APDA American Parkinson Disease Association
Information & Referral Center

Pain in PD

Relevant Publications - Downloadable

“Pain in Parkinson’s"
Published by Parkinson's Disease Society of the United Kingdom, June 2016
This six-page information sheet describes the types of pain associated with PD and looks at how they can be managed. Available in PDF and Word.


Relevant Online Information

“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 Dr. Maria De Leon
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?" by Michael Rezak, MD, PhD
Published by APDA National Young Onset Center
Results of an informal online survey about the impact of pain on quality of life among those with PD. Different body areas for pain were reported among those younger than 60 as compared to those over 60.


Published by the Parkinson's Disease Foundation (Now 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: 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 Dr. Maria De Leon
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 Dr. Maria De Leon
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.


Relevant Online Lectures and 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.


“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 and Fatigue in Parkinson’s Disease”
By the Michael J. Fox Foundation for Parkinson’s Research, July 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.


“Pain in PD”
By the Parkinson’s Disease Foundation (Now 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.


"Understanding Pain in Parkinson's”
By the Parkinson's Disease Foundation (Now the Parkinson's Foundation) as a PDF Expert Briefing, May 24, 2011
The presenter, a clinical neuropsychologist, notes that pain can be under-recognized symptom of PD. He reviews the signs and manifestations of pain as well as current treatments.
Register to view the webinar


Relevant Online Resources on Pain Generally

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.

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 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 Look
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.


This list last updated by Denise Dagan, December 2017. Initially compiled by Lauren Stroshane and Robin Riddle, Stanford Parkinson's Community Outreach, August 2014.

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