoms sometimes cant perform everyday tasks from writing or typing to picking up objects. If you find that youre experiencing numbness or tingling thats getting in the way of your daily activities, you should talk to your doctor immediately.

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What Is Parkinsons Paralysis

Parkinsons paralysis is a common term used by patients of Parkinsons disease and is generally referred as a result of loss of muscle function in the person who is suffering from Parkinsons disease. Paralysis is basically of two types i.e. complete or partial and can occur on either sides of the body.

Paralysis attack on the body can be widespread or can just occur in one area of the body. In many cases, Parkinsons disease leads to paralysis agitans, meaning complete weakness.

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Pain Sites And Assessments

All patients were asked to indicate the distribution of pain sites, duration of pain, and rate average pain intensity over the past 3 months on an 11-point numeric rating scale , with 0 indicating the absence of pain and ten indicating the most intense pain imaginable. The patients reported NRS scores in both the ON and OFF states of motor function on the same day. NRS scores were then transformed into WHO severity stages of mild , moderate , and severe , respectively . MSP responsiveness to Levodopa was defined as a 30% reduction in NRS scores from baseline, 2 h after taking the medication . Data regarding multiple types of pain were also recorded. The ID-pain scale detected central parkinsonian pain.

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Stages Of Parkinsons Symptoms

Parkinsons symptoms can be divided into three categories or phases: pre-motor, motor, and cognitive. These phases dont necessarily happen in chronological order, and not all Parkinsons patients will experience all symptoms.

The premotor phase is the phase of Parkinsons in which non-motor symptoms are present. These symptoms include:

There are two main categories of tremor: resting tremor, and action tremor. Resting tremor occurs when muscles are relaxed, like when your hands are sitting in your lap, and lessen during sleep or when the body part is in use. Action tremors occur with the voluntary movements of a muscle.

Tremors typically affect only one side of the body but may affect both sides as the disease progresses. Fatigue, stress, and intense emotion may worsen tremors.

Other Symptoms: Aging Or Pd

Managing Pain in Parkinson’s

Because the biggest risk factor for developing PD is age , skeletal problems associated with aging are often experienced by people with PD. While it is not clear that PD increases the risk or even the severity of these other skeletal conditions, the problems of PD can make the symptoms of these conditions more prominent.

  • Osteoarthritis, the joint damage associated with general wear and tear on the joints, is nearly universal in aging. Osteoarthritis tends to affect larger joints such as the hip and knee.
  • Arthritis of the spine is also very common. This may contribute to the development of spinal stenosis, narrowing of the canal in the spine that houses the spinal cord. In severe cases, spinal stenosis causes damage to the nerves as they exit the spine or even to the spinal cord itself.
  • Disorders of the fibrous discs between the bones of the spine can also cause pain, or limb numbness or weakness.

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Pain In Parkinsons Disease

Parkinsons patients suffer from the same pain other people have, often amplified by the motor dysfunction, but they also have additional pain problems unique to PD. Lower back pain and back of he neck pain are most common. Strengthening exercises or stretching may be helpful. Identifying the cause of the pain is essential in treating the pain. Treatments include physical therapy, medications, and alternative therapies like Reiki, acupuncture and massage.

The Critical Difference Between Sleepiness And Fatigue

Fatigue is a physical or psychological feeling where people feel weary and exhausted and lacking energy. EDS is about needing and having the urge to sleep.

Fatigue is something that people can experience along with EDS however, people who experience fatigue on its ownthe feeling of being tired and out of energy do not also necessarily fall asleep when sedentary, as people who experience EDS often do.

It is estimated that EDS affects up to 50% to 75% of people living with Parkinsons and fatigue is estimated to affect 40% to 60%. Fatigue, however, is more likely to go undiagnosed.

Because the terms fatigue and sleepiness are so heavily linked, and sometimes used interchangeably, research has concluded that fatigue and EDS should be assessed separately in people with Parkinsons so that we can improve our understanding of their overlapping physiology.

With that knowledge, researchers from the University Hospital of Zurich, Switzerland designed a study to determine the overlap between fatigue and EDS and then associate them with other motor and non-motor symptoms as well as dopaminergic medication.

In their study of 88 outpatients, the researchers found that 72% experienced fatigue or EDS and just under half experienced both. Some of the key findings of the study include:

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Development Of A New Approach

Different classifications have been employed for the distinction between PDrelated and PDunrelated pain syndromes, but motor fluctuations and the response to dopaminergic medication were not usually taken into account, except in the most recent approaches., We here provide an original questionnaire for pain assessment in PD. It can be used in addition, or as an alternative, to the questionnaire currently being developed by the nonmotor study group of the International Parkinson and Movement Disorder Society.,

Our approach is based on a threestep approach: establish a relationship with PD on the basis of a temporal association between the onset of pain and PD symptoms, whereas other causes of pain are excluded determine whether pain depends on motor fluctuations and determine whether pain depends on the antiparkinsonian treatment. At the end of this threestep approach, pain could be classified as a PDrelated or nonPDrelated pain. Finally, concerning PDrelated pain, the type of pain is categorized as one of three main syndromes, . The proposed algorithm was converted into a pain questionnaire named MarburgSao PauloCréteil Questionnaire for Pain in Parkinsons disease .

  • The fluctuation with the dopaminergic state may give an additional hint for an association between pain and PD in moreadvanced cases. Thus, the effects of any antiparkinsonian treatment on pain should be systematically included in the diagnostic algorithm, as recently proposed.

  • Pain Is An Unfortunately Common Problem In Parkinsons Disease

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    Of course, pain is common in the general population, especially among older people. A recent American study found that pain affected about twice as many people with Parkinsons Disease than those of the same age and gender without PD. About 50% of Parkinsons Disease patients in that study suffered from painful disorders. Men and women seem to be about equally affected. A very well described scenario is the patient who is followed for a painful frozen shoulder for a year or so before a tremor develops leading to a diagnosis of PD. Pain clearly plays a major role in quality of life. Everyone with chronic pain enjoys life less, leading to a vicious cycle in which pain causes depression or isolation which in turn leads to more pain.

    Parkinson patients suffer from the same pain problems that other people have, often amplified by the motor dysfunction, but they also have additional pain problems which are unique to PD.

    One recent review classified the types of pain Parkinsons Disease patients have into: musculoskeletal, in which the pain results from problems with the muscles , bones or joints dystonic, which is due to abnormal muscle contractions caused by the Parkinsons Disease or the medications used to treat it radicular pain, which is feels like the pain caused by pinched nerves central pain, which is presumed due to abnormalities in the brain, and is a continuously present pain that cannot be explained otherwise and discomfort related to an unpleasant urge to move.

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