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February 19, 2016
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Leg pain can be significant and have many
causes; some related to Parkinson’s disease, some that increase in frequency
with age and others that are more common in both conditions. Here are just a
few:
Pain
associated with Parkinson’s
▪ Off
related pain – diffuse aching and/or throbbing pain that increases at
end of dopaminergic medicine dosing or when medication levels are low. Unlike
joint pain, this pain is often located in the muscle such as the thigh or calf
but not the knee of ankle. PD medications can often improve this pain.
▪ Restless
leg syndrome – uncomfortable sensations most commonly felt in legs that is
worse at night and while resting and relieved with movement. See related post
on restless leg syndrome for more information.
▪ Dystonia-involuntary
contraction of muscle. This can be common as a symptom of PD, an off related
symptom or as a form of dyskinesia from medication. An example is early
morning foot dystonia described as painful cramping of the toes and feet.
Botulinum toxin (Botox, Myobloc) therapy can help
Musculoskeletal
▪ Arthritis
of the knee, hip or ankle typically causes pain in the join and not muscle.
Although this is unrelated to PD, arthritic pain can worsen when the natural
biomechanics of the joint is altered with PD rigidity, loss of strength and
loss of flexible. Physical therapy and anti-inflammatory agents are an
important treatment for this and the condition described next.
▪ Achilles
tendonitis is pain located at the ankle and plantar faciitis is pain
located under the sole of the foot. Both conditions can flare with a change in
exercise routine, with improper stretching and secondary to the tightness of
the ankle and foot often found in PD.
Neuropathic
▪ Peripheral
neuropathy is caused by nerve damage that begins in the feet. Associated
symptoms are pain, burning, numbness and tingling. The most common causes are
aging, diabetes, vitamin B12, deficiency, thyroid deficiency and blood protein
disorders. this condition not only causes pain but also can worsen balance.
Blood tests can help identify the cause of this problem.
▪ Radiculopathy
or sciatic nerve compression can cause pain in the thigh, calf in foot
depending on the nerves affected. Causes could include arthritis and disk
disease of the spin and compression of the sciatic nerve in the buttock region
due to muscle tightness,
Spinal
stenosis is a problem of narrowing of the spinal canal. Often associated with
back pain and pain in both legs. this type of pain often improves when a person
is bent forward.
General
Pain
Leg
swelling can occur with PD, medications and other medical conditions. Abrupt
change in leg swelling associated with pain could be a sign of a blood clot
requiring immediate medical attention. Lack of movement and dehydration can
increase this risk in PD.
This
information does not represent all types of pain that can occur. As always, be
sure to talk with your healthcare provider if you are experiencing pain in your
legs.
Monique
L. Giroux, MD
Guest
Blogger, Former Medical Director of NWPF
http://www.healthfeeds.co/2016/02/19/is-legpainsyptom-parkinsons-drug-rehab-center/
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