Pain in PD

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


Downloadable Documents (PDF)

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.


Online Articles

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

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

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.


Podcasts & Webinars

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 ?-hour 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


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.


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


Online Resources on Pain (not specific to PD)

11 Tips for Living With Chronic Pain

Published by WebMD.com


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.


Pain Management Tools

Published by the American Chronic Pain Association, 2014

This resource guide to medications and treatment for chronic pain also offers practical advice for living with pain, tools for communicating with a health care provider, preparing for an ER visit, putting together a "pain management team," and free online videos on related topics. 


Expert-Level Resources

"Management of pain in Parkinson's disease"

By Munazza Sophie, MD, and Blair Ford, MD, CNS.  Drugs, 2012 Nov; 26(11):937-48

Abstract available at no charge on PubMed.


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 August 2020 by Stanford Parkinson's Community Outreach.