What Are The Different Stages Of Parkinsons Disease
Each person with Parkinsons disease experiences symptoms in in their own unique way. Not everyone experiences all symptoms of Parkinsons disease. You may not experience symptoms in the same order as others. Some people may have mild symptoms others may have intense symptoms. How quickly symptoms worsen also varies from individual to individual and is difficult to impossible to predict at the outset.
In general, the disease progresses from early stage to mid-stage to mid-late-stage to advanced stage. This is what typically occurs during each of these stages:
Early stage
Early symptoms of Parkinsons disease are usually mild and typically occur slowly and do not interfere with daily activities. Sometimes early symptoms are not easy to detect or you may think early symptoms are simply normal signs of aging. You may have fatigue or a general sense of uneasiness. You may feel a slight tremor or have difficulty standing.
Often, a family member or friend notices some of the subtle signs before you do. They may notice things like body stiffness or lack of normal movement slow or small handwriting, lack of expression in your face, or difficulty getting out of a chair.
Mid stage
Mid-late stage
Standing and walking are becoming more difficult and may require assistance with a walker. You may need full time help to continue to live at home.
Advanced stage
What If You Have Parkinson’s Disease And A Stroke
Stroke is relatively common and so is Parkinson’s disease, so one person can have both. If you or your loved one has a stroke as well as Parkinson’s disease, it is normal for you to be concerned.
The conditions have different causes, but the movement problems of Parkinson’s disease combined with the effects of a stroke can make it even more difficult for you or your loved one to get around than if you only had one of the two problems.
If you have both conditions, it is more important to pay attention to things such as safeguarding your home to prevent falls and getting a walker or a cane in order to avoid falls.
What Is Parkinsonian Gait
Parkinsonian gait is a defining feature of Parkinsons disease, especially in later stages. Its often considered to have a more negative impact on quality of life than other Parkinsons symptoms. People with Parkinsonian gait usually take small, shuffling steps. They might have difficulty picking up their feet.
Parkinsonian gait changes can be episodic or continuous. Episodic changes, such as freezing of gait, can come on suddenly and randomly. Continuous changes are changes in your gait that happen all the time while walking, such as walking more slowly than expected.
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Examining Muscle Weakness And Rigidity In Parkinsons Disease
The sun peeks over the horizon, and before long Dad is up and at it. Its a boxing day, and he wants to time his medications to optimize control over his Parkinsons symptoms.
The other part of his routine revolves around his morning stretches. Muscle rigidity is the first obstacle that he faces when he wakes, and he chooses to confront it with a stretching practice.
Parkinsons disease claims multiple functions as it progresses. Understanding how the disease affects the patient may help to inform treatment decisions. Im a curious person, and Dads stretching routine makes me wonder if Parkinsons disease directly affects the way muscles work. I think about how muscle rigidity and weakness are linked and how others handle these symptoms.
Living With Parkinsons Disease
Depending on severity, life can look very different for a person coping with Parkinsons Disease. As a loved one, your top priority will be their comfort, peace of mind and safety. Dr. Shprecher offered some advice, regardless of the diseases progression. Besides movement issues Parkinsons Disease can cause a wide variety of symptoms including drooling, constipation, low blood pressure when standing up, voice problems, depression, anxiety, sleep problems, hallucinations and dementia. Therefore, regular visits with a neurologist experienced with Parkinsons are important to make sure the diagnosis is on target, and the symptoms are monitored and addressed. Because changes in your other medications can affect your Parkinsons symptoms, you should remind each member of your healthcare team to send a copy of your clinic note after every appointment.
Dr. Shprecher also added that maintaining a healthy diet and getting regular exercise can help improve quality of life. Physical and speech therapists are welcome additions to any caregiving team.
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How Is Pain Diagnosed Assessed And Treated
Diagnosing and treating pain in people with Parkinsons can be difficult and often, common ways of reducing pain, such taking painkillers or doing regular, gentle exercise may not help.
Usually, your doctor or Parkinsons nurse specialist will be able to help you to manage the more common types of pain, such as shoulder pain and headaches. Certain other types of pain, however, such as pain caused by involuntary movements or burning mouth, may need the help of your Parkinsons specialist.
Completing a Kings Parkinsons Disease Pain Questionnaire and showing it to your heath-care professional will help them to understand the pain you are suffering from1. Completing the 24-hour Hauser2 diary, a home diary designed to assess your motor symptoms, over the same period of time, would further help your doctor or Parkinsons nurse to better understand the pain you are experiencing and to treat it more quickly.
To ensure Parkinsons pain is assessed and diagnosed efficiently, a specific scale has been designed. Kings Parkinsons Pain Scale 1 is a validated scale which covers the common types of Parkinsons related pain. Your Parkinsons specialist might use this scale to help understand the type of Parkinsons pain you have even better and assess what needs to be done to help you further.
References:
What Are The Causes And Symptoms Of Parkinsons Disease
As a neurodegenerative disorder, Parkinsons Disease leads to the progressive deterioration of motor function due to loss of dopamine-producing brain cells. While the cause of Parkinsons Disease is unknown, researchers speculate that both genetic and environmental factors are involved. Studies also show that men are 50% more likely to develop the disorder than women.
Primary symptoms of Parkinsons Disease:
- tremor
- dementia
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My Parkinson’s Story: Pain
This 10-minute video alternates between an interview with a man and and doctors. The man shares his experience with pain as a symptom of Parkinson’s disease. The doctors explain that pain is common in Parkinson’s disease, often due to rigidity or dystonia, which can be exacerbated by “off” periods. Pain caused by Parkinson’s symptoms can be relieved by Parkinson’s medications, exercise, DBS and botox injections. Pain is an invisible symptom that should be mentioned to your neurologist.
Make Commercial Breaks Movement Breaks
If youre watching TV, stand up and march while you swing your arms during the commercials. To increase your muscular strength, lift soup cans or a do a few downward dogs.
Moving more every day is easier said than done. Remember, even small changes can make a big difference. Pat yourself on the back for all of the movement activities you do each day. Every victory counts!
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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.
Periodic Limb Movement Disorder And Restless Legs Syndrome
Do you often feel the irresistible urge to move your legs around during the night in order to get comfortable? If so, you might have restless legs syndrome . This condition can be associated with PLMD . PLMD causes slow rhythmic movements of the legs and feet, whereas restless legs syndrome causes more twitchy unpleasant sensations in the legs. Naturally, if you are frequently moving your legs, you are likely to wake up throughout the night, limiting your ability to get a good nights sleep. Periodic limb movements are quite common in older adults as well as those with Parkinson’s. Restless legs syndrome frequently affects middle-aged and older adults in addition to people with PD.
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What Type Of Pain Occurs With Parkinsons Disease
The types of pain associated with Parkinsons include: aching or burning pain from muscles or skeleton, sharp pain from a nerve or nerve root, numbness or pins and needles pain also radiating from a nerve or nerve root, pulsing or aching pain that results from tightness or ongoing twisting and writhing movements , restlessness caused from akathisia, and sudden, sharp burning pain that occurs for no known reason.
Sleep And Depression In Parkinson’s Disease
Depression is seen in approximately 40% of PD patients in the course of their disease. Most persons with depression, including PD patients, also will experience problems with sleep. In depression, sleep does not refresh you like it used to, or you wake up too early in the morning. Dreams for depressed people are different, too–they are rare and often depict a single image.
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Home Care Tips For Restless Legs Syndrome
The following approaches can reduce symptoms in patients with mild or moderate RLS and may be used in combination with medication in RLS patients who have severe symptoms.
- Sleep hygiene: Good sleep hygiene means maintaining a bedroom environment and a daily routine that supports high-quality sleep. Avoiding alcohol and caffeine is especially important for RLS patients because these substances can worsen symptoms.
- Exercise: Because physical inactivity often triggers RLS symptoms, exercise may be helpful. A research study found that RLS patients showed af 39% reduction in symptom severity after six weeks of engaging in an exercise program compared to an 8% symptom reduction in patients who did not exercise.
- Pneumatic pressure therapy: Pneumatic compression devices increase blood flow to the legs by filling with air to squeeze the legs. Researchers found that the device improved RLS symptoms, quality-of-life, and fatigue after one month of daily use compared to a control group.
- Massage and hot baths: Using massage and hot baths to stimulate the legs is widely recommended in RLS literature however, there is limited scientific evidence supporting the effectiveness of these methods at this time.
Learn more about treating RLS here.
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What Drug Treatments Are Commonly Prescribed For Pain
Dopamine agonists are often the neurologists first weapon to alleviate Parkinsons-related pain. Levodopa is used to treat many types of pain due to Parkinsons because it treats the motor symptoms such as rigidity and dystonia that are causing them. Other medicines called analgesics can also be used to treat pain. When talking with your doctor, it is critical to let her know about all of the medications you are taking including over the counter drugs, herbs, vitamins and mineral supplements. Without complete information, your doctor may prescribe a drug that could have serious adverse effects.
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Shooting Pain And Paraesthesia
Radicular pain is a sharp pain that shoots down a limb and often affects fingers or toes. Paraesthesia is sometimes described as a feeling of pins and needles or perhaps numbness in a limb which has fallen asleep. Such pain is usually related to trapped nerves in the spinal cord and can feel similar to an electric shock, a tingling or a burning sensation.
Treatment: Painkillers and exercise will generally settle the pain. If not your specialist may refer you for tests such as an MRI scan to check for a trapped nerve in the spinal cord.
Fecal Incontinence In Advanced Parkinsons Disease
Fecal incontinence is a very debilitating symptom that can occur in advanced PD and refers to the involuntary release of fecal matter.
Once again, fecal incontinence, especially if it is a new symptom, should be fully evaluated to determine if there is a cause unrelated to PD. Diseases of the gut such as inflammatory bowel disease or compression of the lower spine cord can be the reason.
If related to PD, there are typically two situations to consider. One possibility is that severe constipation with impacted bowel movement allows loose stool from higher up in the gastrointestinal tract to escape around the edges of the obstruction. In this situation, fecal incontinence could be a harbinger of bowel obstruction. Aggressive and continuous treatment of constipation can help avoid this potential scenario.
Fecal incontinence can also be related to nerve dysfunction of the anal sphincter, or the ring of muscle that controls when feces is released. Cognitive dysfunction and mobility issues may further interfere with getting to the bathroom in time. Some treatment options are similar to urinary incontinence including the use of bedside equipment to minimize mobility issues and introduction of pelvic floor exercises to strengthen the musculature that keeps feces in place.
As with urinary incontinence, frequent and rapid exchange of dirtied incontinence products can keep skin intact and prevent infection.
Tips and Takeaways
Dr. Rebecca Gilbert
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Increased Feelings Of Anxiety Or Depression
Anxiety and depression have been linked to Parkinsons. In addition to movement problems, the disease can also have an impact on your mental health. Its possible that changes in your emotional well-being can be a sign of changing physical health as well.
If you are more anxious than usual, have lost interest in things, or feel a sense of hopelessness, talk to your doctor.
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.
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The Parkinsons Disease News Today Forums Are A Place To Connect With Other Patients Share Tips And Talk About The Latest Research Check Them Out Today
PD pain can resemble pain from other disease processes, especially as the patient ages and faces a multitude of other pain-causing conditions such as arthritis, spine degeneration, poor muscular conditioning, and such. In my case, PD pain is distinguished by the following:
- The progression of body pain correlated with the progression of the disease over time.
- Levodopa, a dopaminergic therapy, successfully reduces the pain.
- The pain is worse during off periods.
My PD pain also has a particular characteristic: stinging , irritating tingling, burning, and muscle heaviness with increased pain on movement. This pain happens over large regions of the body and varies in severity. At its worst, it can last several days and reach level 7, inducing spontaneous tears.
PD with episodic chronic pain is disabling in several ways. First, high levels of pain obstruct clear thinking. Second, high levels of pain induce the fight-or-flight response, which interferes with emotion management. Third, the amount of energy necessary to manage it is very tiring . Chronic PD pain entails much more than body symptoms.
I have been a communicator most of my life, but it remains a struggle to find words that describe the unique character of PD pain. If you experience PD pain, please share your descriptors in the comments. Together we may find a common dialogue that will help others.
Leg Pain And Parkinson’s
Interestingly enough, one of my early symptoms of the disease was deep searing pain in my left leg, the type of pain my grandma had complained about many times. Initially this type of pain was worst in the morning as well as at night, making me think is was some sort of fasciitis. However not only did typical anti-inflammatories and muscle relaxants not alleviate my pain but pain worsened over time to a constant burning pain that felt as if someone was tearing the muscle and pouring hot oil on it. The pain was so excruciating it was permeating into all aspects of my life. I was constantly in need of deep tissue massage asking my husband to massage my legs just as my grandmother had asked of us time and time again. This helped only temporarily.
Which brings me to the four types of leg pain in PD.
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Second Type Of Leg Pain Is Caused By Dystonia
When related to levodopa, it usually occurs as a wearing off but can also occur at peak dose. In most cases this leg pain is unilateral and has direct correlation to medication intake. When pain is due to dystonia, it is more common in early morning. This type of leg pain is usually accompanied by toes curling and foot abnormally posturing.
Walking With Parkinsons: Freezing Balance And Falls
Parkinsons disease can change the way a person walks. Movement Symptoms like stiff muscles, rigidity and slow movement make it harder to take normal steps. In fact, short, shuffling steps are a common sign of PD, as is freezing, the feeling that your feet are stuck to the floor, for people with mid-stage to advanced PD.
On their own, these changes are distressing enough. But add the fact that Parkinsons affects balance and they also become dangerous, putting people with PD at risk of falling. The good news is that with exercise and physical therapy, people with PD can improve their balance. What can you do to minimize freezing and avoid falls? Read on to find out.
The following article is based on the latest research and a Parkinsons Foundation Expert Briefings about Parkinsons-related freezing, balance and falls hosted by Fay B. Horak, PhD, PT, Professor of Neurology at the Oregon Health & Science University, a Parkinsons Foundation Center of Excellence.
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