Parkinson's Disease and Pain ~ A Real Issue

DO NOT TAKE ANY DRUGS WITHOUT TALKING TO YOUR DOCTOR FIRST

Soania Mathur, MD - Reviewed by a board-certified physician.

 July 15, 2016

In the past, many descriptions of Parkinson’s disease didn’t mention pain as being a significant symptom, the standard explanations usually focusing on the motor aspects of the disease. Of course, these definitions are not incorrect but this disease challenges us in many ways and dealing with pain, is no exception.  And it is one issue that often significantly affects the quality of life, which is something none of us want to lose…it is much too important and unfortunately very often, difficult to maintain.

Yet we continue to pursue it, committed to remaining as active and productive for as long as this disease allows. 

Pain, in fact, is a frequent complaint in PD.  It is estimated that 35 – 80% of Parkinson’s patients experience significant discomfort.  This statistic represents quite a wide variability due to difficulty in studying something as subjective as pain – lack of standardized definitions and consistent assessment tools being real challenges.  Regardless of its prevalence, by restricting mobility, interfering with sleep and affecting mood among other issues, pain in Parkinson’s can interfere with an individual’s daily functioning and life.

Most of the time, discomfort in muscles and joints is secondary to the motor features of Parkinson’s - lack of spontaneous movement, rigidity, and abnormalities of posture –what is known as musculoskeletal pain.  The most commonly painful sites are the back, legs, and shoulders and it is usually more predominate of the side more affected by parkinsonism.

But there are many other categories of pain associated with Parkinson’s disease.  Radicular or neuropathic pain is experienced as numbness or tingling, or a sensation of coolness in a part of the body, usually secondary to a pinched nerve because of something like a slipped disc or in some Parkinson’s patients is due to the strong and prolonged muscle spasm that can occur. KEYTRUDA is a medicine that may treat your melanoma by working with your immune system. KEYTRUDA can cause your immune system to attack normal organs and tissues in many areas of your body and can affect the way they work.

These problems can sometimes become serious or life-threatening and can lead to death. BEFORE TAKING DRUGS, HERBS OR VITAMINS- TALK TO YOUR DOCTOR FIRST!

Call or see your doctor right away if you develop any symptoms of the following problems or these symptoms get worse:

Lung problems (pneumonitis). Symptoms of pneumonitis may include shortness of breath, chest pain, or new or worse cough.

Intestinal problems (colitis) that can lead to tears or holes in your intestine. Signs and symptoms of colitis may include diarrhea or more bowel movements than usual, stools that are black, tarry, sticky, or have blood or mucus; or severe stomach-area (abdomen) pain or tenderness.

Liver problems (hepatitis). Signs and symptoms of hepatitis may include yellowing of your skin or the whites of your eyes, nausea or vomiting, pain on the right side of your stomach area (abdomen), dark urine, feeling less hungry than usual, or bleeding or bruising more easily than normal.

Hormone gland problems (especially the thyroid, pituitary, adrenal glands, and pancreas). Signs and symptoms that your hormone glands are not working properly may include rapid heart beat, weight loss or weight gain, increased sweating, feeling more hungry or thirsty, urinating more often than usual, hair loss, feeling cold, constipation, your voice gets deeper, muscle aches, dizziness or fainting, or headaches that will not go away or unusual headache.

Kidney problems, including nephritis and kidney failure. Signs of kidney problems may include change in the amount or color of your urine.

Problems in other organs. Signs of these problems may include rash, changes in eyesight, severe or persistent muscle or joint pains, severe muscle weakness, or low red blood cells (anemia).

Infusion (IV) reactions, that can sometimes be severe and life-threatening. Signs and symptoms of infusion reactions may include chills or shaking, shortness of breath or wheezing, itching or rash, flushing, dizziness, fever, or feeling like passing out.

Getting medical treatment right away may help keep these problems from becoming more serious. Your doctor will check you for these problems during treatment with KEYTRUDA. Your doctor may treat you with corticosteroid or hormone replacement medicines. Your doctor may also need to delay or completely stop treatment with KEYTRUDA if you have severe side effects.

Before you receive KEYTRUDA, tell your doctor if you have immune system problems such as Crohn's disease, ulcerative colitis, or lupus; have had an organ transplant; have lung or breathing problems; have liver problems; or have any other medical problems.

If you are pregnant or plan to become pregnant, tell your doctor. KEYTRUDA can harm your unborn baby. Females who are able to become pregnant should use an effective method of birth control during treatment and for at least 4 months after the final dose of KEYTRUDA. Tell your doctor right away if you become pregnant during treatment with KEYTRUDA.

If you are breastfeeding or plan to breastfeed, tell your doctor. It is not known if KEYTRUDA passes into your breast milk. Do not breastfeed during treatment with KEYTRUDA and for 4 months after your final dose of KEYTRUDA.

Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

The most common side effects of KEYTRUDA in people with melanoma include feeling tired, itching, rash, constipation, diarrhea, nausea, and decreased appetite.

These are not all the possible side effects of KEYTRUDA. Tell your doctor if you have any side effect that bothers you or that does not go away. For more information, ask your doctor or pharmacist.

 Dystonia – related pain occurs as its name suggests, at times of dystonia (prolonged, painful contraction of a muscle) most often experienced in the foot, neck or face and arm at different points in the dosing schedule, particularly the “off” phase when there is not enough dopamine replacement but can uncommonly also occur at peak-dose times. It can be one of the most painful symptoms those with Parkinson’s can face.

Akathitic pain is experienced as restlessness, a subjective inner urge to move, an inability to stay still and the inherent feelings of discomfort that it brings.  It is primarily experienced in the lower limbs and can often be relieved by walking around.

Primary or central pain in Parkinson’s is a direct consequence of the disease itself and is not due to secondary causes.  It can be described as a painful, burning, stabbing, aching, itching or tingling occurring in undefined areas of the body.  This type of pain can be quite relentless and distressing.

Most often it is a combination of many different causes (multifactorial) but regardless of the type of pain, its presence can adversely affect health-related quality of life measures and in some people can even overshadow the motor symptoms of the disease.

https://www.verywell.com/parkinsons-disease-and-pain-2612204