Lower Back Pain And Back Of The Neck Pain Are Most Common
Pain occurs for a number of reasons and its not always clear what the cause is, making it difficult to figure out how best to treat it. I believe that most common pain problems in Parkinsons Disease are the same as in the general population, but amplified. Low back pain and back of the neck pain are probably the most common pain conditions in PD. The reason Parkinsons Disease patients have so many problems with their low back and their neck is their posture. Parkinsons Disease causes a stooped posture. Some of this happens with age anyway, particularly in women after menopause when their bones soften, but is always worse from the PD. All Parkinsons Disease patients have some degree of stooped posture and many also tilt to one side. Because of the stooped posture, the muscles in the lower back have to pull much harder to keep the spine upright.
How Can I Reduce My Risk Of Getting Leg Cramps
Experts cant promise that youll never have a leg cramp again, but there are some steps you can take that might reduce your risk!
- Make sure that you stay hydrated drink six to eight glasses of water each day. Dont drink as much alcohol and caffeine.
- Adjust how you sleep. Use pillows to keep your toes pointed upwards if you sleep on your back. If you lie on your front, try hanging your feet over the end of the bed. Both positions can keep you in a relaxed position.
- Gently stretch your leg muscles before you go to sleep.
- Keep blankets and sheets loose around your feet so that your toes are not distorted.
- Wear shoes that fit you well and support your feet.
- Perform frequent leg exercises.
- Stretch your muscles before and after you exercise.
- Experiment with mild exercise right before bed. Walk on the treadmill or ride a bicycle for a few minutes.
How Do You Know You Have Dystonia
Dystonia symptoms, similar to other Parkinsons symptoms, vary from person to person. Up to 30 percent of people with PD experience dystonia.
What body parts can it affect? The involuntary movements and spasms most commonly occur in the arms, hands, legs and feet. Other common body parts include the neck, muscles around the eyes, vocal cords and jaw. Stress or fatigue can make dystonia symptoms worse.
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Strengthening Exercises Or Stretching May Be Helpful
Imagine that the spine is like a telephone pole or the mast of a sailboat. If the pole is not exactly upright, even a slight tilt requires a great force to keep it from tilting further and falling. In the human body, this means that the lower back muscles are under great stress. It also means that the tension on the back bones is much increased as well. This worsens whatever problems, like arthritis, that are already present. The same process applies to the neck, although the forces are less great. Strengthening exercises or stretching may be helpful. Almost everyone over the age of 60 has arthritis in their spine. Luckily most dont have pain from it, but those who do will have it worsened by the spine curvature caused by the PD.
PD patients also frequently have an aching discomfort in their muscles, particularly in the thighs and shoulders. I think this is due to the rigidity, or stiffness, that is part of the Parkinsons Disease syndrome, but Ive seen many patients with this pain and no apparent stiffness on examination, hence not explained. It is common and it often, but not always, responds to alterations of the usual Parkinsons Disease medications for movement. Exercise and stretching may be helpful as well and should always be tried first before increasing medications.
Pain is a challenge in PD. We cant measure it and often cannot find its cause. It is, however, often treatable, and reducing pain improves quality of life.
What Causes Numbness And Tingling In The Arms And Legs
Diabetic neuropathy is a nerve condition of the extremities causing numbness, tingling, and pain. Wernickes encephalopathy can cause confusion, lack of muscle coordination, and vision problems. Cold exposure symptoms include color changes on the skin, numbness, stinging, redness, blisters, and more.
There is no need for treatment other than patience. Its worthwhile to note that carpal tunnel syndrome can also cause numbness in the middle fingertip . However, there will be other symptoms with carpal tunnel syndrome.
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Restless Leg Syndrome And Parkinsons Disease
Restless Legs Syndrome is a neurologic and sleep-related condition characterized by an irresistible urge to move the legs. The symptoms respond to dopaminergic medications such as dopamine agonists or levodopa, which are also used to treat Parkinsons disease , making an association between RLS and PD likely. Here we explore RLS and its potential connections with PD. This post was adapted from content originally written by Dr. J Steven Poceta, neurologist and sleep medicine specialist.
What Parts Of The Body Are Affected By Dystonia
Dystonia is usually worse on the side of the body where the PD symptoms are more pronounced. It can be localised to a single muscle or to a group of muscles, but in people with PD it is most commonly seen in the feet. Spasms in the calf muscles can cause the toes to curl into a claw-like position. The foot may also turn in at the ankle and sometimes the big toe can stick up . This can be very uncomfortable, especially for people who try to fit their feet into tight-fitting shoes. Although most common in the feet, dystonia can occur in other parts of the body.
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Revisiting Pain In Pdthe 50 Shades Of Pain Experienced By Parkinsons Patients
Pain is a quality of life issue for people with Parkinsons disease and can be under treated by doctors who may assume that is worsens as the disease progresses, although for some pain is an initial symptom of PD. This article helps focus your physicians attention in the right direction to accurately diagnose your pain.
How Can I Help Myself
You will need to try a variety of sensory tricks to see what works for you as dystonia affects everyone differently.
Spasms may be reduced by touching the affected part of the body either before or during any movement known to trigger dystonia. Although this may not prevent or stop a spasm, touching can distract or trick the brain and reduce the length and intensity of a muscle contraction.
Simple massage exerting pressure on the foot, or the use of a hot water bottle or heated pad can also help, as can movement and exercise see Coping Strategies Tips & Tricks.
For eye spasms, some people find lying down, singing, yawning, laughing, chewing, putting pressure on the eyebrows or just talking can help. Spasms in the vocal cords may respond to yawning or sneezing.
Simply relaxing may also help so try taking a bath, having a massage or a calming activity such as yoga.
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Muscle Cramps And Dystonia
People with Parkinsons disease often find that they are prone to a variety of aches and pains. For example, muscular rigidity and a reduction in, or absence of, movement can lead to cramps, which are often quite distressing and which may not be relieved by ordinary painkillers. Occasionally, people with PD may experience severe muscle spasms or dystonias that are different from ordinary muscle cramps and have different causes and treatments. This information sheet aims to describe the different types of muscle cramps and dystonias that may occur in PD and what treatments may be available for them
Why Does Dystonia Occur In Parkinsons Disease
Dystonia in PD is commonly associated with the Wearing Off of the effects of levodopa containing medications , in which the drug treatment becomes ess effective before the next dose of the Sinemet, Madopar or Stalevo is due. This effect is known as Off dystonia and can often occur in the morning on waking up. A person can experience painful muscular spasms and may be unable to get out of bed until the mornings dose of medication begins to take effect. Off dystonia can sometimes be managed by taking a controlled-release levodopa preparation which releases the drug over a four to six-hour period at night, but you should discuss this possibility with your GP or specialist.
Dystonia in PD can also be associated with the action of levodopa itself as the medication reaches its peak effectiveness. This is known as On dystonia and is caused by too much dopamine in the brain over-stimulating the muscles
Finally, dystonia in PD may be unrelated to the dose of levodopa and can occur as a feature of the condition itself. This can happen at any time of the day, but is usually briefer than dystonias related to levodopa.
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Talking To Your Doctor
How do you know if your neck pain is potentially related to early signs of Parkinsons disease?
You cant know for sure, but you and your doctor can explore the issue. If your neck pain is accompanied by any of the other early warning signs of the condition, such as stiff shoulder, small handwriting, hand tremor, reduced arm swing, and shuffling gait, then it becomes more likely that you may have Parkinsons disease.
If you have one or more of these symptoms, you should speak to a neurologist about them. Early identification may allow doctors to slow the progression of the disease, if, in fact, you do have the disease.
What Is The Difference Between Leg Cramps And Restless Legs Syndrome
Although both nocturnal leg cramps and restless legs syndrome tend to happen to you at night or when youre at rest, restless legs syndrome doesnt cause the severe pain. Restless legs syndrome is uncomfortable, but not agonizing. Its a crawling sensation that makes you want to move your legs. When you do move, the restlessness stops, but there is still discomfort.
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Low Blood Pressure When Standing
Orthostatic hypotension refers to a persistent drop in blood pressure that occurs when you move from sitting to standing, or from lying down to sitting up or standing. It can cause:
OH is defined as a blood pressure drop of 20 millimeters of mercury in systolic blood pressure, or a drop of 10 millimeters in diastolic blood pressure.
How Dystonia Is Diagnosed
If your GP thinks you could have dystonia, they may refer you to a specialist called a neurologist for tests.
To diagnose dystonia, a neurologist may:
- ask about your symptoms
- ask about any other conditions you have and if anyone else in your family has dystonia
- carry out some blood and urine tests
- arrange a brain scan to look for any problems
If you’re diagnosed with dystonia, your neurologist can tell you which type you have and what your treatment options are.
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Tips For Dealing With Chronic Pain
Chronic pain is one that last more than 3-6 months , or pain that extends behind the expected period of healing. This blog post explains the different types of pain caused by Parkinsons disease and how to address pain brought on by the disease, by medications, or by comorbid disease. It is always best to treat pain before it becomes chronic.
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Managing Pain In Parkinson’s
This article summarizes the incidence, types, and causes of reported pain in Parkinson’s Disease . A table of recommendations on how to involve patients with Parkinson’s in their own pain management is provided, along with approaches to pain assessment. Finally, there is a discussion of pain management principles in PD, including optimization of dopaminergic medications, use of analgesics, and innovative treatments for pain management .
Urinary Issues In Advanced Parkinsons Disease
Urinary dysfunction and symptoms in PD are most commonly caused by overactivity of the detrusor muscle, or the muscle of the bladder, which contracts excessively despite the fact that it is not filled with urine. This causes an increased urge to urinate and/or an increased frequency of urination, which can be especially prominent at night. In advanced PD, this could culminate in urinary incontinence, or involuntary release of urine. Mobility issues which make getting to the bathroom slower and more cumbersome, compound the problem.
Always remember that people with advanced PD may have other medical problems that affect their urination such as an enlarged prostate. Make sure to have a complete evaluation before assuming that the problem is only related to PD. It is also essential to keep in mind that if changes in urination occur suddenly, there could be a urinary tract infection present.
Once other medical issues and urinary tract infection are ruled out, there are a number of approaches to the issue of urinary incontinence in a person with advanced PD:
Unfortunately, for some, the above available options may not be sufficient to effectively treat urinary incontinence in advanced PD. If this is the reality, it becomes extremely important to keep the skin dry with frequent changes of incontinence products to prevent skin breakdown and the potential development of skin infection.
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Levodopa And Other Dopaminergic Drugs
Dopaminergic drugs increase the availability of the chemical messenger dopamine in the brain and are one of the first-line treatments for severe RLS and PLMD. These drugs reduce the number of limb movements per hour and improve the subjective quality of sleep. People with either condition who take these drugs have experienced up to 100% initial reduction in symptoms.
Dopaminergic drugs, however, can have severe side effects . They do not appear to be as helpful for RLS related to dialysis as they do for RLS from other causes.
Dopaminergic drugs include dopamine precursors and dopamine receptor agonists.
The dopamine precursor levodopa was once a popular drug for severe RLS, although today it is usually recommended only for patients with occasional symptoms who may take it nightly as needed. It may also be helpful for long car rides or plane trips. The standard preparations combine levodopa with carbidopa, which improves the action and duration of levodopa and reduces some of its side effects, particularly nausea. Levodopa combinations are well tolerated and safe.
Levodopa acts fast, and the treatment is usually effective within the first few days of therapy.
A rebound effect causes increased leg movements at night or in the morning as the dose wears off, or as tolerance to the drug builds up.
Long-term use of dopaminergic drugs can lead to tolerance, in which the drugs become less effective.
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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.
Risk Factors For Periodic Limb Movement Disorder
About 6% of the general population has PLMD. However, the prevalence in older adults is much higher, reaching almost 60%. Studies suggest that PLMD may be especially common in older women. As with RLS, there are many conditions that are associated with PLMD. They include sleep apnea, spinal cord injuries, stroke, narcolepsy, and diseases that destroy nerves or the brain over time. Certain drugs, including some antidepressants and anti-seizure medications, may also contribute to PLMD. About a third of people with PLMD also have RLS.
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S Of The Body Affected By Dystonia
People with Parkinson’s can experience this disease-related cramping or clenching differently. Areas impacted include:
- Arms, hands, legs and feet: Involuntary movements, spasms or twisting and “curling”
- Neck: May twist uncomfortably, causing the head to be pulled down or to the side. This is called cervical dystonia or spasmodic torticollis
- Muscles around the eyes: May squeeze involuntarily, leading to a person to blink too much or to have difficulty opening the eyes also called blepharospasm.
- Vocal cords and swallowing muscles: May cause a person’s voice to sound softened, hoarse or breathy
- Jaw: May open or close forcefully or there may be grimacing of the face
- Abdominal wall: May cause sustained contractions, involuntary, writhing movements of the abdominal wall, or grimacing of the face
Impaired Posture And Balance
Postural instability is the most difficult Parkinsons symptom to treat, and one of the most important criteria for diagnosing Parkinsons.
Postural instability is the inability to balance due to loss of postural reflexes and often leads to falls. Patients with impaired posture and balance might revert to a stooped posture and have a shuffling gait.
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