Pain is a common, though often overlooked non-motor symptom of Parkinson's disease (PD). There are several types of pain associated with physical changes caused by PD. Since the majority of people diagnosed with PD are over the age of 65, it can be difficult to distinguish which pain is PD-related and which are age-related. Here are some resources to understand how pain may manifest in those with PD, and ways to cope with it.
Downloadable Documents | Online Articles | Podcasts & Webinars | Pain Info Not Specific to PD | Expert-level Resources
Pain in Parkinson’s
Published by Parkinson's Disease Society of the United Kingdom, June 2016
This six-page information sheet (PDF) describes the types of pain associated with PD and looks at how they can be managed. Available in PDF and Word.
Ask the MD: Pain and Parkinson’s Disease
Published by the Michael J. Fox Foundation, February 22, 2017
There are many potential causes of pain in Parkinson’s disease. This page highlights eight of them, what makes pain worse, and multiple daily approaches to pain management.
How to Deal with the 6 Common Causes of Leg pain in PD?
By Maria De León, MD. Published by defeatparkinsons.com, August 24, 2015
Severe leg pain is a common complaint from people with PD. Lately, it is understood that central pain is common to Parkinson’s disease, and can even be the first sign of PD, usually bilaterally. This blog post lists six causes of lower limb pain, and the importance of treating it. Treatments depend on properly identifying the source of pain. Some treatment suggestions are included.
Is Pain a Symptom of Parkinson’s Disease?
Published by American Parkinson Disease Association, August 27, 2019
This blog post, written by movement disorder specialist, Dr. Rebecca Gilbert, identifies four types of pain in Parkinson’s disease and discusses seven pain management options.
Pain
Published by the Parkinson's Foundation
This webpage discusses various physical changes caused by Parkinson's disease, surgeries and aging that may cause pain, as well as medical therapies to relieve rigidity and muscle contractions that contribute to changes in posture, and tips for maintaining healthy bones.
Pain in Parkinson’s Disease
Published by American Parkinson Disease Association, August 22, 2015
Parkinson’s 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.
Pain in Parkinson’s Disease: A Spotlight on Women
By Kristin Della Volpe. Published by Practical Pain Management, May 16, 2017
This 2-page interview with neurologist, Dr. Jori E. Fleisher, discusses pain in Parkinson’s disease with some interesting statistics about women and pain. Dr. Fleisher outlines the 4 primary types of pain in PD, how depression interferes with pain management, the role of exercise and medications in pain management as well as alternative therapies.
Revisiting Pain in PD…the 50 shades of Pain Experienced by Parkinson’s patients
By Maria De León, MD. Published by defeatparkinsons.com, October 9, 2014
Pain is a quality of life issue for people with Parkinson’s 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 physician’s attention in the right direction to accurately diagnose your pain.
Tips for dealing with Chronic Pain
By Maria De León, MD. Published by defeatparkinsons.com, March 4, 2016
Chronic pain is one that last more than 3-6 months (some say 12months), or “pain that extends behind the expected period of healing.” This blog post explains the different types of pain caused by Parkinson’s 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.
Dystonia and Pain Management for Parkinson's
By Parkinson Society British Columbia, November 24, 2021
Movement disorder specialist Alfonso Fasano, MD, PhD, outlines how to tease apart whether pain is a symptom of PD or due to an orthopedic issue. He explains how to approach the treatment of pain in concert with your medical team, going over several treatment options. Finally, Dr. Fasano focuses on causes of and treatments for dystonia and dyskinesias. After a 40-minute talk he spends 30 minutes answering questions.
Living Well with Chronic Pain and Illness
By the Davis Phinney Foundation, March 16, 2021
Author Toni Bernhard was diagnosed 20 years ago with myalgic encephalomyelitis. In this 1-hour interview she shares what she's learned about living with chronic pain and illness and how to live well no matter what obstacles you are facing.
Managing Pain in Parkinson's
By the Davis Phinney Foundation, March 2, 2022
In this 45-minute webinar movement disorder specialist Jori Fleisher, MD, emphasizes the realness of pain in Parkinson's explaining the causes of pain in Parkinson's as well as how to talk to your doctor about your pain and additional medical and non-medical management strategies.
Webinar Notes on the Stanford PD Community Blog
My Parkinson's Story: Pain
By the Veteran's Administration
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.
Pain and Parkinson’s
By the Davis Phinney Foundation, April 6, 2020
This 50-minute webinar discusses the prevalence of pain in those with PD, the structure of the pain pathway and different types of pain experienced in PD, what causes pain in early stages and how it may change as PD progresses, how pain impacts mental health, how to talk to your doctor about pain, different treatments for different types of pain (pharmacologic and non-pharmacologic), and what you can do every day to manage pain. Registration is required, but its free.
Webinar notes on the Stanford PD Community Blog
Pain in Parkinson's
By Parkinson Society British Columbia, June 15, 2021
In this 1-hour webinar pain specialist and anesthesiologist Brenda Lau, MD, discusses common types and causes of Parkinson’s-related pain, as well as strategies for self-managing pain. This presentation also offers tips on how people with Parkinson's can change their mindset about their pain to reduce its intensity.
Parkinson's Pain and Fatigue
By the Michael J. Fox Foundation for Parkinson’s Research, July 21, 2016
This 63-minute audio with slides is conducted as a panel interview of two doctors and a Parkinson’s patient about pain and fatigue in Parkinson’s disease. Discussion about pain is first, discussion about fatigue begins at 26:43 minutes. [Registration is required, but is free.]
Pain in PD
By the Parkinson's Foundation, January 10, 2017
In this 65-minute audio with slides, Dr. Jori Fleisher describes four types of pain experienced in Parkinson’s disease, and how to keep a pain diary for communication with your neurologist to find the most effective treatment, which should include physical therapy, exercise and individualized pharmacotherapy.
Twist and Shout - Pain and Cramping in PD
By PMD Alliance, October 11, 2021
In this 1 hour, 15 minutes webinar, movement disorder specialist Johan Samanta, MD, talks about pain and answers listener questions. He shares what makes pain worse and better for those with PD and how to treat pain, whether the cause is due to Parkinson's (PD) or aging.
Webinar Notes on the Stanford PD Community Blog
What a Pain! Understanding and treating pain in PD
By the American Parkinson Disease Association (APDA) Northwest Chapter, May 8, 2020
In this 1-hour webinar movement disorder specialist, Dr. Pravin Khemani, discusses causes of pain in PD and treatment strategies for pain in PD, and from other causes.
Webinar notes on the Stanford PD Community Blog
11 Tips for Living With Chronic Pain
Published by WebMD.com
ACPA and Stanford Resource Guide to Chronic Pain Management
Published by the American Chronic Pain Association and Stanford University, Division of Pain Medicine, 2021
This 213-page downloadable PDF is a comprehensive, integrated guide to medical, interventional, psychological/behavioral, pharmacologic, rehabilitative, complementary and integrative, and self-help strategies in the treatment of chronic pain. It covers general information compiled from multiple sources, is updated yearly and includes imbedded web links for certain medications and treatments and relevant internet sites of interest.
Chronic Pain Assessment
Published by WebMD.com
This questionnaire can help identify type(s) of pain and determine whether someone should see a pain specialist.
How to Cope With Pain
Published anonymously by a Pennsylvanian board-certified psychiatrist
Website describes many practical methods for dealing with chronic pain, including breathing and relaxation exercises, guided imagery, and stress management. Includes a blog with an in-depth series of articles on the different types of pain medications and new research into their use.
Opening the Medicine Box in the Mind: The Psychology of Pain
By the Stanford Health Library, November 5, 2015
In this 50-minute lecture, Beth Darnall, PhD explains how our experience of pain goes beyond the physical sensation of pain. It has emotional and psychological components that affect our ability to treat pain. She cites research to demonstrate that and shares 13 specific tips to reduce the experience of pain and increase treatment effectiveness. Audience questions follow the lecture.
"Management of pain in Parkinson's disease"
By Munazza Sophie, MD, and Blair Ford, MD, CNS. Drugs, 2012 Nov; 26(11):937-48
Managing Pain in Parkinson's
By Rachel Brunner, PharmD, and Amanda Gerberich, PharmD, BCPS. Published by Practical Pain Management, January 22, 2021
This article summarizes the incidence, types, and causes of reported pain in Parkinson's Disease (PD). 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 (botulinum toxin and cannabinoids).
Negative Impact of Severity of Pain on Mood, Social Life and General Activity in Parkinson's Disease
By Abdul Qayyum Rana, et. al. Neurological Research, August 23, 2018
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.
"Pain in Parkinson's disease: Prevalence and characteristics"
By A.G. Beiske, et. al. Pain, 2009 Jan;141(1-2):173-7
Abstract available at no charge on PubMed. The authors make a call for "improved attention to assessment and treatment of pain in the follow-up of Parkinson's disease patients."
Pain Management in Patients With Parkinson’s Disease: Challenges and Solutions
By Orjan Skogar and Johan Lokk. Journal of Multidisciplinary Healthcare, 2016; 9: 469-479
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.
Understanding Pain in Parkinsonʼs Disease for Individuals with and without Deep Brain Stimulation: The Patientʼs Perspective
By Jeffrey Wertheimer, PhD, et. al. Published by DBS-STN.org, Winter 2010-2011
Report is on a study of pain in individuals with PD who have undergone DBS and those who have not, in order to identify the impact of DBS on pain.
Last updated September 2021 by Stanford Parkinson's Community Outreach.
