Pain and motor complications in Parkinson's disease

Abstract

Aims: To study the association of pain with motor complications in 117 patients with Parkinson's disease. Methods: Patients were asked to refer any pain they experienced at the time of study and lasting since at least 2 months. Basic parkinsonian signs and motor complications (including motor fluctuations and dyskinesia) were assessed and Unified Parkinson's Disease Rating Scale (UPDRS) motor score part III (during on) and part IV were calculated. Information on age, sex, duration of disease, use of dopamine agonists and levodopa, years of levodopa treatment and current levodopa dosage, medical conditions possibly associated with pain, and depression were collected. Single and multiple explanatory variable logistic regression models were used to check the association of pain with the investigated variables. Results: Pain was described by 47 patients (40%) and could be classified into dystonic (n.19) and non dystonic pain (n.16); in 12 patients both types coexisted. Multiple explanatory variable logistic regression models indicated a significant association of pain with motor complications (adjusted OR, 5.7; 95% CI, 2 to 16.5; p = 0.001). No association was found between pain, dystonic or non dystonic, and the other investigated variables including medical conditions known to be associated to pain in the general population. There was a significant correlation (r = 0.31, p,0.05) between severity of pain (measured on a Visual Analogue Scale) and severity of motor complications (UPDRS part IV). Conclusions: Pain may be a representative feature of Parkinson's disease frequently associated with motor complications. The association is independent of a number of potentially relevant demographic and clinical variables.

Pain in Parkinson’s disease: analysis of 50 cases in a clinic of movement disorders

“…This difference was not made clear on the motor analysis by UPDRS, which was similar between the patients with and without pain, as observed in a recent study 16 , contrary to two previous studies 17,18 that demonstrated motor fluctuations between the groups with and without complaints of pain.…”

Pain characterization in patients with Parkinson’s disease

“…Pain has been more deeply studied in recent years as a PD symptom which substantially affects QL of at least one third of patients 11 . Considering our results, mean age of studied population and presence of pain, there has been no correlation, similarly to literature reports [12][13][14] . Fill et al 4 have carried out a detailed literature review evaluating possible mechanisms, classifications and potential risk factors for PD pain, and have observed that age was not systematically considered in all studies and that correlation between different types of pain and age was not investigated in some studies.…”

Clinical Study on Chronic Pain in Parkinson's Disease Patients in Shanghai, China

“…In advanced stages, pain may be caused by motor fluctuations (dyskinesia or off-period dystonia), and may be radicular or due to musculoskeletal problems [27,28]. In most of the published work, pain in PD was found to be related to a musculoskeletal cause or dystonia [1,3,29,30,31,32]. Musculoskeletal pain (44.4%) and dystonia-related pain (19.1%) were the most common types of pain (table 4).…”

“…Musculoskeletal pain (44.4%) and dystonia-related pain (19.1%) were the most common types of pain (table 4). Musculoskeletal problems are common in patients with PD, and in some studies, appear to be related to the presence of rigidity and akinesia [30]. One of the most common musculoskeletal problems in PD is shoulder stiffness, and a stiff shoulder may be the first sign of PD.…”